Park JongBeom, Lee Soo Yeun, Lee Hyung Soon, Shin Sug Kyun, Kim Tae Hwan
Department of Surgery, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
Korean J Transplant. 2021 Mar 31;35(1):41-47. doi: 10.4285/kjt.20.0050. Epub 2021 Mar 12.
The aim of this study was to evaluate the safety and feasibility of prophylactic ureteric stenting during kidney transplantation (KT).
The authors retrospectively reviewed patients who underwent KT between June 2016 and June 2019. The prophylactic ureteral stenting group (double-J [DJ]) and no-stent group (no-DJ) were compared with respect to the clinical data and surgical outcomes.
A total of 42 patients underwent KT; 17 patients were classified into the DJ group and 25 patients into the no-DJ group. Antithymocyte globulin induction and donor-specific antibody positivity were significantly higher in the DJ group. There were no significant differences between the groups in terms of symptomatic urinary tract infection (UTI). The time to postoperative UTI was significantly shorter in the DJ group than in the no-DJ group (33.5±7.8 vs. 105.3±71.6 days, P=0.013). The development of postoperative BK viremia was significantly higher in the no-DJ group (0.0% vs. 16.0%, P=0.035). Urologic complications were significantly higher in the no-DJ group (0.0% vs. 16.0%, P=0.035). In the no-DJ group, urologic complications occurred in four patients ureteroneocystostomy stenosis in three patients and ureteroneocystostomy leakage in one patient. Percutaneous ureteral interventions were performed for all patients using percutaneous nephrostomy and reno-uretero-vesical stenting. However, there were no postoperative urologic complications in the DJ group.
Prophylactic ureteric stenting during KT may be safe and feasible without significantly increasing the incidence of UTI and BK viremia. Additionally, prophylactic ureteric stenting may reduce urologic complications after KT.
本研究的目的是评估肾移植（KT）期间预防性输尿管支架置入术的安全性和可行性。
作者回顾性分析了2016年6月至2019年6月期间接受KT的患者。比较了预防性输尿管支架置入组（双J [DJ]）和无支架组（无DJ）的临床资料和手术结果。
共有42例患者接受了KT；17例患者被归入DJ组，25例患者被归入无DJ组。DJ组中抗胸腺细胞球蛋白诱导和供体特异性抗体阳性率显著更高。两组在有症状的尿路感染（UTI）方面无显著差异。DJ组术后UTI发生时间显著短于无DJ组（33.5±7.8天对105.3±71.6天，P = 0.013）。无DJ组术后BK病毒血症的发生率显著更高（0.0%对16.0%，P = 0.035）。无DJ组的泌尿系统并发症显著更高（0.0%对16.0%，P = 0.035）。在无DJ组中，4例患者发生泌尿系统并发症，3例患者为输尿管膀胱吻合口狭窄，1例患者为输尿管膀胱吻合口漏。所有患者均采用经皮肾造瘘和肾输尿管膀胱支架置入术进行经皮输尿管干预。然而，DJ组术后无泌尿系统并发症。
KT期间预防性输尿管支架置入术可能是安全可行的，且不会显著增加UTI和BK病毒血症的发生率。此外，预防性输尿管支架置入术可能会减少KT后的泌尿系统并发症。
