Ureteric stent in renal transplantation

Area of Science:

• Urology
• Transplantation Surgery
• Nephrology

Background:

• Ureteroneocystostomy in kidney transplantation can lead to urological complications (UC) like stenosis and fistula.
• Ureteral catheters are employed prophylactically to mitigate these risks.
• This study investigates the impact of ureteral stenting on UC rates in renal transplantation.

Purpose of the Study:

• To evaluate the influence of ureteral stent use on the incidence of urological complications following kidney transplantation.
• To compare the rates of UC associated with different types of ureteral catheterization: double J stent (JJ), external tumor (ET) catheter, and no catheter (NC).

Main Methods:

• Retrospective review of 2061 kidney transplants performed between July 1991 and January 2012.
• Categorization of cases based on ureteral management: JJ stent (n=1890), ET catheter (n=52), and NC (n=119).
• Analysis of UC rates, considering factors such as recipient/donor characteristics, surgery duration, and donor organ parameters.

Main Results:

• Overall UC rate was 5.9%, with significantly higher rates for ET (17.3%) and NC (8.4%) compared to JJ (5.4%) (P < .0005).
• Increased UC risk was associated with surgery duration exceeding 3 hours, older donor age, and higher donor weight.
• Multivariate analysis identified donor weight, JJ stent use (vs. ET), and prolonged surgery time as independent predictors of UC.

Conclusions:

• Ureteral catheterization with a double J stent is associated with a lower incidence of urological complications in kidney transplantation.
• The protective effect of JJ stents is particularly noted in transplants involving heavier donor organs.
• External tumor catheters should be avoided due to their high association with urological complications.