*Purpose: Ureteric Stent placement is a is common practice at the time of kidney transplantation to reduce the incidence and severity of Major Urological Complications (MUC). The exact time required for the stent to be in place to prevent MUC is unknown. However, longer duration of stent placement is associated with urinary tract infections (UTI), hematuria and other irritative bladder symptoms. The aim of this process improvement project was to determine if earlier stent removal would decrease UTI rates without the increased risk of anastomotic complications.

*Methods: In August 2019, timing of stent removal was moved from 6-8 weeks (Late) post-transplant to 3-4 weeks (Early). A retrospective review of adult, solitary kidney transplant recipients was performed. Urinary tract infections (UTI) occurring within the first 60 days post-transplant and readmissions secondary to UTI were collected. Urinary complications tracked included urine leak, ureteral stenosis or stricture requiring intervention and urinomas. Data were compared using descriptive statistics and were analyzed using SPSS v25.

*Results: A total of 188 patients were transplanted between 8/16/19 and 3/25/20, 10 multi-organ recipients were excluded. Baseline demographics were similar between groups. Only 3% (3/91) of patients with early stent removal (<30 days) experienced a UTIs prior versus 11% (10/86) in the late group (p=0.044). These early UTIs required readmission in 6% (5/86) patients in the late group versus 1% (1/91) in the early group (p=0.198). There was no difference in urologic complications between early and late stent removal.

*Conclusions: Early stent removal decreases UTIs and UTI related readmissions without increasing the rate of urologic complications

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