Ranganathan M, Akbar M, Ilham M A, Chavez R, Kumar N, Asderakis A
Transplant Unit, University Hospital of Wales, Cardiff, Wales, UK.
Transplant Proc. 2009 Jan-Feb;41(1):162-4. doi: 10.1016/j.transproceed.2008.10.022.
Stenting of the ureter is commonly performed during renal transplantation to avoid early complications. However, it predisposes to infections that may pose a significant threat to the graft and patient. Our study sought to investigate the incidence of infections associated with stents in renal transplant recipients.
A retrospective analysis of 100 consecutive renal transplant recipients performed over 1 year with 6 months follow-up.
The median recipient age was 46 years (range, 19-71 years). Among the study group, 75 patients received an organ from deceased donor and 25 from live donor. In our study, there were 79 patients with a stent (ST) and 18 without a stent (WOST); 3 patients who required nephrectomy were excluded from the study. There were 2 ureteric stenoses that occurred following stent removal: 1 required surgical correction and 1 was treated radiologically. There were no cases of urinary leak. The incidence of urinary tract infection (UTI) was significantly greater among ST compared with WOST subjects (71% vs 39%; P = .02). New episodes of UTI following removal of the stent were more common among patients who had experienced infections while having a stent compared with infection-free stented patients (54% vs 30%; P = .04).
A ureteric stent may help to reduce early postoperative complications (leak and stricture), but increased the likelihood of UTI. Infection while having a ureteric stent was associated with a high recurrence rate of UTI even after stent removal.
肾移植期间通常会进行输尿管支架置入术以避免早期并发症。然而,这会增加感染风险,可能对移植物和患者构成重大威胁。我们的研究旨在调查肾移植受者中与支架相关的感染发生率。
对连续100例肾移植受者进行回顾性分析,这些患者在1年内接受手术,并进行6个月的随访。
受者的年龄中位数为46岁(范围为19 - 71岁)。在研究组中,75例患者接受了来自 deceased donor的器官,25例接受了来自 live donor的器官。在我们的研究中,79例患者置入了支架(ST),18例未置入支架(WOST);3例需要肾切除术的患者被排除在研究之外。支架取出后发生了2例输尿管狭窄:1例需要手术矫正,1例接受了放射治疗。没有尿漏病例。与WOST组相比,ST组的尿路感染(UTI)发生率显著更高(71%对39%;P = 0.02)。与未发生感染的置入支架患者相比,在置入支架期间发生感染的患者在支架取出后UTI新发病例更为常见(54%对30%;P = 0.04)。
输尿管支架可能有助于减少术后早期并发症(漏尿和狭窄),但会增加UTI的可能性。即使在支架取出后,输尿管支架置入期间的感染仍与UTI的高复发率相关。