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Enhanced survival rates of kidney grafts may elevate the risk of cardiac morbidity and mortality due to prolonged exposure to the hemodynamic effects of arterio-venous fistulas (AVF). Although VA ligation reduces left ventricle (LV) mass, its impact on cardiovascular (CV) morbidity or mortality is unclear. High-flow VAs can complicate KT patients, and immunosuppressive medication may increase these complications. Despite preserving VA for future hemodialysis (HD) use, central catheters are used in nearly two-thirds of patients. Detecting transplant patients who can undergo AVF ligation and reconstruction when returning to HD allows for flexible decision-making with a multidisciplinary approach, personally tailored to patients at their discretion. Therefore, an algorithm involving Doppler ultrasound and cardiac evaluation is advisable.<\/jats:p>","DOI":"10.1177\/11297298261468406","type":"journal-article","created":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T07:03:23Z","timestamp":1792652603000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Vascular access management after kidney transplantation position paper on behalf of the Vascular Access Society and the European Kidney Transplant Association"],"prefix":"10.1177","author":[{"given":"Bar\u0131\u015f","family":"Akin","sequence":"first","affiliation":[{"name":"Department of Surgery, Florence Nightingale Hospital, Demiroglu Bilim University, Istanbul, Turkey"},{"name":"European Kidney Transplant Association, Section of European Society of Transplantation, Amsterdam, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamara 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