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Management of thrombosed HeRO post renal Tx

Posted By Tushar J. Vachharajani, Tuesday, August 23, 2016

Renal Tx in Jan 2016, Allograft working well with serum creat at 1.5 mg/dl. Now has a thrombosed HeRO. What would be an ideal treatment option to avoid risk of infective endocarditis/ bacteremia? 

A) Do nothing

B) Remove the catheter portion and leave the graft intact

C) Remove the entire HeRO device

 

Would having information on the presence or absence of underlying central venous stenosis alter the management? Unfortunately, I have no way to get that information.

 

Tags:  HeRO 

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Permalink | Comments (4)
 

Comments on this post...

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Daniel V. Patel says...
Posted Tuesday, August 23, 2016
Remove the catheter portion- we've seen pulmonary embolism from these when they are not functioning.
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Daniel V. Patel says...
Posted Tuesday, August 23, 2016
http://www.ncbi.nlm.nih.gov/pubmed/23567802
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Nicholas Inston says...
Posted Wednesday, August 24, 2016
Totally agree.Had a HeRO clot and patient refused removal for 9 months.
Started to get crescendo PEs that were attributed to a old femoral DVT (iliac vein occlussion above it (!).
On gentle removal of HeRO segment loose clot in HeRO lumen up to tip. Was poorly adherent. Suspect further clot dislodged on removal. but asymptomatic.
previous graft oversew just befor the connector if no infection present or treat as infected graft.
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James Wynn says...
Posted Wednesday, August 24, 2016
Agree w/ taking out catheter portion and oversewing graft segment. As a matter of fact, from a post-transplant care standpoint, I would be inclined to take out the catheter segment post-kidney txp even if it were patent.
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