No evidence for the need of a routine renal transplant ultrasound after elective transplant ureteric stent removal-A retrospective cohort study

Pediatr Transplant. 2020 Jun;24(4):e13704. doi: 10.1111/petr.13704. Epub 2020 Apr 7.

Abstract

Transplant ureteric stent insertion reduces the incidence of MUCs, but it is not known whether routine PSRGU is needed to detect unmasked MUCs. This study evaluated whether routine PSRGU in the pRTR is a useful tool to identify MUCs before they become clinically apparent. A retrospective analysis was undertaken of the clinical outcomes following elective stent removal from pediatric kidney-only transplant recipients at two London centers between 2012 and 2016. Our policy was to perform PSRGU either routinely or urgently if there were concerning symptoms or biochemical evidence of renal allograft dysfunction. Elective stent removal was performed in 86% (97 of 113 pRTR), and 75 (77%) of whom had routine PSRGU at a median (IQR) of 6 (2-8) days after stent removal. There were changes to management in 3 (4%) of pRTR with PSRGU identifying no MUC. Nineteen patients (25%) had urgent PSRGU, most commonly due to renal allograft dysfunction, at a median (IQR) of 5.5 (2.7-12.3) days after stent removal. Of these, two pRTR required ureteric intervention. For our current practice of removing transplant stents at 4-6 weeks post-transplantation, our study has found no evidence to support routine PSRGU after elective stent removal.

Keywords: kidney transplantation; major urological complications; pediatric; post-stent removal graft ultrasonography; transplant ureteric stent; ultrasound.

MeSH terms

  • Adolescent
  • Child
  • Device Removal*
  • Diagnostic Tests, Routine
  • Elective Surgical Procedures
  • Female
  • Humans
  • Kidney Transplantation*
  • Male
  • Postoperative Complications / diagnostic imaging*
  • Retrospective Studies
  • Stents*
  • Ultrasonography
  • Ureter / diagnostic imaging*
  • Ureter / surgery*
  • Urologic Diseases / diagnostic imaging*