Novel bone anchored port for hemodialysis: first results in humans

Conventional central venous haemodialysis catheters are prone to infections (1.65 – 5.5 per 1000 catheter days). Based on the low infection rate of percutaneous bone conduction hearing aids (e.g. Baha), a novel vascular access for haemodialysis was developed in Bern, which is implanted into the retroauricular skull (bone anchored port = BAP). The goal is to prevent infections by completely subcutaneous catheter placement and immobilization of the port.

So far, a BAP has been implanted in six dialysis patients in a clinical trial. The inclusion criterion is the contraindication for an arterio-venous (A/V) fistula and the indication for a permanent vascular access for haemodialysis. Patients are followed for complications, catheter infections, tolerability and functionality of the BAP. All implantations succeeded without intraoperative complications. Postoperatively, two patients showed disturbed cutaneous wound healing, which was treated conservatively in one and with wound revision in another case. Patients tolerate the BAP very well, manipulations are painless. Dialysis is possible soon after surgery. Connection and execution of the dialysis are unproblematic. The inner valve of the first implant blocked and had to be exchanged, which was possible without complications and without anaesthesia. So far, no catheter infection occurred.

With the novel BAP it seems possible to avoid catheter infections. The BAP can thus provide a safe alternative for patients, who cannot be dialyzed via an A/V fistula or a conventional catheter. Thanks to its ease of use, the system could open up new perspectives for decentralized or home dialysis.

Publication History

Publication Date:
23 April 2019 (online)