Tuesday, September 19, 2017

Transonic Monitoring for Dialysis Access

   The Transonic Hemodialysis Monitor uses ultrasound Doppler and ultrasound dilution (Transonic) as an addition to typical vascular access monitoring done in hemodialysis centers.  The monthly transonic test shows the access blood flow.  Knowing the access flow helps to watch out for blockage and measure the function of the fistula/graft in aid of making the access serve longer.  This equipment is attached to the line while the patient is on dialysis as seen on the photo.

   A fistula can last up to 35 years, however, maturation takes three to six months, in rare cases, can take up to a year which is too long to wait for someone requiring dialysis.  For some patients, the fistula may never mature.  Mine refused to mature.  It was abandoned and a graft was placed instead.

   Grafts have a lifespan of approximately 4 to 6 years but can last longer, up to 10 years with proper care.  Thanks to Davita’s Transonic lady, Maria Tancioco, I get information that my 7 year old graft, through Transonic shows pretty good function.  According to Maria the typical blood flow for graft is 500ml per minute, mine is consistently at 1400ml per minute as per recent test.  

   “Measurement of flow could reduce thrombosis, increase thrombosis-free and secondary patency in arteriovenous fistulas, and reduce vascular access-associated costs”.  Vascular access maintenance such as Fistulagram, an X-ray procedure to check for blood clots or blockages and Fistuloplasty, a procedure to open blocked or narrowed fistula by stretching with a special balloon are expensive and painful.

   The sad thing is that I’ve been with several different dialysis centers managed by different providers and I found the Transonic Hemodialysis Monitor only in Davita.  That means a greater number of centers are not fully equipped.  

Postscript in video

See also:

1 comment:

  1. Hi Lori,
    My name is Miriam, I’m the daughter of the Cor Drost, the Engineer who started Transonic and I currently work at Transonic in marketing. We’re a small, family company in upstate NY that is dedicated to helping to improve patient care. I shared your article with Cor and Dr. Nikolai Krivitski, the creator of the Transonic hemodialysis monitor. We’re all so very pleased that you have found Transonic to be helpful for your access surveillance and we agree – we’d love to see these meters at all of the clinics out there! Unfortunately, due to US’s tight reimbursements for hemodialysis, it’s a hard road for many clinics to get the extra cost and staff approved for these crucial measurements. DaVita has done a great job understanding the usefulness of the measurements and putting patients first so that the Transonic measurements can get done. We’ll do our best to keep pushing to make this a standard of care for all patients. We wish you the best of luck in keeping that graft of yours going for as long as it can - stay well!