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James E. Cimino, M.D.: Recipient of the 2008 International Society for Hemodialysis Belding Scribner Trailblazer Award

Dr. James E. Cimino (Figure 1) received the International Society for Hemodialysis Belding Scribner Trailblazer Award at the Annual Dialysis Conference on March 1, 2008, in Orlando, Florida. The Teflon shunt developed by Dr. Belding Scribner in 1960 first made long-term hemodialysis for chronic renal failure possible. Nevertheless, this was far from ideal because of episodes of clotting and infections, and maintaining vascular access was still a major problem for nephrologists in the early l960s. While a medical student, Jack Cimino had worked as a phlebotomist at the New York Blood Center and had observed the rapid flow of blood through large-gauge needles. Remembering this, he began using simple venipuncture with 2 large needles for vascular access for hemodialysis. This worked well in fluid-overloaded patients, but the outflow became insufficient once their cardiac failure improved. Cimino therefore returned to the needle concept but thought of combining the 2 methods by developing a direct subcutaneous connection between the artery and the vein, rather than using an external shunt. Cimino,