Ureteral stents are associated with reduced risk of ureteral complications after kidney transplantation: A large single center experience

Sameh A. Fayek, Jeffrey Keenan, Abdolreza Haririan, Matthew Cooper, Rolf N. Barth, Eugene Schweitzer, Jonathan S. Bromberg, Stephen T. Bartlett, Benjamin Philosophe

Research output: Contribution to journalArticle

Abstract

BACKGROUND.: Controversy exists regarding the benefit of ureteral stents in kidney transplantation. We aimed to examine the association of stents with risk of ureteral complications, particularly in relationship with donor type. METHODS.: Kidney transplants from 2005 to 2009 were evaluated (n=1224). Patients with previous or simultaneous nonkidney transplants, death, or lost to follow-up within 90 days were excluded, unless already developed a ureteral complication. Only cases with a single extravesical ureteroneocystostomy were included. The cohort (n=961) was divided into stent (32.2%) and no-stent (67.7%) groups. Poisson regression was used to examine the association of stent with ureteral complications (leak or stricture) and urinary tract infections (UTI). RESULTS.: Ureteral complication rate was 1.9% in stent versus 5.8% in no-stent group (P=0.007). UTI rate was 14.2% with stent versus 7.9% without stent (P=0.003). Stent use was independently associated with reduction in ureteral complications (incidence rate ratios [IRR], 0.40; P=0.04; 95% confidence interval [CI], 0.17-0.96) and an increase in UTI risk (IRR, 1.79; P=0.006; 95% CI, 1.18-2.74). Stent protective effect was primarily related to reduction in stricture risk (IRR, 0.23; P

Original languageEnglish (US)
Pages (from-to)304-308
Number of pages5
JournalTransplantation
Volume93
Issue number3
DOIs
StatePublished - Feb 15 2012
Externally publishedYes

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Kidney Transplantation
Stents
Urinary Tract Infections
Incidence
Pathologic Constriction
Confidence Intervals
Transplants
Lost to Follow-Up
Tissue Donors
Kidney

Keywords

  • Kidney transplant
  • Leak
  • Stricture
  • Ureteral stent
  • Urinary tract infection

ASJC Scopus subject areas

  • Transplantation

Cite this

Ureteral stents are associated with reduced risk of ureteral complications after kidney transplantation : A large single center experience. / Fayek, Sameh A.; Keenan, Jeffrey; Haririan, Abdolreza; Cooper, Matthew; Barth, Rolf N.; Schweitzer, Eugene; Bromberg, Jonathan S.; Bartlett, Stephen T.; Philosophe, Benjamin.

In: Transplantation, Vol. 93, No. 3, 15.02.2012, p. 304-308.

Research output: Contribution to journalArticle

Fayek, Sameh A. ; Keenan, Jeffrey ; Haririan, Abdolreza ; Cooper, Matthew ; Barth, Rolf N. ; Schweitzer, Eugene ; Bromberg, Jonathan S. ; Bartlett, Stephen T. ; Philosophe, Benjamin. / Ureteral stents are associated with reduced risk of ureteral complications after kidney transplantation : A large single center experience. In: Transplantation. 2012 ; Vol. 93, No. 3. pp. 304-308.
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abstract = "BACKGROUND.: Controversy exists regarding the benefit of ureteral stents in kidney transplantation. We aimed to examine the association of stents with risk of ureteral complications, particularly in relationship with donor type. METHODS.: Kidney transplants from 2005 to 2009 were evaluated (n=1224). Patients with previous or simultaneous nonkidney transplants, death, or lost to follow-up within 90 days were excluded, unless already developed a ureteral complication. Only cases with a single extravesical ureteroneocystostomy were included. The cohort (n=961) was divided into stent (32.2{\%}) and no-stent (67.7{\%}) groups. Poisson regression was used to examine the association of stent with ureteral complications (leak or stricture) and urinary tract infections (UTI). RESULTS.: Ureteral complication rate was 1.9{\%} in stent versus 5.8{\%} in no-stent group (P=0.007). UTI rate was 14.2{\%} with stent versus 7.9{\%} without stent (P=0.003). Stent use was independently associated with reduction in ureteral complications (incidence rate ratios [IRR], 0.40; P=0.04; 95{\%} confidence interval [CI], 0.17-0.96) and an increase in UTI risk (IRR, 1.79; P=0.006; 95{\%} CI, 1.18-2.74). Stent protective effect was primarily related to reduction in stricture risk (IRR, 0.23; P",
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AU - Fayek, Sameh A.

AU - Keenan, Jeffrey

AU - Haririan, Abdolreza

AU - Cooper, Matthew

AU - Barth, Rolf N.

AU - Schweitzer, Eugene

AU - Bromberg, Jonathan S.

AU - Bartlett, Stephen T.

AU - Philosophe, Benjamin

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N2 - BACKGROUND.: Controversy exists regarding the benefit of ureteral stents in kidney transplantation. We aimed to examine the association of stents with risk of ureteral complications, particularly in relationship with donor type. METHODS.: Kidney transplants from 2005 to 2009 were evaluated (n=1224). Patients with previous or simultaneous nonkidney transplants, death, or lost to follow-up within 90 days were excluded, unless already developed a ureteral complication. Only cases with a single extravesical ureteroneocystostomy were included. The cohort (n=961) was divided into stent (32.2%) and no-stent (67.7%) groups. Poisson regression was used to examine the association of stent with ureteral complications (leak or stricture) and urinary tract infections (UTI). RESULTS.: Ureteral complication rate was 1.9% in stent versus 5.8% in no-stent group (P=0.007). UTI rate was 14.2% with stent versus 7.9% without stent (P=0.003). Stent use was independently associated with reduction in ureteral complications (incidence rate ratios [IRR], 0.40; P=0.04; 95% confidence interval [CI], 0.17-0.96) and an increase in UTI risk (IRR, 1.79; P=0.006; 95% CI, 1.18-2.74). Stent protective effect was primarily related to reduction in stricture risk (IRR, 0.23; P

AB - BACKGROUND.: Controversy exists regarding the benefit of ureteral stents in kidney transplantation. We aimed to examine the association of stents with risk of ureteral complications, particularly in relationship with donor type. METHODS.: Kidney transplants from 2005 to 2009 were evaluated (n=1224). Patients with previous or simultaneous nonkidney transplants, death, or lost to follow-up within 90 days were excluded, unless already developed a ureteral complication. Only cases with a single extravesical ureteroneocystostomy were included. The cohort (n=961) was divided into stent (32.2%) and no-stent (67.7%) groups. Poisson regression was used to examine the association of stent with ureteral complications (leak or stricture) and urinary tract infections (UTI). RESULTS.: Ureteral complication rate was 1.9% in stent versus 5.8% in no-stent group (P=0.007). UTI rate was 14.2% with stent versus 7.9% without stent (P=0.003). Stent use was independently associated with reduction in ureteral complications (incidence rate ratios [IRR], 0.40; P=0.04; 95% confidence interval [CI], 0.17-0.96) and an increase in UTI risk (IRR, 1.79; P=0.006; 95% CI, 1.18-2.74). Stent protective effect was primarily related to reduction in stricture risk (IRR, 0.23; P

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KW - Leak

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KW - Urinary tract infection

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