A new position paper published in Transplant International provides much-needed guidance on how to manage vascular access (VA) following kidney transplantation (KT): an area where clinical practice has varied widely.
Produced jointly by the Vascular Access Society (VAS) and the European Kidney Transplant Association (EKITA-ESOT), the expert statement reviews current evidence on the haemodynamic impact of arteriovenous fistulas (AVFs) and highlights how high-flow accesses may contribute to cardiovascular strain in transplant recipients.
The authors propose a practical algorithm for post-transplant VA surveillance, recommending routine Doppler assessment, cardiac evaluation where flows are elevated, and multidisciplinary decision-making. They note that elective AVF ligation may be appropriate for some stable recipients with high-flow access, while emphasising the importance of individualised care and patient involvement.
The paper also calls for further prospective studies to understand long-term outcomes and to refine guidance. As transplant survival continues to improve, the authors argue that proactive VA management will be increasingly important for protecting long-term cardiovascular health.
Read the full publication here.