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The impact of prophylactic ureteral stenting during kidney transplantation on postoperative surgical outcomes

대한이식학회지 2021년 35권 1호 p.41 ~ 47
박종범, 이수연, 이형순, 신석균, 김태환,
소속 상세정보
박종범 ( Park Jong-Beom ) - National Health Insurance Service Ilsan Hospital Department of Surgery
이수연 ( Lee Soo-Yeun ) - National Health Insurance Service Ilsan Hospital Department of Surgery
이형순 ( Lee Hyung-Soon ) - National Health Insurance Service Ilsan Hospital Department of Surgery
신석균 ( Shin Sug-Kyun ) - National Health Insurance Service Ilsan Hospital Department of Internal Medicine
김태환 ( Kim Tae-Hwan ) - National Health Insurance Serivce Ilsan Hospital Department of Radiology

Abstract


Background: The aim of this study was to evaluate the safety and feasibility of prophylactic ureteric stenting during kidney transplantation (KT).

Methods: The authors retrospectively reviewed patients who underwent KT between June 2016 and June 2019. The prophylactic ureteral stenting group (double-J [DJ]) and no-stent group (no-DJ) were compared with respect to the clinical data and surgical outcomes.

Results: A total of 42 patients underwent KT; 17 patients were classified into the DJ group and 25 patients into the no-DJ group. Antithymocyte globulin induction and donor- specific antibody positivity were significantly higher in the DJ group. There were no significant differences between the groups in terms of symptomatic urinary tract infection (UTI). The time to postoperative UTI was significantly shorter in the DJ group than in the no-DJ group (33.5±7.8 vs. 105.3±71.6 days, P=0.013). The development of postoperative BK viremia was significantly higher in the no-DJ group (0.0% vs. 16.0%, P=0.035). Urologic complications were significantly higher in the no-DJ group (0.0% vs. 16.0%, P=0.035). In the no-DJ group, urologic complications occurred in four patients: ureteroneocystostomy stenosis in three patients and ureteroneocystostomy leakage in one patient. Percutaneous ureteral interventions were performed for all patients using percutaneous nephrostomy and reno-uretero-vesical stenting. However, there were no postoperative urologic complications in the DJ group.

Conclusions: Prophylactic ureteric stenting during KT may be safe and feasible without significantly increasing the incidence of UTI and BK viremia. Additionally, prophylactic ureteric stenting may reduce urologic complications after KT.

키워드

Ureter; Stents; Postoperative complication; Kidney transplantation; Urinary tract infection

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