Assessing the value of ureteral stent placement in pediatric kidney transplant recipients.
Assessing the value of ureteral stent placement in pediatric kidney transplant recipients.
复制标题
评估儿童肾移植受者输尿管支架置入的价值。
DOI：
10.1097/tp.0b013e318169bf11
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发表时间：
2008
期刊：
影响因子：
6.2
通讯作者：
Howard,RichardJ
中科院分区：
文献类型：
--
作者：
Dharnidharka,VikasR;Araya,CarlosE;Wadsworth,ChristopherS;McKinney,MichaelC;Howard,RichardJ
Background.Ureteral stent placement at kidney transplantation may reduce stenosis or leakage (S/L) complication rates. However, stent placement may also increase risk for early urinary tract infection (early UTI;< 3 months after transplant) and BK virus allograft nephropathy (BKVAN). In children, the usefulness of stent placement is not well defined.Methods.We analyzed retrospective data from children transplanted at our center for the three above outcomes in relation to stents. At our center, stent placement decision is driven by surgeon preference.Results.Among 129 transplants from 1996 to 2006, early UTI was seen in 9.3% and S/L in 4.6%. By univariate analyses, stent placement was a significant risk factor for early UTI (P= 0.0399) but not protective for S/L (P= 0.23). In multivariate analyses, stent placement, human leukocyte antigen match, and bladder augmentation increased the odds ratio for early UTI. Only deceased donor source increased the odds ratio for S/L. In a truncated data set from 1999 to 2006, BKVAN occurred in 9 of 93 (9.6%). Per minute increase in warm ischemia time was the only significant risk factor for BKVAN by both univariate and Cox regression analyses. Stent placement did not improve graft survival (P= 0.5726) but required general anesthesia for removal in the operating room, leading to additional cost and potential risk.Conclusion.Routine stent placement in children in this era of low urological complication rates and BKVAN needs reevaluation.
