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首页> 美国政府科技报告 >Mechanisms of Vascular Access Problems in Hemodialysis
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Mechanisms of Vascular Access Problems in Hemodialysis

机译：血液透析中血管通路问题的机制

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In an attempt to delineate factors responsible for graft failure, we have developed an experimental model in the Spanish Brush goat using subcutaneous grafts and implantable electromagnetic flow probes allowing sequential hemodynamic flow measurements and hematology/coagulation studies. Surgical implantation of bovine grafts (BG), reinforced bovine graft (RBG), Gore-Tex graft (PTFE), and Johnson & Johnson experimental Annisgraft (J&J) were performed on female goats. The grafts were placed in the carotid-jugular position with implantable electromagnetic flow probes placed around the grafts. Routine dialysis both in nephrectomized animals and those with functional kidneys were performed. Baseline flow rates in 12 animals averaged 1778 ml. per minute (range 520-2000). The gradual progressive decrease in blood flow was seen until thrombosis occurred. At necropsy, clotted grafts were observed to have junctional outflow stenosis due to neointimal hyperplasia. Coagulation studies were performed on goats with grafts in place with an without dailysis. Increased platelet activity was demonstrated in some goats with clotted grafts with loss of the biphasic response in platelet aggregation studies. The fibringen was significantly increased in functioning bovine grafts over control values. The remaining coagulation studies did not differ significantly from the control values.

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