Prophylactic Ureteric Stents in Renal Transplant Recipients: A Multicenter Randomized Controlled Trial of Early Versus Late Removal. Issue 8 (17th March 2017)

• Record Type: Journal Article
• Authors: Patel, P.; Rebollo‐Mesa, I.; Ryan, E.; Sinha, M. D.; Marks, S. D.; Banga, N.; Macdougall, I. C.; Webb, M. C.; Koffman, G.; Olsburgh, J.
• Is Part Of: American journal of transplantation. Volume 17:Issue 8(2017)
• Page Start: 2129
• Page End: 2138
• Publication Date: 2017-03-17
• Subjects: clinical research/practice -- kidney transplantation/nephrology -- urology -- clinical trial -- kidney (allograft) function/dysfunction -- quality of life (QOL) -- surgical technique; Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ajt.14223
• Languages: English
• ISSNs: 1600-6135

Abstract

Abstract : Prophylactic ureteric stenting in renal transplantation reduces major urological complications; however, morbidity is related to the indwelling duration of a stent. We aimed to determine the optimal duration for stents in this clinical setting. Patients (aged 2–75 years) from six UK hospitals who were undergoing renal transplantation were recruited and randomly assigned to either early stent removal at 5 days (without cystoscopy) or late removal at 6 weeks after transplantation (with cystoscopy). The primary outcome was a composite of stent‐related complications defined as pain, visible hematuria, migration, fragmentation, and urinary tract infections (UTIs) within 3 mo of transplantation. Between May 2010 and Nov 2013, we randomly assigned 227 participants, with 205 included in the final analysis of the primary outcome. Stent‐related complications were significantly higher in the late versus early stent removal groups (36 of 126 [28.6%] vs. 6 of 79 [7.6%]; p < 0.001). The majority of stent complications consisted of UTIs, with an incidence of 31 of 126 (24.6%) in the late group compared with 6 of 79 (7.6%) in the early group (p = 0.004). We found early stent removal on day 5 significantly reduced stent‐related complications and improved quality of life in the first 3 mo after transplantation (ISRCTN09184595). Abstract : In this randomized controlled trial, the authors determine that early prophylactic stent removal in renal transplant recipients at 5 days is beneficial, in terms of stent‐related complications and quality of life, compared to stent removal at 6 weeks.