Impact of ureteral stenting on urological complications after kidney transplantation surgery: a single-center experience

Transplant Proc. 2014 Dec;46(10):3459-62. doi: 10.1016/j.transproceed.2014.08.051.

Abstract

Background: Urological complications such as ureteral strictures and ureteral leakage can affect the outcome of kidney transplantation by increasing morbidity and mortality, including graft loss. Controversy still exists regarding the role of stents in renal transplantation. The aim of this study was to evaluate the role of ureteral stenting in kidney transplantation.

Methods: We performed a retrospective study on a series of 798 consecutive renal transplants performed in our center between January 1, 2004, and December 31, 2011. Ureteral stents were used in 152 cases (19.1%) of the total (stent group) and were removed 2 weeks postoperatively. Donor and recipient age, sex, type of ureteroneocystostomy, stent and non-stent patients, cold and warm ischemia time, and urological complications were analyzed.

Results: The overall incidence of urological complications was 7.8% (62 cases). Ureteral stenosis (3.1%) and ureteral leakage (2.4%) were the most common complications; 39.7% (25 cases) of complications were recorded in the first month after transplantation. Major urological complication rate was 3.3% in the stent group compared with 8.8% in the non-stent group (P = .04). However, stent use was associated with the increase of urinary tract infections rate in the stent group (51.3%) compared with the non-stent group (17.9%) (P = .03).

Conclusions: In our study, the use of ureteral stents significantly decreased urological complications in kidney transplant recipients but increased the risk for development of urinary tract infections.

MeSH terms

  • Adult
  • Female
  • Humans
  • Incidence
  • Kidney Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Postoperative Complications*
  • Retrospective Studies
  • Romania / epidemiology
  • Stents*
  • Transplant Recipients*
  • Ureter / surgery*
  • Ureteral Obstruction / epidemiology
  • Ureteral Obstruction / etiology*
  • Ureteral Obstruction / surgery