Impact of Ureteral Double J Stenting on Kidney Transplant Outcome at Duhok Transplant Center, Iraq

Abstract

Background: Renal transplant is considered the treatment of choice for end stage renal disease. During the transplantation, stents are placed routinely at duhok transplant center (DTC) to protect the ureter-bladder anastomosis and to decrease anastomosis-related complications. Objectives: The aim of this study was to compare the incidence of urinary tract infection (UTI) and other postoperative complications in patients undergoing renal transplant with or without stent insertion. Methods: All recipients of kidney transplantation at DTC between January 2012 and December 2013 took part in this study. The patients were followed up at the same center and those who developed post-operative complications were referred back to DTC for management. The study included data of following up the patients for 12 months. Results: No significant difference was found in GFR between the two groups 12 months after transplant (Mean ± SD: 74.11 ± 12.2 for stented group versus 77.4 ± 14.6 for non-stented group, U test, P > 0.05). 29.4% (10/34) of stented patients developed UTI in the first 14 days, while only 7.4% (2/27) of the patients in the non-stented group developed this complication (P = 0.045) (OR: 5; CI95: 1-26.3). 44% (15/34) of the stented subjects developed late UTI which was significantly higher than that found in non-stented group where only 20.8% (5/24) of subjects developed UTI (P = 0.039) (OR: 3.5; CI95: 1-11.3). Conclusions: Stents increased the risks of urological infections and might have a detrimental effect on graft survival. It might be inferred that stenting should not be placed routinely; but only used in selective patients with strong indications.