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Abstract

Objectives: Double J stent placement at kidney transplant may reduce stenosis or leakage complication rates. However, placement may also increase risk for early urinary tract infection (ie, < 3 mo after transplant). In children, the usefulness of double J stent placement is not well defined. Materials and Methods:We analyzed retrospective data from children who received transplants at the Gazi University Transplantation Center and Pediatric Nephrology (Ankara, Turkey) for outcomes related to double J stents. At our center, double J stent placement decision is made by the transplant surgery team during operation. Placements were routinely performed in all transplant recipients. Stent removal occurs within 6 week after transplant. Results: Among 42 transplants since 2006, early urinary tract infection was seen in 7% and stenosis in 3.6% of patients, with no leakage reported. Mean stent removal time was 6 ± 0.5 weeks. Early urinary tract infection was seen in 3 recipients with posterior urethral valve and neurogenic bladder (2 recipients) and meningoma cells and neurogenic bladder (1 recipient). All 3 recipients with early urinary tract infection received clean intermittent catheterization after transplant for adequate emptying of the bladder. In our study group, stent complications such as migration (2 patients) and hematuria (1 patient) were seen, but crusting, breakage, and stone formation were not seen. The 3 patients with urinary tract infection had neurogenic bladder types, complicating the urine outflow system. Stent placement was not a significant risk factor for early urinary tract infection and but had a protective effect. Conclusions:In our study group, we observed no risk factors for routine double J stent placement in pediatric renal transplant procedures. Stent placement was not a risk factor for early urinary tract infection. However, regardless of stent placement, when a recipient had complicated urologic outflow problems, infection became a long-term hurdle.

Posttransplantation Vesicoureteral Reflux in Renal Grafts and Their Outcomes in Pediatric Transplantation: Should We Be Afraid ?

“…All the cases were female. Their mean transplantation age was 8.75 year (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16) . Case 1 had infantile nephrotic syndrome, case 2 had nephronophthisis, case 3 had VUR and dysplastic kidney, and case 4 had end-stage renal failure due to Ig A nephropathy.…”

“…Urological complications occurring after renal transplantation is an important problem causing increased morbidity and hospitalization. Frequency varies between 2.9% and 21% in different centers and one of the most frequent complication is related to ureter (11) . VUR, encountered as a complication, is an important reason of UTIs in the post-transplant period.…”

“…Results: All of four cases were female. Their mean transplantation age was 8.7 years (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16). High grade (Grade 4) VUR was determined in the graft kidney in all but one.…”

Renal Tranplantation in Living Kidney Donors: First Experiences

“…Katater kullanılmasını önermeyenler kateterin kalsifikasyon ve artmış idrar yolu enfeksiyonuna neden olduğunu ve dokunun içine gömülebileceğini bildirilmişlerdir. 21,22 Katater kullanımını destekleyen çalışmalar kataterin idrar kaçağını ve erken postoperatif tıkanma oranlarını azalttığını ve bu nedenle uzun süreli izlemde daha az cerrahi revizyon gerektirdiğini belirtmişlerdir. 9 Biz üreter anastomozunda rutin olarak double J katederi kullandık ve yaklaşık 3 hafta sonra katateri çıkardık.…”