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The Allium Ureteral Stent for the Treatment of Ureteral Complications Following Renal Transplantation—A Single-Center, Single-Surgeon Series
Ureteral complications such as urinary leak, ureteral necrosis or ureteral stenosis are common complications after renal transplantation with major short- and long-term issues, including graft impairment and graft loss. At present, there is no agreement on the optimal management of ureteral complica...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10179408/ https://www.ncbi.nlm.nih.gov/pubmed/37176757 http://dx.doi.org/10.3390/jcm12093317 |
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author | Weinberger, Sarah Hubatsch, Mandy Klatte, Tobias Neymeyer, Jörg Friedersdorff, Frank |
author_facet | Weinberger, Sarah Hubatsch, Mandy Klatte, Tobias Neymeyer, Jörg Friedersdorff, Frank |
author_sort | Weinberger, Sarah |
collection | PubMed |
description | Ureteral complications such as urinary leak, ureteral necrosis or ureteral stenosis are common complications after renal transplantation with major short- and long-term issues, including graft impairment and graft loss. At present, there is no agreement on the optimal management of ureteral complications. The aim of the current study was to evaluate the safety and efficacy of the self-expanding, large-caliber Allium ureteral stent in patients with ureteral complications following renal transplantation. In this retrospective study, the electronic database of Charité University Hospital was screened for patients receiving the self-expandable Allium ureteral stent in the transplant ureter after kidney transplantation between January 2016 and March 2022. Descriptive statistics were used to describe the outcomes. There were six men and four women with a median age of 61 years (interquartile range, 55 to 68 years). Nine out of 10 patients had ureteric stenosis, which was diagnosed at a median of two years (interquartile range 10 months to 9 years) following renal transplantation. The median operating time was 49 min (interquartile range, 30 to 60 min). Endoscopic Allium stent placement was successful in all patients with ureteric stenosis. The median length of stay in the hospital was four days (interquartile range 2 to 7 days). Only one patient (#5) had a postoperative grade IIIb Clavien–Dindo complication. Patients had follow-ups every 3 months with ultrasound and serum creatinine. Dislocation of the Allium stent was seen in four patients; all occurred within three months. Ultimately, three patients required ureteric re-implantation, two of which had early dislocation of the stent. Six patients are managed with a permanent Allium stent. The median dwell time was 11 months (interquartile range 3 to 20 months) and maximum dwell time was 23 months. The overall success rate was 60% (6 out of 10). According to our data, the Allium stent represents a safe and minimally invasive option with a success rate of 60%. It might, therefore, represent an alternative to DJ stents, nephrostomies or immediate re-implantation. As all dislocations occurred within three months, frequent early postoperative follow-up is required. |
format | Online Article Text |
id | pubmed-10179408 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-101794082023-05-13 The Allium Ureteral Stent for the Treatment of Ureteral Complications Following Renal Transplantation—A Single-Center, Single-Surgeon Series Weinberger, Sarah Hubatsch, Mandy Klatte, Tobias Neymeyer, Jörg Friedersdorff, Frank J Clin Med Brief Report Ureteral complications such as urinary leak, ureteral necrosis or ureteral stenosis are common complications after renal transplantation with major short- and long-term issues, including graft impairment and graft loss. At present, there is no agreement on the optimal management of ureteral complications. The aim of the current study was to evaluate the safety and efficacy of the self-expanding, large-caliber Allium ureteral stent in patients with ureteral complications following renal transplantation. In this retrospective study, the electronic database of Charité University Hospital was screened for patients receiving the self-expandable Allium ureteral stent in the transplant ureter after kidney transplantation between January 2016 and March 2022. Descriptive statistics were used to describe the outcomes. There were six men and four women with a median age of 61 years (interquartile range, 55 to 68 years). Nine out of 10 patients had ureteric stenosis, which was diagnosed at a median of two years (interquartile range 10 months to 9 years) following renal transplantation. The median operating time was 49 min (interquartile range, 30 to 60 min). Endoscopic Allium stent placement was successful in all patients with ureteric stenosis. The median length of stay in the hospital was four days (interquartile range 2 to 7 days). Only one patient (#5) had a postoperative grade IIIb Clavien–Dindo complication. Patients had follow-ups every 3 months with ultrasound and serum creatinine. Dislocation of the Allium stent was seen in four patients; all occurred within three months. Ultimately, three patients required ureteric re-implantation, two of which had early dislocation of the stent. Six patients are managed with a permanent Allium stent. The median dwell time was 11 months (interquartile range 3 to 20 months) and maximum dwell time was 23 months. The overall success rate was 60% (6 out of 10). According to our data, the Allium stent represents a safe and minimally invasive option with a success rate of 60%. It might, therefore, represent an alternative to DJ stents, nephrostomies or immediate re-implantation. As all dislocations occurred within three months, frequent early postoperative follow-up is required. MDPI 2023-05-06 /pmc/articles/PMC10179408/ /pubmed/37176757 http://dx.doi.org/10.3390/jcm12093317 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Brief Report Weinberger, Sarah Hubatsch, Mandy Klatte, Tobias Neymeyer, Jörg Friedersdorff, Frank The Allium Ureteral Stent for the Treatment of Ureteral Complications Following Renal Transplantation—A Single-Center, Single-Surgeon Series |
title | The Allium Ureteral Stent for the Treatment of Ureteral Complications Following Renal Transplantation—A Single-Center, Single-Surgeon Series |
title_full | The Allium Ureteral Stent for the Treatment of Ureteral Complications Following Renal Transplantation—A Single-Center, Single-Surgeon Series |
title_fullStr | The Allium Ureteral Stent for the Treatment of Ureteral Complications Following Renal Transplantation—A Single-Center, Single-Surgeon Series |
title_full_unstemmed | The Allium Ureteral Stent for the Treatment of Ureteral Complications Following Renal Transplantation—A Single-Center, Single-Surgeon Series |
title_short | The Allium Ureteral Stent for the Treatment of Ureteral Complications Following Renal Transplantation—A Single-Center, Single-Surgeon Series |
title_sort | allium ureteral stent for the treatment of ureteral complications following renal transplantation—a single-center, single-surgeon series |
topic | Brief Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10179408/ https://www.ncbi.nlm.nih.gov/pubmed/37176757 http://dx.doi.org/10.3390/jcm12093317 |
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