Experience of HeRO dialysis graft placement in a challenging population

Objective: To assess the outcomes of the hemodialysis reliable outflow(HeRO) device in a subset of hemodialysis access-challenged patients with central venous obstruction. Methods: Retrospective analysis of a series of patients in 2 centers who underwent placement of theHeROdevice between September 2009 andNovember 2010. Patients' demographics, access history, HeROpatency, and number of reinterventions were analyzed. Results: Eleven patients underwent 12 HeROimplantations. The average duration of dialysis prior to HeROplacement was 5.55±3.64 years. Primary and secondary patencies at 6 months and 1 year were 36.4% and 54.5% and 9.1% and 45.5%, respectively. Conclusions: In the end-stage renal disease population with central venous occlusive disease, the HeRO device offers the best long-term dialysis option when an arteriovenous fistula or graft is not possible. Close follow-up and subsequent aggressive interventions can prolong the use of the HeRO and avoid the last resort of dialysis catheters.