Optimal Timing for Removal of the Double-J Stent After Kidney Transplantation

Yüksel, Yücel; Tekin, S.; Yüksel, Deniz; Duman, İbrahim; Sarıer, Mehmet; Yücetin, L.; Kiraz, Kemal; Demirbaş, Murat; Sezer, M. Aslan; Demirbaş, A.; Asuman, Y.H.

doi:10.1016/j.transproceed.2017.01.008

Cited by 11 publications

(23 citation statements)

References 14 publications

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“…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]).…”

Section: Resultsmentioning

confidence: 99%

“…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].…”

Section: Resultsmentioning

confidence: 99%

“…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.…”

Section: Introductionmentioning

confidence: 99%

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

Visser

Staaij

Muthusamy

et al. 2019

JCM

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Implanting a ureteric stent during ureteroneocystostomy reduces the risk of leakage and ureteral stenosis after kidney transplantation (KTx), but it may also predispose to urinary tract infections (UTIs). The aim of this study is to determine the optimal timing for ureteric stent removal after KTx. Searches were performed in EMBASE, MEDLINE Ovid, Cochrane CENTRAL, Web of Science, and Google Scholar (until November 2017). For this systematic review, all aspects of the Cochrane Handbook for Interventional Systematic Reviews were followed and it was written based on the PRISMA-statement. Articles discussing JJ-stents (double-J stents) and their time of removal in relation to outcomes, UTIs, urinary leakage, ureteral stenosis or reintervention were included. One-thousand-and-forty-three articles were identified, of which fourteen articles (three randomised controlled trials, nine retrospective cohort studies, and two prospective cohort studies) were included (describing in total n = 3612 patients). Meta-analysis using random effect models showed a significant reduction of UTIs when stents were removed earlier than three weeks (OR 0.49, CI 95%, 0.33 to 0.75, p = 0.0009). Regarding incidence of urinary leakage, there was no significant difference between early (<3 weeks) and late stent removal (>3 weeks) (OR 0.60, CI 95%, 0.29 to 1.23, p = 0.16). Based on our results, earlier stent removal (<3 weeks) was associated with a decreased incidence of UTIs and did not show a higher incidence of urinary leakage compared to later removal (>3 weeks). We recommend that the routine removal of ureteric stents implanted during KTx should be performed around three weeks post-operatively.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Visser

Staaij

Muthusamy

et al. 2019

JCM

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“…Moreover, it was reported by Liu et al [24] that removal of the DJ stents 1 week post-operatively reduced the risk of UTI when compared to results with the usual removal at 4 weeks. Verma et al [18] and Yuksel et al [25] made a recommendation of using a DJ stent for 14 days, which would greatly reduce the risk of complications when compared with usage for a longer period of time. In his research, Yuksel et al [25] reported rates of UTI and UC of 1.4% and 5.1%, respectively, and found that these low infection rates were likely due to long-term preoperative antibiotic use.…”

Section: Discussionmentioning

confidence: 99%

Does early removal of double J stents reduce urinary infection in living donor renal transplantation?

Soylu¹,

Aydın²,

Atli³

et al. 2019

aoms

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A b s t r a c tIntroduction: Prophylactic use of double J (DJ) stents in recipients is highly accepted in renal transplantation. In this study, the association between the frequency of urologic complications (UC) and urinary tract infections (UTI), and the early or late removal of DJ stents was investigated. Material and methods: A total of 116 live-donor renal transplant patients were included in the study during a 4-year period, with a mean follow-up of 29.2 ±15.3 months. In all, DJ stents were used. All patients were clinically monitored for graft function by assessment of the complete blood count, renal biochemistry, urine analysis and blood drug level according to our follow-up protocol. Results: The patients were divided into 2 groups according to the time of their stent removal: group I (n = 44), removal within the first 14 days; and group II (n = 72), removal after 14 days. No urinary leaks were detected in either of the groups. Three patients suffered from anastomotic stricture (group I, n = 1; group II, n = 2). The rates of UTI were similar in groups I and II (13.6% vs. 16.6%, respectively, p = 0.79). The rate of UTI in women was found to be 3.8 times higher than in men. Conclusions:The results of our study demonstrated that DJ stent removal within 14 days did not reduce the risk of UTI when compared to stent removal after 14 days. Similar effects on complication rates for ureteral stenting for these 2 removal periods were observed.

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“…Böbrek naklinde üreter ile mesane arasında en sık yapılan anastomoz teknikleri intravezikal yapılan Leadbetter-Politano (LP) ve ekstravezikal yapılan Witzel, Sampson, Röhl, Taguchi ( U Stich) ve Lich Gregoir (LG) ÜNS'dir (9,13,14). Tek üreterli böbreklerde de hangi yöntemin kullanılması gerektiği hakkında görüş birliği yoktur ancak tek üreterli böbreklerde en çok tercih edilen teknik LG ÜNS' dir (6,9,15 Literatürde yayınlanan düşük hasta sayılı çalışmalarda böbrek nakli sonrası ÜD anomalisi olan hastalarda üriner sistem enfeksiyonu, hidronefroz, üreter nekrozu ve idrar kaçağı gibi komplikasyonların tek toplayıcı sistemi olan böbrek nakli alıcı hastalarına gore daha sık görüldüğü belirtilmiştir (1,3,5,16). Fakat hasta potansiyeli fazla olan ve ÜD'li greft böbreklerle daha sık…”

Section: Resimunclassified

Üreter Dubpli̇kasyonlu Greft Böbreklerde Naki̇l Tecrübemi̇z

Yüksel

2019

SDÜ Tıp Fakültesi Dergisi

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AmaçKronik böbrek yetmezliğinin en etkili tedavisi böbrek naklidir. Böbrek nakli sonrası ürolojik komplikasyonlar morbiditeyi arttırmaktadır. Üreter duplikasyonu (ÜD), böbrek donörlerinde üst üriner sistemin en sık görülen anomalisidir. ÜD prevalansı % 0.6 -% 1 arasında değişmektedir. ÜD'li böbrek greftlerinde yapılacak üreter-mesane anastomoz tekniği ile ilgili görüş birliği yoktur. Bu çalışmamızda, kliniğimizde yapılmış olan ÜD' li renal transplantasyon tecrübelerimizi ve sonuçlarımızı paylaşmayı amaçladık. Gereç ve YöntemOcak 2013 -Aralık 2017 tarihleri arasında Antalya Medicalpark Organ Nakli Bölümü'nde ÜD'li greft böbrek ile nakil yapılan hastaların sonuçları retrospektif olarak analiz edildi. Hastaların yaş, cinsiyet, donör türü, donör yaşı, donör ameliyatının tipi, böbrek nakli sonrası takip süresi, ortalama ameliyat süresi, böbrek nakli öncesi diyaliz türleri, böbrek nakli sayısı, böbrek nakli sonrası üriner komplikasyonlar, kreatinin düzeyi, greft sağ kalımı, hasta sağ kalımı değerlendirildi. BulgularMerkezimizde Ocak 2013-Aralık 2017 tarihleri arasında 2039 böbrek nakli yapıldı. Olguların 28 (% 0,1)'inde ÜD saptandı. Hastaların ortalama yaşı 38.07 ± 14.7 (8y-60y), erkek/kadın oranı 1.1'di. Böbrek alıcılarının 15'i erkek 13'ü kadın, böbrek donörlerinin 22'si canlı, 6'sı kadavraydı. Donörlerde kadın/erkek oranı 3 olarak saptandı. Ortalama donör yaşı 48.6 ± 15.5 (14y-81y) olarak belirlendi. On üç hasta preemptif, 14 hasta hemodiyaliz alırken 1 hasta da periton diyalizi yapmaktaydı. Ortalama ameliyat süresi 80.6 ± 13.4 dk (65dk-109dk) ölçüldü. Bir hastada böbrek nakli sonrası 2. ayda idrar kaçağı oluştu (%3,5). Diğer hastalarda üriner komplikasyon saptanmadı. SonuçBöbrek nakil ameliyatlarında greft böbreklerde ÜD, böbrek nakli için engel kabul edilmemelidir. Tecrübelerimize göre ÜD olan greft böbreklerde tek ostiumlu Lich Gregoir üreteroneosistostomi yönteminin 2 adet double-j stent kullanılarak yapılması diğer yöntemlere göre daha güvenlidir.

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Optimal Timing for Removal of the Double-J Stent After Kidney Transplantation

Cited by 11 publications

References 14 publications

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

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

Does early removal of double J stents reduce urinary infection in living donor renal transplantation?

Üreter Dubpli̇kasyonlu Greft Böbreklerde Naki̇l Tecrübemi̇z

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