Introduction: Vascular access is the lifeline for chronic intestinal failure patients who are dependent on parenteral nutrition. The traditional use of long term tunnelled central venous catheters is associated with a high incidence of bloodstream infections, central venous stenosis/occlusions and eventually loss of access.

Methods: We inserted a HeRO graft in a 28-year-old female patient with intestinal failure and central venous occlusion (4/6 major vessels) following long-term central venous catheters. The patient is active on the waiting list for an intestinal transplant.

Results: There were no post-operative complications. The HeRO graft is cannulated on alternate days with a size 18 Gauge venflon. Parenteral nutrition was initially infused at 1 litre over 12 hours rate but is now infused at an 8 hourly rate. Bloods are taken via the graft on alternate days.

Discussion: There is lack of data regarding the use of AVFs/AVGs for long-term parenteral nutrition. The high access flows associated with AVFs/AVGs provide continuous movement of highly viscous parenteral feeds and is therefore appealing in the prevention of infections as parenteral nutrients get dispersed in the circulation and do not pool in a tube. The high access flows also enable a much quicker feed rate thereby improving the patient's quality of life. Regular blood tests for this challenging patient group can be facilitated via the AVFs/AVGs. This is the first report of a HeRO graft being used for parenteral nutrition.

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