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Arteriovenous fistulas are a preferred access for hemodialysis. Subsequent hemodynamic changes in systemic circulation may cause heart failure. The general conclusions that can be drawn from the few available studies are that high‑flow fistulas causing symptomatic heart failure should be subjected either to reconstruction or ligation. However, it is still unclear whether a well‑functioning fistula should be ligated after successful kidney transplantation.

To close or not to close: fistula ligation and cardiac function in kidney allograft recipients