Kidney Transplant Program - Vascular Access Surgery and Recovery - New York City - Montefiore Einstein Center for Transplantion

Prior to a vascular access surgery, patients may have an electrocardiogram (ECG or EKG), blood and urine tests and a chest X-ray to inform the surgeon of their latest health information. Before being taken to the operating room, patients are given a mild tranquilizer for relaxation.

Electrodes, or small metal discs, attached to an electrocardiogram are then placed on the patient's chest to monitor the heart's rhythm and electrical activity. A local anesthetic is given to numb the area where AVF or graft will be placed. Most of the times general anesthesia is not required. Typically IV sedation is all that is needed and is given by an anesthesiologist to make you comfortable during the surgery.

The surgeon will then create the AV fistula or the AV graft in one arm. For patients who are right-handed, the fistula or graft is typically placed in the left arm and vice versa. But this is typically decided prior to surgery by your surgeon during the consultation. Patients who receive an AV graft or AV Fistula will not need to spend the night in the hospital for observation of any potential swelling or redness.

After the surgery, patients may use their arm as they normally do, but are advised to avoid heavy lifting. An AV fistula can get wet 24 to 48 hours after the procedure, but a catheter cannot get wet.

Patients with an AV graft should always be able to feel the blood rushing through it. By placing a finger on the skin over the graft, they should feel a slight vibration. This sensation is called a 'thrill'.