Despite widespread technological advances, gaining access to an appropriate amount of the patient’s blood for treatment presented a significant problem in the early years of dialysis. Typically, a glass cannula or tube would be surgically placed in a blood vessel to allow access. Unfortunately, the complex nature of the surgery coupled with the fact the cannula could not remain in place for a significant period of time meant it was impossible to provide the type of dialysis treatment necessary to save the lives of patients with chronic renal failure (so-called uremics).



Quinton, Dillard and Scribner’s vascular access


Still, the most decisive breakthrough in the field of vascular access came in 1966 from Brescia, Cimino and their colleagues. Their work remains of basic importance to dialysis today. Using surgery, Brescia and his colleagues joined an artery in the arm with a nearby vein. The vein is normally not exposed to high arterial blood pressure, so the operation “arterialized” the vein and caused it to swell. Needles could then be more easily placed in this vein, which lay beneath the skin, to allow repeated access. This technique lowered the risk of infection in the vascular access and permitted dialysis treatment over a period of years. The so-called Arteriovenous (AV) Fistula remains the access of choice for dialysis patients, and some AV fistula implanted more than 30 years ago are still in use today.

The developments that began with the Scribner Shunt allowed the long-term treatment of patients with chronic kidney failure. In the spring of 1960, Belding Scribner implanted a shunt in the American Clyde Shields, in Seattle. Shields became the first chronic hemodialysis patient, and the dialysis treatments allowed him to live an additional eleven years before dying of cardiac disease in 1971.



Clyde Shields.............................Belding H. Scribner
(1921 – 1971)........................... (1921 – 2003)

These initial successes provided a fertile basis for the first-ever chronic hemodialysis program, which was established in Seattle in the following years. Over the years, Belding Scribner and his team consciously refrained from seeking patent protection for many of their inventions and innovations to ensure swift distribution of their life-saving techniques for dialysis patients. The lifelong efforts of Belding Scribner were recognized in 2002 when he and Willem Kolff were awarded the distinguished “Albert Lasker Award for Clinical Medical Research”. Scribner died in 2003 at the age of 82.