The pros and cons of preserving a functioning arteriovenous fistula after kidney transplantation

Bram M. Voorzaat, Jan van Schaik, Hans-Marc J. Siebelink, Jan H. Tordoir, Joris I. Rotmans*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


The autologous arteriovenous fistula (AVF) for hemodialysis burdens the cardiovascular system with increased cardiac output and pulmonary artery pressure, increasing cardiovascular risk. This article reviews literature on the benefits and drawbacks of a functioning AVF after kidney transplantation and discusses the cardiovascular effects of AVF closure. Several cohort studies demonstrate a significant cardiac burden of an AVF and improvement of cardiac dimensions after AVF ligation. However, no randomized trials have been conducted on routine AVF closure after successful kidney transplantation. Therefore, clinical trials are warranted to evaluate whether the cardiovascular benefits of routine AVF closure outweigh the potential harm for patients after successful kidney transplantation.
Original languageEnglish
Pages (from-to)S16-S22
JournalJournal of vascular access
Issue numberS1
Publication statusPublished - Mar 2016


  • Arteriovenous shunt surgical
  • Cardiac output
  • Hypertrophy left ventricular
  • Kidney transplantation
  • Renal dialysis

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