Program Book - Keck School of Medicine of USC - University of ...

Hemodialysis Fistula MaturationConsortium (HFMC)• NINDK-sponsored prospective cohort study of 600 patients with new AVF• Goal: to better understand predictors and causes of AVF maturation• Standardized data collected in 4 domains which comprehensively addressfactors hypothesized to be associated with AVF maturation– Vascular Anatomy (pre- and post AVF creation)• Size, flow parameters, anatomical abnormalities of artery and vein as measured by US– Vascular Biology• Functional characteristics assessed by flow mediated dilatation, arterial pulse wavevelocity, and venous capacitance• Morphometric and molecular analyses of venous tissue• Plasma biomarker analysis– Clinical Patient Attributes• Demographics, dialysis history, comorbidities• Intra-operative and surgical factors– Processes of Care• Pre, intra, and post-operative factors• 485 patients enrolled as of 9/17Optimization of AVF MaturationPre-operative Maneuvers to OptimizeAVF Maturation• Arm veins need to preserved!– No PICC lines– Blood draws or IV from mid-forearm or hand (notantecubital fossa)• Duplex ultrasound needs to be considered … ifquality of vein is questionable on a tourniquetassisted physical exam• Potential central venous stenosis should beanticipated, interrogated if necessary, andavoided88