Introduction:

Complications after kidney transplant (tx) commonly originate from ureterovesical anastomosis, it accounts for 3-9% of urinary complications. Due to the difference in the surgical preference, those patients had either ureteral stent or no stent placement during the tx procedure.

Methods

Retrospective chart review on 125 kidney tx recipients at ECMC from 1/1/16 to 12/31/16. The clinical characteristics were collected & ureteral complications (ureteral strictures, pyuria, perinephric fluid collections, BK viremia, eGFR). Data analyses were performed with T & chi-square tests & Bonferroni corrections.

Results:

46 (36.8%) kidney recipients had ureteral stents placed, with duration of 36.5 ± 9.9 days (mean±SD). There were no difference in the age, gender, or ethnicity in the stent group vs. non-stent group. There were no differences in the eGFR at 1 month, 3 months, 6 months, 12 months post-tx. Similarly, there were no differences in the occurrence of urinary tract infection (UTI) during the 0-3 months, 3-6 months, or 6-12 months post-tx. There were no difference in seroma/hematoma detected post-tx between the two groups. There was one patient from the non-stent group who developed urinoma/urinary leak, and one with lymphocele. No patients in the stent group experienced urinoma or lymphocele. However, there were 8 (10.1%) patients in the non-stent group who developed ureteral stricture vs. none in the stent group (p=0.026). Of those who developed ureteral stricture (N=8), 8 (100%) had hydronephrosis on allograft ultrasound and required percutaneous nephrostomy tube placement, 2 (25%) needed additional reconstructive surgeries, 2 (15%) needed extended-period percutaneous nephrostomy tubes placement (> 6 months), 7 (87.5%) needed hospitalization due to urinary obstruction, 2 (25%) needed ICU admission due to a complication from the obstruction or a procedure to relieve urinary obstruction.

Conclusion:

At ECMC the ureteral stricture rate was higher in the non-ureteral stent recipients, requiring further interventional radiology and surgical interventions potentially contributing to patient morbidity, if similar results obtained from further studies, then consideration for routine or selective ureteral stenting is recommend.

CITATION INFORMATION: Hamid M., Kumar J., Anjum S., Patel S., Gudleski G., Mietz S., Ott M., Chang S. Urological Complications of Prophylactic Ureteral Stent vs. No Stent in Kidney Transplant Recipients at Erie County Medical Center (ECMC) Am J Transplant. 2017;17 (suppl 3).

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