title: Thirty-Day Outcomes After Percutaneous Nephrostomy of Renal Transplant Kidneys: 19-Year Experience and Comparison With Existing Practice Parameters.
abstract: OBJECTIVE
  The purpose of our study was to document the technical success rate, complications, and 30-day outcome after percutaneous nephrostomy catheter insertion into renal grafts.
  
  
  METHODS
  Radiologic and clinical databases were used to identify all adult patients who underwent renal transplantation from January 1994 through December 2012. Patients who underwent transplant percutaneous nephrostomy catheter insertion for the immediate management of ureteric obstruction or leak were identified, and the 30-day outcomes were recorded. Complications were graded using the Society of Interventional Radiology and Clavien classification systems.
  
  
  RESULTS
  Of 1476 consecutive kidney transplants, a total of 73 nephrostomy catheters were successfully inserted into 52 patients (male, 36; age range, 24-72 years), 45 with strictures and seven with strictures with leaks. The median serum creatinine level improved from 276 μmol/L (95% CI, 229-342 μmol/L) to 195 μmol/L (95% CI, 170-223 μmol/L) 7 days after intervention (p = 0.0001). Five complications were seen within 30 days and all were related to bleeding (Society of Interventional Radiology classification: grade A, n = 2; grade B, n = 2; grade D, n = 1; and Clavien classification system: grade I, n = 4; grade IIIa, n = 1). The overall complication rate was 6.8% (5/73), and the major complication rate was 1.4% (1/73). There were no cases of bowel injury or septicemia. The 30-day graft and mortality rates were 0%.
  
  
  CONCLUSIONS
  Transplant percutaneous nephrostomy catheter insertion has a high technical and clinical success rate. The 30-day graft and mortality rates were 0%, the overall complication rate was 6.8%, and the major complication rate was 1.4%.
authors.affiliation: 1 All authors: Department of Radiology, St George's Hospital and Medical School, Blackshaw Rd, London, SW17 0QT, UK.
authors.forename: Uday
authors.initials: U
authors.lastname: Patel
authors.affiliation: 1 All authors: Department of Radiology, St George's Hospital and Medical School, Blackshaw Rd, London, SW17 0QT, UK.
authors.forename: Justyn Hwee
authors.initials: JH
authors.lastname: Jeon
authors.affiliation: 1 All authors: Department of Radiology, St George's Hospital and Medical School, Blackshaw Rd, London, SW17 0QT, UK.
authors.forename: Shankar
authors.initials: S
authors.lastname: Kumar
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous; D011183:Postoperative Complications / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D014517:Ureteral Obstruction / Q000601:surgery*
keywords: complications; outcome; percutaneous nephrostomy; renal transplant