ULTRASOUND (US) AFTER ELECTIVE JJ STENT REMOVAL (EJJR) IN KIDNEY TRANSPLANTATION

ABSTRACT

Introduction: Transplantation (KTx) is considered the best renal replacement therapy and improving its outcomes remains a primary challenge. KTx ureteral JJ stenting has been used to prevent urological complications, but there is no consensus about EJJR timing and literature regarding routine US imaging after EJJR to detect complications is lacking. Aim: Define the incidence of urological complications diagnosed by routine US after EJJR in KTx, determine US utility and best time interval to perform it. Methods: We retrospectively analysed all routine KTx US performed in our Unit from 2016 until 2020 by an experienced interventional nephrologist. US post EJJR findings were compared with previous patient US. KTx characteristics, treatment and outcomes were recorded. Results: - 345 KTx were done, 62.9% were male receptors, 81.7% had a first KTx and 91.5% were from a deceased donor. No routine US post EJJR was done in 20.9% due to the COVID pandemic. - Mean timing to elective JJ stent removal was 36.4 ± 25 days (SD). - Mean time from EJJR to US was 16.3 ± 28.8 days (SD). - Urinary tract (UT) ectasia (19.7%) and grade I UT dilatation (3.6%) were not considered pathological. - 47.3% (129) had a complication detected 88.4% (114) had a collection, 8.5% (11) had UTD 5.4% grade II and 3.1% grade III. 3% had other complications. Conclusion: Routine US after EJJR allowed a timely diagnosis and early treatment of urological complications, a key factor for successful transplantation. KTx US is a cost - effective and reproducible test that provides crucial information to guide clinical decisions, being most efficient when performed 10 days post removal. Interventional nephrologists could do this examination promptly.