Double J or percutaneous single J-uretic stent after renal transplantation; differences in urologic complication

M.A.C.J. Gelens, J.H.H. van Laanen, A.G. Peppelenbosch, M.H.L. Christiaans

Wednesday 4 march 2020

14:50 - 15:00h at Theaterzaal

Parallel session: Parallel sessie III – Klinische abstracts

Background: Intraoperative uretic stenting reduces the risk of urologic complications after renal transplantation. Our standard protocol consisted of placement of internal double J stents (JJ) during renal transplantation, but hereby monitoring diuresis post transplantation is difficult in patients who have renal rest function. For this reason we changed our standard protocol to placement of a percutaneous single J-uretic stents (PS) in patients with a living kidney transplantation and rest function. JJ stents were left in situ for 6 weeks and single J splints for 7 days. Later on we also reduced the duration of the JJ catheter from 6 to 2 weeks. In this study we compare the urologic complication between JJ en PS.

Methods: This retrospective study includes 66 recipients of living donors who were transplanted in 2017 and 2018. In forty-nine living recipients, with rest diuresis more than 500cc, a PS was placed, in seventeen recipients, with rest diuresis less than 500cc, a JJ was placed. Urologic complications were monitored for 3 months.

Initial Immunosuppression regimen consisted of tacrolimus, mycophenolate mofetil and steroids (10 days).

Results: In both groups the patient survival was 100%, graft survival was 96% in group 1 and 94% in group 2. Urologic complications were comparable in both groups; hydronephrosis was for group 1 and 2 respectively, 12% and 6 %, p=0.46 Leakage was resp. 4% and 6%, p=0,55. The need for ureterreimplantation was resp. 2% and 5,9%, p= 0.43. The percentage of urine tract infection was resp 39% and 41% p= 0.86 between the two groups.

Conclusions: There are no differences in postoperative urologic complications between JJ or PS in recipients of living donors.