Effectiveness of a 5-day external stenting protocol on urological complications after renal transplantation.
BACKGROUND
Ureteral stents are successful in reducing urological complications after renal transplantation. However, the optimal duration and method of stenting have not yet been clarified. The objective of the present study was to investigate the frequency of urological complications when a 5-day external stented ureterocystostomy protocol was followed.


METHODS
A single-center nonrandomized analysis of 392 kidney transplantations between June 2003 and June 2007 was conducted. From July 2005 all 196 renal transplant recipients received a 5-day external stented ureterocystostomy. A urological complication was defined as any cause leading to the placement of a percutaneous nephrostomy catheter and/or surgical revision of the ureterocystostomy.


RESULTS
In the non-stented group, 21 of the 196 patients (10.7%) developed a urological complication compared to 13 patients (6.6%) in the stented group (p = 0.151). In the stented group, 2 of the 66 recipients of a living donor transplant (3.0%) developed a urological complication compared to 8 of the 59 recipients (13.6%) in the non-stented group (P = 0.030). Eleven of 130 recipients of a deceased donor transplant (8.5%) in the stented group developed a urological complication, compared to 13 of the 137 recipients (9.5%) in the non-stented group (P = 0.769). The surgical revision rate of the stented and the non-stented group was 5/13 39% and 6/21 29%, respectively.


CONCLUSIONS
A 5-day routine external stent protocol is efficacious in living donor renal transplantation in preventing early postoperative ureter obstruction, but this stenting period seems inadequate for deceased donor renal transplantation.
Minnee
Robert C
RC
Department of Surgery, Academic Medical Center, Meibergdreef 9, Amsterdam, AZ 1105, The Netherlands. rcminnee@hotmail.com
Bemelman
Frederike J
FJ
Laguna Pes
Pilar P
PP
ten Berge
Ineke J M
IJ
Legemate
Dink A
DA
Idu
Mirza M
MM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D002102:Cadaver; D002985:Clinical Protocols; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D015607:Stents; D014513:Ureter / Q000601:surgery*; D014517:Ureteral Obstruction / Q000209:etiology / Q000517:prevention & control*; D001743:Urinary Bladder / Q000601:surgery*; D014570:Urologic Diseases / Q000209:etiology / Q000517:prevention & control; D055815:Young Adult