The Role of Prophylactic versus Selective Ureteric Stenting in Kidney Transplant Patients: A Retrospective Review. (December 2014)

• Record Type: Journal Article
• Authors: Ordon, Michael; Ghiculete, Daniela; Stewart, Robert; Pace, Kenneth T.; Honey, R. John D'A.
• Is Part Of: Progress in transplantation. Volume 24:Number 4(2014)
• Page Start: 322
• Page End: 327
• Publication Date: 2014-12
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; Transplantation; Organ Procurement; Tissue Donors; Transplantation of organs, tissues, etc; Electronic journals; Periodicals; Periodicals; 362.1783
• DOI: 10.7182/pit2014422
• Languages: English
• ISSNs: 1526-9248

Abstract

Objective: To evaluate the role of prophylactic versus selective ureteric stenting in the development of postoperative ureterovesical complications in kidney transplant recipients. Methods: Records of 614 transplant patients seen from January 2006 to May 2011 were retrospectively reviewed. The primary outcome was the rate of ureterovesical complications, defined as the development of ureteric obstruction or a ureterovesical anastomotic leak. The secondary outcomes were the rate of urinary tract infections and forgotten stents. Using a χ 2 test, we compared the primary and secondary outcomes across the selective and prophylactic cohorts. Logistic regression was used to compare the 2 cohorts while adjusting for potential confounders. Results: The selective and prophylactic cohorts consisted of 258 and 330 patients, respectively. Unadjusted analysis showed that the prophylactic group had a significantly lower rate of ureterovesical complications than did the selective group (2.12% vs 6.20%; odds ratio, 0.33; P = .01). After adjustment for differences in sex and donor type, the prophylactic group still had a lower risk for ureterovesical complications (odds ratio, 0.30; P = .009). Rates of urinary tract infections and forgotten stents did not differ significantly between the 2 groups. Conclusions: Prophylactic stenting is associated with a significantly lower rate of ureterovesical complications than is selective stenting.