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ROUTINE URETERAL STENTING IN KIDNEY TRANSPLANT REDUCES POSTOPERATIVE HYDRONEPHROSIS AND PERCUTANEOUS URETERAL INTERVENTIONS: A SINGLE-CENTER EXPERIENCE

DONG HWAN KİM, HYUNG SUB PARK, Jİ SU BANG, HYO JİN SHİN, BYUNG JUN YOON, SEJOONG KİM, JONG CHEOL JEONG, SEOKWOO PARK, TAESEUNG LEE

Experimental and Clinical Transplantation - 2024;22(1):9-16

Department of Surgery, Gyeongsang National University Hospital, Jinju, Republic of Korea

 

Objectives: The effect of routine ureteral stenting on postoperative hydronephrosis and percutaneous ureteral intervention in kidney transplant remains unknown. This study aimed to evaluate the effects of routine ureteral stenting on hydronephrosis and percutaneous ureteral intervention and the cost benefit of ureteral stenting in kidney transplant. Materials and Methods: We retrospectively analyzed patients who underwent kidney transplant at a tertiary institution between 2005 and 2021. We adopted a ureteral stenting protocol in 2017, and a comparison was performed with previous patients without stents. Results: In total, 539 patients underwent kidney transplant (271 with stents [51.3%], 268 without stents [49.7%]). Hydronephrosis was detected in 16 cases (5.9%) and 30 cases (11.2%) of groups with and without stents, respectively (P = .041). Among patients with hydronephrosis, the number of patients who underwent percutaneous ureteral intervention was significantly lower in the stent group than in the nostent group (1 [6.25%] vs 10 [33.33%]; P = .014). Twenty patients (3.71%) experienced major urologic complications (19 [7.1%] in the no-stent group, and 1 [0.4%] in the stent group; P = .001). No significant differences between the groups were shown in the incidence of urinary tract infections within 3 months of transplant (24 [8.9%] vs 22 [8.2%]; P = .846). No differences were shown between the groups in ureterovesical anastomosis time (24.4 vs 24.03 min; P = .699) or 1-year graft survival (97% vs 97.8%; P = .803). The healthcare cost was significantly lower in the stent group than in the no-stent group by $1702.05 ($15 000.89 vs $16 702.95; P < .001). Conclusions: Routine ureteral stenting in kidney transplant significantly decreased the incidence of postoperative hydronephrosis and percutaneous ureteral intervention. Stenting did not lead to increased urinary tract infections and was cost-effective.