Routine Use of the Scribner Shunt for Haemodialysis

The Scribner shunt (Quinton, Dillard, Cole, and Scribner, 1962) (Fig. 1) is an artificial arteriovenous fistula made of inert plastic tubing which is used for repeated haemodialysis. When dialysis is required the U-tube connecting the arterial and venous limbs of the shunt is removed and the patient is con nected to the dialyser. At the end of dialysis the U-tube is replaced. The use of the Scribner shunt in intermittent haemodialysis for chronic renal failure is well recognized, and Chisholm (1961) has advocated its use in some patients with acute renal failure and especially those who have few available veins, it is our belief that it should be used in all patients with acute renal failure who are likely to require more than one haemo dialysis ; certain patients with acute renal failure may be alternatively managed successfully by peritoneal dialysis. It is the purpose of this paper to show that the routine use of the Scribner shunt, as opposed to repeated cannulation, saves time and trouble in a busy artificial kidney unit and increases the safety of dialysis. Now that all parts of this shunt are manufactured in Great Britain the increase in cost is not significant. Improvements in the technique of insert ing the shunt, the experience of the first year, and the com plications encountered are also outlined.