Review of stentless, tubeless, apposed renal (STAR) transplant wound management programme

We aimed to review the necessity of conventional interventions in renal transplant for preventing complications arising out of the use of wound drains, ureteral stents and stapled skin closures.

We reviewed a series of 33 patients who received stentless, tubeless/drainless and suture-apposed living donor renal transplants (STAR group) and compared the results to a control non-STAR group of 36 patients in whom all three interventions of drains, stents and skin staples were used.

No significant differences in demographics and clinical characteristics were observed between the two groups. With regard to the overall surgical complications, no significant differences in terms of wound infection, seroma, perinephric collections, urinoma, bacteriuria or vascular complications were observed between the groups. When analysed according to the interventions specific for preventing complications, although slightly more asymptomatic perinephric collections were observed and two lymphoceles required treatment in the STAR group, these differences were not statistically significant. Similarly, no significant differences in ureteric or skin-related complications were observed between the groups. Both groups had comparable good outcomes for renal function, graft survival and patient survival.

The routine use of ureteric stents, drains or skin staples may not be necessary for uncomplicated renal transplants. Potential complications associated with the placement of these interventions can be avoided without compromising on the safety of patients and/or the outcome of transplants.