Early Stent Removal After Kidney Transplantation: Is it Possible?

Abstract

BackgroundThe most important surgical complications of renal transplantation are stenosis and obstruction of the ureterovesical anastomosis. Routine use of ureteral stents can prevent this complication, but the optimal time for ureteral stent use is still controversial.ObjectivesThe purpose of this study is to compare the benefits and complications of early and delayed stent removal after surgery. Early ureteral stent removal can decrease some complications, such as urinary tract infections (UTIs), bladder irritation symptoms, persistent hematuria, and the risk of stent crusting; its benefits include easier stent removal and shorter hospitalization time.Patients and MethodsAll patients who underwent kidney transplantation from May 2011 until March 2012 in Modarres Hospital were included in this study. We classified the patients into three groups, based on time of stent removal (10, 20, and 30 days after transplantation).ResultsNinety-one patients were studied; urologic complications (hydroureteronephrosis and urinoma) in these three groups were analyzed and showed no statistical significant difference.ConclusionsWe can remove the ureteral stent earlier after kidney transplantation with no increase in the prevalence of surgical complications.

Timing of Ureteric Stent Removal and Occurrence of Urological Complications after Kidney Transplantation: A Systematic Review and Meta-Analysis

“…Of the 1043 articles identified from the initial literature search, fourteen articles were within the scope of this systematic review; three randomised controlled trials (RCTs) [20,21,31], nine retrospective cohort studies [8,13,19,22,23,32,33,34,35] and two prospective studies [36,37]. A total of 3216 patients were included, of which 2406 patients (74.8%) underwent living donor KTx (two studies did not record if they used living or deceased donors [34,35]).…”

“…We could not specify the type of stent in five studies. The authors of these five papers were contacted, but unfortunately, we received no response [19,34,35,36,37]. All studies reported the age of the recipients, except for the preliminary results in the three included abstracts [34,35,36].…”

“…All studies reported the age of the recipients, except for the preliminary results in the three included abstracts [34,35,36]. Only four studies reported that they both included adults and children [19,21,23,37]. All articles described the incidence of UTIs, and nine articles also reported urinary leakage and/or ureteral stenosis [19,20,21,31,32,33,35,36,37].…”

“…Therefore, the guideline advises stents to be removed earlier than six weeks post-transplant (which is protocol in most transplant centres) rather than later. Therefore, in the last two years, studies have started to investigate different timings of stent removal within one-month post-transplant [8,18,19,20,21,22,23]. Recently, Thompson et al [24] published a review regarding this topic; however, the authors included fewer studies and did provide a robust conclusion about timing of stent removal as their focus was more on the difference between per-urethral and bladder indwelling stents.…”

Relationship Between Tacrolimus Dosage and Renal Function, Acute Rejection and Early Infections, Single Center Experience

“…Por lo tanto, la relación TAC C / D puede ayudar a los médicos de trasplantes de una manera simple para individualizar el régimen inmunosupresor 25 . Por lo que, es necesario más investigaciones en este aspecto clínico-práctico en nuestro medio.…”