ABSTRACT
Objective: to verify if the routine use of DJ-stent in kidney transplantation is worthwhile we performed a comparison between stented versus non-stented ureteroneocystostomy in kidney transplant patients. We have evaluated the mean graft function one-year postoperatively in addition to some clinical and surgical complications
Methods: this study is performed in two centers of kidney transplantation in our university. From the beginning of January 2010 until the end of December 2013 we had 220 patients [mean age was 39 +/- 7 years]. All of them were transplanted from living donors [related or non-related], with or without DJ-stenting. The follow up was one-year postoperatively
Results: no important differences were noted between the two groups [group 1 is DJ-stented, group 2 is non-stented]. These results are eligible regarding either graft function one-year postoperatively [creatine clearance=79 +/- 15 in group 1 versus 83 +/- 11 in group 2, p-value=0.08 or in clinical and surgical complications. Ureteral obstruction was noted in 0.8% versus 5% in group 1 and group 2 respectively, p-value=0.9]. Urinary leakage was found in 2% versus 8% in group 1 and 2 respectively, p-value=0.08. Urinary tract infections were documented in 45% of group 1 versus 35% of group 2, p-value =0.08. Gross hematuria was seen in 22% of group 1 versus 17% of group 2, p-value=0.12. Irretitive lower urinary tract symptoms happened in 78% of group 1 versus 16% in group 2, p-value=0.03
Conclusions: the follow-up demonstrated similar results between two groups, with one exception, regarding irretitive lower urinary tract symptoms which were higher in stented group. We believe that a larger double-blinded prospective study is more capable, if it is performed in the future, to answer the main question in this study: is it worthwhile to use DJ-stent routinely in ureteroneocystostomy in kidney transplantation. In the mean while we do not recommend the routine use of ureteral stent in kidney transplantation, otherwise just in selected cases as compromised vascularity or difficult anstomosis