Objective: Retrospective analysis of hemodialysis catheters implanted using transhepatic venous route in terms of safety and functionality in patients with exhausted conventional venous access routes. Material and Methods: Ten patients underwent placement of 22 transhepatic 14F tunneled hemodialysis catheters at our center in the period 2007-2011. Catheter safety was assessed by means of complications encountered. Catheter functionality was assessed by means of the data derived from the electronic documents and digital images captured during the device problems and catheter revisions. Catheter patency was described using Kaplan-Meier survival curve. Results: Technical success was achieved in all patients. There was no hepatic injury or bleeding related to the procedure. Catheter functionality was impared due to the complications such as thrombosis, migration and infection. The catheter thrombosis rate was 0.18, the catheter migration rate was 0.12, and catheter-related infection rate was 0.08 per 100 catheter-days. Mean device patency was 132 (28-214) catheter days. Fifty percent of the catheters functioned longer than 182 catheter days. Mean catheter stay in-situ was 283 (20-629) catheter days. Mean single access patency was 217 (20-571) catheter days. Conclusion: By using transhepatic venous route, effective and safe hemodialysis can be performed in long term in patients with limited venous access.