What is arteriovenous (AV) graft surgery?

Arteriovenous (AV) graft surgery creates a synthetic access point into the body’s circulatory system to perform dialysis. Dialysis removes wastes and extra fluid from your blood when the kidneys can no longer perform this function. This is known as kidney failure. AV graft surgery allows blood to flow from your body to the dialysis machine and back into your body after filtering.

AV graft surgery involves connecting a vein to an artery with an artificial tube or graft. The graft is usually made of synthetic material. Surgeons sometimes use a transplanted animal or human blood vessel. 

An arm is the usual location for an AV graft, but a thigh can also be used. The graft is tough and can tolerate the multiple needle punctures needed for dialysis better than a normal vein. After AV graft surgery, you will feel a “buzzing” sensation over the graft. 

AV graft surgery carries some risks and potential complications. It is only one option for dialysis access. Other options include an AV fistula (directly sewing an artery and a vein together) and a venous catheter, which is for short-term dialysis. I

AV graft surgery is generally for people who need long-term dialysis and have small or unhealthy blood vessels. You may have other dialysis access options. Consider getting a second opinion about all your dialysis access choices before having AV graft surgery.

Why is arteriovenous (AV) graft surgery performed?

Your doctor may recommend arteriovenous (AV) graft surgery as part of a complete dialysis treatment plan for kidney failure. Kidney failure is a life-threatening condition in which there is a buildup of waste and fluid in the body due to poor kidney function. Dialysis uses a machine to filter wastes and extra fluid from the blood.  

People with kidney failure may require dialysis permanently or for a short time. Kidney failure that occurs suddenly (acute kidney failure) can sometimes be reversed by rapidly treating the cause, such as a drug overdose, shock, or a kidney infection. 

AV graft surgery is often used for people who have small or unhealthy blood vessels and need long-term dialysis for permanent kidney damage. People who have AV graft surgery may be waiting for a kidney transplant. 

Your doctor may recommend AV graft surgery for kidney failure due to:

  • Autoimmune diseases including systemic lupus erythematosus that affects the kidneys
  • Certain inherited diseases including polycystic kidney disease, which causes large cysts in the kidneys that damage kidney tissue
  • Conditions that reduce blood flow to the kidneys including shock and renal artery stenosis (narrowing of the renal arteries) 
  • Diseases that cause kidney inflammation including nephritis and glomerulonephritis
  • Infections including repeated bladder infection, pyelonephritis (kidney infection), or septicemia (blood infection)
  • Kidney cancer
  • Medication use or abuse including intravenous (IV) drug abuse, overdose of certain drugs, or long-term use of certain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Poorly treated or untreated chronic diseases including diabetes and high blood pressure that cause kidney damage over time
  • Trauma including injuries to the kidneys or arteries that supply blood to the kidneys
  • Urinary tract obstructions including kidney stones, tumors, congenital deformities, and enlarged prostate glands

Ask your doctor about all of your treatment options and consider getting a second opinion before deciding on AV graft surgery.

Who performs arteriovenous (AV) graft surgery?

A general surgeon or vascular surgeon performs arteriovenous (AV) graft surgery. A general surgeon specializes in the surgical treatment of a wide variety of diseases, disorders and conditions. A vascular surgeon specializes in surgery of the blood vessels.

How is arteriovenous (AV) graft surgery performed?

Your arteriovenous (AV) graft surgery will be performed in a hospital or outpatient surgery center. Surgeons usually create AV grafts in the arm, but sometimes they use the thigh.&