Brief Article
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World J Transplant. Mar 24, 2013; 3(1): 1-6
Published online Mar 24, 2013. doi: 10.5500/wjt.v3.i1.1
Effect of ureteric stents on urological infection and graft function following renal transplantation
Jacob A Akoh, Tahawar Rana
Jacob A Akoh, Tahawar Rana, South West Transplant Centre, Plymouth Hospitals NHS Trust, Derriford Hospital, Plymouth PL6 8DH, United Kingdom
Author contributions: Akoh JA conceptualised the study, analysed data, wrote the paper, critically appraised and approved the manuscript; Rana T finalised data collection and entry to excel spreadsheet, performed literature review, contributed to writing and appraisal of manuscript.
Correspondence to: Jacob A Akoh, FRCSEd, FRCS(Gen), Consultant General, Transplant Surgeon, South West Transplant Centre, Plymouth Hospitals NHS Trust, Level 04, Derriford Hospital, Plymouth PL6 8DH, United Kingdom. jacob.akoh@nhs.net
Telephone: +44-1752-517536 Fax: +44-1752-517576
Received: October 1, 2012
Revised: November 15, 2012
Accepted: December 1, 2012
Published online: March 24, 2013
Processing time: 199 Days and 8.9 Hours
Abstract

AIM: To compare urological infections in patients with or without stents following transplantation and to determine the effect of such infections on graft function.

METHODS: All 285 recipients of kidney transplantation at our centre between 2006 and 2010 were included in the study. Detailed information including stent use and transplant function was collected prospectively and analysed retrospectively. The diagnosis of urinary tract infection was made on the basis of compatible symptoms supported by urinalysis and/or microbiological culture. Graft function, estimated glomerular filtration rate and creatinine at 6 mo and 12 mo, immediate graft function and infection rates were compared between those with a stent or without a stent.

RESULTS: Overall, 196 (183 during initial procedure, 13 at reoperation) patients were stented following transplantation. The overall urine leak rate was 4.3% (12/277) with no difference between those with or without stents - 7/183 vs 5/102, P = 0.746. Overall, 54% (99/183) of stented patients developed a urological infection compared to 38.1% (32/84) of those without stents (P = 0.0151). All 18 major urological infections occurred in those with stents. The use of stent (Wald χ2 = 5.505, P = 0.019) and diabetes mellitus (Wald χ2 = 5.197, P = 0.023) were found to have significant influence on urological infection rates on multivariate analysis. There were no deaths or graft losses due to infection. Stenting was associated with poorer transplant function at 12 mo.

CONCLUSION: Stents increase the risks of urological infections and have a detrimental effect on early to medium term renal transplant function.

Keywords: Urological infection; Ureteric stent; Renal transplantation; Creatinine; Estimated glomerular filtration rate