Effect of ureteric stents on urological infection and graft function following renal transplantation

Table 1 Indications for stent placement during the initial transplant procedure n (%)

Reason		Comments
Routine	159 (86.9)
Ureter related	9 (4.9)	e.g., Stripped ureter
Poor kidney perfusion	6 (3.3)
Contracted/thin bladder	3 (1.6)	Compliance mismatch
Technical factors	3 (1.6)	e.g., intra-abdominal implantation
Ileal conduit	1 (0.5)
Small kidney	1 (0.5)	Concern about size of renal artery
Long cold ischaemia time (> 24 h)	1 (0.5)
Total	183 (99.8)

Table 2 Comparison of groups with or without stent at initial transplant procedure n (%)

Parameter	Stented group (n = 183)	Without stent group (n = 102)	P value
Gender (male)	118 (65)	63 (62)	0.648
Age (yr), mean ± SE	52.4 ± 1.0 (53.7)1	49.1 ± 1.3 (50.6)1	0.035
Diabetes	31 (17)	13 (13)	0.347
BMI > 30 kg/m2	39 (21)	21 (21)	0.531
Vesico-ureteric reflux	11 (6)	14 (14)	0.031
First transplant	151 (83)	89 (87)	0.315
Type of transplant
DCD	111 (61)	78 (77)	0.023
DBD	12 (7)	5 (5)
LD	60 (33)	19 (19)
Delayed graft function	55 (30)	35 (34)	0.595
Septrin	173 (99)	91 (93)	0.002
Urine leak	7 (4)	5 (5)	0.746
Ureter stenosis	6 (3)	7 (7)	0.359
Ureter necrosis	1 (0.5)	0 (0)
Infection	91 (53)	40 (42)	0.075
Operation-infection interval (d)
mean ± SE	28.1 ± 3.7	33.3 ± 6.2	0.451
Median	10.5	11.0

¹Median age in parenthesis. Figures in parenthesis indicate percentages (except for age), corrected for number with relevant data. BMI: Body mass index; DCD: Donation after circulatory death; DBD: Donation after brain death; LD: Living donation.

Table 3 Effect of stent use on various outcome parameters, and infection and type of urological infection on allograft function

	Cr6	Cr12	eGFR6	eGFR12
Stent
Yes
mean ± SE	137.5 ± 4.6	139.7 ± 4.7	50.9 ± 1.3	49.9 ± 1.3
Median	123.5	125	52	49.5
n	180	176	180	176
No
mean ± SE	132.4 ± 5.6	124.4 ± 5.4	52.1 ± 1.9	54.8 ± 2.1
Median	120.5	120	52	55
n	78	74	77	73
F-statistic	0.42	3.603	0.256	4.047
P value	0.517	0.059	0.614	0.045
Parameters
Infection
Yes
mean ± SE	143.1 ± 6.2	144.0 ± 6.2	49.5 ± 1.6	48.9 ± 1.7
n	121	118	120	117
No
mean ± SE	128.0 ± 4.0	125.5 ± 4.3	53.4 ± 1.4	54.4 ± 1.4
n	123	119	123	119
F-statistic	2.232	3.123	2.154	4.038
P value	0.109	0.046	0.118	0.019
Infection type
UTI
mean ± SE	140.6 ± 6.9	139.8 ± 6.8	50.2 ± 1.8	50.3 ± 1.8
n	105	104	104	103
MUI
mean ± SE	156.4 ± 11.5	167.6 ± 11.6	45.8 ± 3.8	41.3 ± 3.7
n	18	16	18	16
F-statistic	0.558	1.299	0.524	1.783
P value	0.574	0.277	0.593	0.173

UTI: Urinary tract infection; MUI: Major urological infection; Cr₆: Creatinine at 6 mo; Cr₁₂: Creatinine at 12 mo; eGFR₁₂: Estimated glomerular filtration rate at 12 mo; eGFR₆: Estimated glomerular filtration rate at 6 mo.