The Fight Fibrin Sheath (FFS) campaign launched globally this week as an international coalition of vascular access surgeons, nephrologists, researchers and industry partners aims to address a widespread but overlooked complication of dialysis catheters.
Fibrin sheath, a fibrous protein-based formation, develops in nearly every patient within hours of central venous catheter (CVC) insertion. This condition affects 80-100% of CVCs within the first week, directly impacting 50-75% of dialysis patients who begin treatment via catheter. Many of these patients continue relying on catheters as their primary vascular access for six months or longer, during which untreated fibrin sheath restricts blood flow, triggers repeated clinical interventions, and shortens catheter lifespan.
“Fibrin sheath is a massive issue that no-one is talking about,” said Nick Inston, Consultant Vascular Access Surgeon at Queen Elizabeth Hospital Birmingham and FFS campaign spokesperson. “It’s a problem that clinical practice and device technology should be solving, yet it’s been managed as a routine, unavoidable side effect of catheter use rather than treated as a problem.”
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A Long-Standing Problem Without Solutions
Despite being first documented more than four decades ago, fibrin sheath remains under-researched and under-addressed. Recent global clinician surveys reveal it is the dominant failure mode in catheter care, with professionals reporting lower confidence in preventing it than any other complication. “CVCs have been vilified despite their continued importance,” Inston noted. “We say it’s time for the community, including industry, to start looking at catheters again.”
Collaborative Efforts to Drive Change
The FFS campaign unites clinicians, researchers, patient advocates and device manufacturers around three core objectives: advancing research into fibrin sheath prevention, increasing awareness among patients and policymakers, and encouraging manufacturers to prioritize innovation in catheter design. The initiative invites healthcare practitioners to sign a pledge demonstrating support for evidence-based solutions, amplifying collective professional voices in the process.
Full information about the FFS campaign, including resources on fibrin sheath, participant experiences and updates, is available at fightfibrinsheath.com. The website also provides details on how individuals and organizations can participate in the effort to improve outcomes for the hundreds of thousands of patients dependent on dialysis catheters daily.
