title: Use of stenting in living donor kidney transplantation: does it reduce vesicoureteral complications?
abstract: The risk of urologic complications after kidney transplantation is 0% to 30%. We studied the impact of prophylactic stent placement during transplantation by assessing the necessity for a percutaneous nephrostomy (PCN) after living kidney transplantation. From January 2003 to December 2007, 342 living donor kidney transplantations were performed. Intra- and postoperative data were collected retrospectively from 285 patients with stent and 57 without. Baseline characteristics were not significantly different between groups, except for the number of previous transplantations: 31 (11%) patients with versus 16 (28%) without stent had a history of >1 transplantation (P < .001). From patients with PCN, 55 (87%) patients in the stented group received a PCN <3 months versus 11 (100%) in the nonstented group (P = .71). The reoperation rate for urologic complications was similar in both groups (3% (stented) versus 5% (nonstented; P = .43). In multivariate analysis, risk for PCN was similar in both groups (odds ratio 1.21, 95% confidence interval 0.5-2.5). Recipient survival was not significantly different. One- and 3-year death-censored graft survival was not significantly different between stented (89% and 84%) and nonstented group (90% and 85%, P = .71 and P = .96). Ureteral stent insertion is not associated with a reduced rate of PCN placement in living donor kidney transplantation.
authors.affiliation: Department of Surgery, Erasmus MC, Rotterdam, The Netherlands. l.dols@erasmusmc.nl
authors.forename: L F C
authors.initials: LF
authors.lastname: Dols
authors.forename: T
authors.initials: T
authors.lastname: Terkivatan
authors.forename: N F M
authors.initials: NF
authors.lastname: Kok
authors.forename: T C K
authors.initials: TC
authors.lastname: Tran
authors.forename: W
authors.initials: W
authors.lastname: Weimar
authors.forename: J N M
authors.initials: JN
authors.lastname: IJzermans
authors.forename: J I
authors.initials: JI
authors.lastname: Roodnat
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D015607:Stents; D001745:Urinary Bladder Diseases / Q000517:prevention & control; D055815:Young Adult