Prophylactic Ureteric Stents in Renal Transplant Recipients: A Multicenter Randomized Controlled Trial of Early Versus Late Removal

TY - JOUR

T1 - Prophylactic Ureteric Stents in Renal Transplant Recipients

T2 - A Multicenter Randomized Controlled Trial of Early Versus Late Removal

AU - Patel, P.

AU - Rebollo-Mesa, I.

AU - Ryan, E.

AU - Sinha, M. D.

AU - Marks, S. D.

AU - Banga, N.

AU - Macdougall, I. C.

AU - Webb, M. C.

AU - Koffman, G.

AU - Olsburgh, J.

PY - 2017/2/17

Y1 - 2017/2/17

N2 - 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).

AB - 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).

KW - Clinical research/practice

KW - Clinical trial

KW - Kidney (allograft) function/dysfunction

KW - Kidney transplantation/nephrology

KW - Quality of life (QOL)

KW - Surgical technique

KW - Urology

UR - http://www.scopus.com/inward/record.url?scp=85015683267&partnerID=8YFLogxK

U2 - 10.1111/ajt.14223

DO - 10.1111/ajt.14223

M3 - Article

AN - SCOPUS:85015683267

SN - 1600-6135

JO - American Journal of Transplantation

JF - American Journal of Transplantation

ER -