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Korean J Transplant 2021; 35(1): 41-47

Published online March 31, 2021

https://doi.org/10.4285/kjt.20.0050

© The Korean Society for Transplantation

The impact of prophylactic ureteral stenting during kidney transplantation on postoperative surgical outcomes

JongBeom Park1 , Soo Yeun Lee1 , Hyung Soon Lee1 , Sug Kyun Shin2 , Tae Hwan Kim3

1Department of Surgery, National Health Insurance Service Ilsan Hospital, Goyang, Korea
2Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea
3Department of Radiology, National Health Insurance Service Ilsan Hospital, Goyang, Korea

Correspondence to: Hyung Soon Lee
Department of Surgery, National Health Insurance Service Ilsan Hospital, 100 Ilsan-ro, Ilsandong-gu, Goyang 10444, Korea
Tel: +82-31-900-0975
Fax: +82-31-900-0138
E-mail: soon0925@nhimc.or.kr

Received: October 19, 2020; Revised: January 13, 2021; Accepted: January 14, 2021

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: The aim of this study was to evaluate the safety and feasibility of prophylactic ureteric stenting during kidney transplantation (KT).
Methods: The authors retrospectively reviewed patients who underwent KT between June 2016 and June 2019. The prophylactic ureteral stenting group (double-J [DJ]) and no-stent group (no-DJ) were compared with respect to the clinical data and surgical outcomes.
Results: A total of 42 patients underwent KT; 17 patients were classified into the DJ group and 25 patients into the no-DJ group. Antithymocyte globulin induction and donor- specific antibody positivity were significantly higher in the DJ group. There were no significant differences between the groups in terms of symptomatic urinary tract infection (UTI). The time to postoperative UTI was significantly shorter in the DJ group than in the no-DJ group (33.5±7.8 vs. 105.3±71.6 days, P=0.013). The development of postoperative BK viremia was significantly higher in the no-DJ group (0.0% vs. 16.0%, P=0.035). Urologic complications were significantly higher in the no-DJ group (0.0% vs. 16.0%, P=0.035). In the no-DJ group, urologic complications occurred in four patients: ureteroneocystostomy stenosis in three patients and ureteroneocystostomy leakage in one patient. Percutaneous ureteral interventions were performed for all patients using percutaneous nephrostomy and reno-uretero-vesical stenting. However, there were no postoperative urologic complications in the DJ group.
Conclusions: Prophylactic ureteric stenting during KT may be safe and feasible without significantly increasing the incidence of UTI and BK viremia. Additionally, prophylactic ureteric stenting may reduce urologic complications after KT.

Keywords: Ureter, Stents, Postoperative complication, Kidney transplantation, Urinary tract infection

HIGHLIGHTS
  • Prophylactic ureteric stenting during kidney transplantation (KT) may be safe and feasible without significant increasing incidence of urinary tract infection and BK viremia.

  • Prophylactic ureteric stenting may reduce the urinary complications after KT.