Il ruolo della terapia immunosoppressiva nello sviluppo degli aneurismi venosi delle fistole arterovenose per emodialisi nei pazienti con trapianto renale

Introduction Venous aneurysm is known as long-term complication of a haemodialysis arteriovenous fistula (AVF), having an estimated incidence of 5-6%. The purpose of our study is to investigate the role of immunosuppressive therapy in the development of AVF aneurysms in renal transplant patients and whether the AVF closure is required following surgery. Methods Twenty-three consecutive patients with symptomatic venous aneurysm of an AVF were submitted to ligation and resection of the fistula, between February 2013 and March 2016. Results Twenty-one patients (kidney transplant group) were still assuming immunosuppressive therapy from a median period of 11 years. In the remaining two patients (control group) the immunohistochemical stain CD4 CD8 demonstrated a significantly lesser lymphocyte infiltrate, almost exclusively located in the adventitial tunica comparing with transplanted group. Discussion According to our results, the AVF closure should be considered in patients with a well functioning kidney graft and estimated lower risk of rejection.