A novel retroauricular fixed port for hemodialysis: surgical procedure and preliminary results of the clinical investigation

Inspired by bone conduction implants, which have a low infection rate, a bone-anchored port (BAP) system for hemodialysis was designed.To demonstrate the surgical procedure for the BAP and to present preliminary results of the clinical investigation.Patients with end-stage renal disease and contraindications for an arteriovenous forearm fistula were recruited for BAP implantation. A workflow specifically developed for implantation was followed. Postoperative evolution, the dialysis procedure, the functionality of the implant, and signs of infection were monitored.So far, five patients have been implanted with the BAP system. Hemodialysis with the BAP was unproblematic in all five patients, on average starting from the 9th day after implantation (range 2 to 15 days). Up to now, 1789 cumulative patient days (average 355 days, range 154 to 448 days) have been recorded. One patient died 14 months after implantation, from a cardiac arrest unrelated to the system. Dialysis was painless, and no catheter-related infections have occurred.BAP implantation can be safely performed but requires an interdisciplinary team. No infections related to the device have occurred.The presented system is a promising addition to the choices of vascular accesses for hemodialysis patients.