RESUMO
We present the first report on the long term use of the LifeSite hemodialysis access system in patients who have no possibility of arteriovenous fistula creation. This system consist of a titanium alloy valve and silicone catheter which is placed in a central vein. Conventionally two devices are placed for optimal blood draw and return but single needle dialysis is possible using only one device. We have used this system in six patients since February 1999. Four patients continue to use the LifeSite for dialysis while one patient transferred to peritoneal dialysis because of hemodynamic instability during dialysis and one patient died of mesenteric infarction. Blood flow using two devices is excellent (300-345 ml/min). The infection rate is low (about 1.7 episodes per 1,000 days) and most patients were successfully treated without the need to remove the device. Two patients required temporary removal of one device because of local infection. While this, they were dialysed via a single needle using the remaining device. In our experience the LifeSite system appears a useful alternative in patients in whom a native fistula is not possible and it is able to provide effective dialysis for at least three years.
