GPHC performs rare transhepatic procedure to restore dialysis access for patient

The Georgetown Public Hospital Corporation (GPHC) has announced that it has successfully performed a complex transhepatic dialysis catheter insertion, restoring life-sustaining treatment for a patient who had exhausted all conventional vascular access options. According to the hospital, the patient, Diana Parasram, suffers from kidney failure and had been undergoing chronic haemodialysis when repeated vascular access procedures resulted in significant vein damage.

According to medical officials, long-term dialysis can cause scarring and blockages of major veins, limiting available sites for catheter placement. Dialysis is a life-sustaining medical procedure that filters waste products, toxins, and excess fluid from the blood when the kidneys fail. It acts as an artificial kidney, primarily using haemodialysis (machine filtering) or peritoneal dialysis (abdominal lining filtering). Treatments are usually required several times a week.
However, Parasram’s case became increasingly complicated after imaging revealed that her upper body veins, typically used for dialysis access through the jugular vein into the superior vena cava, were no longer viable. Efforts to assess and reopen the veins proved unsuccessful.

Transhepatic approach
With traditional access routes no longer available, the nephrology team referred the case to interventional radiology for advanced intervention. At the time, Parasram was dependent on a femoral vein catheter inserted in the groin. Medical professionals note that femoral catheters are considered temporary solutions and are associated with higher risks of infection and thromboembolic complications, including blood clots that can migrate to the lungs.
Faced with limited alternatives, the hospital stated that the medical team proceeded with a specialised transhepatic approach, a highly technical procedure in which a catheter is inserted through the liver into the inferior vena cava, the large vein that returns blood to the heart. The approach is typically reserved for patients who have exhausted standard vascular access sites. GPHC confirmed that the procedure was completed successfully.
Parasram was able to undergo dialysis using the newly placed catheter the following day without complications. Medical officials indicated that the case highlights the complexity of managing long-term kidney failure and highlights the importance of multidisciplinary collaboration between nephrology and interventional radiology teams in delivering advanced care locally. Parasram is expected to continue dialysis treatment while awaiting a kidney transplant.