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Kidney Week

Abstract: PO2122

Kidney Graft Ultrasound (US) After Elective JJ Stent Removal (EJJR)

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Sosa Barrios, Haridian, Hospital Universitario Ramon y Cajal, Madrid. IRYCIS, Madrid, Spain
  • Burguera, Victor, Hospital Universitario Ramon y Cajal, Madrid. IRYCIS, Madrid, Spain
  • Viera, Elizabeth R., Hospital Universitario Ramon y Cajal, Madrid. IRYCIS, Madrid, Spain
  • Villa, Daniel, Hospital Universitario Ramon y Cajal, Madrid. IRYCIS, Madrid, Spain
  • Galeano, Cristina, Hospital Universitario Ramon y Cajal, Madrid. IRYCIS, Madrid, Spain
  • Jimenez Alvaro, Sara, Hospital Universitario Ramon y Cajal, Madrid. IRYCIS, Madrid, Spain
  • Martin Capon, Irene, Hospital Universitario Ramon y Cajal, Madrid. IRYCIS, Madrid, Spain
  • Fernandez-Lucas, Milagros, Hospital Universitario Ramon y Cajal, Madrid. IRYCIS, Madrid, Spain
  • Rivera Gorrin, Maite, Hospital Universitario Ramon y Cajal, Madrid. IRYCIS, Madrid, Spain
Background

Improving kidney transplant (KTx) outcomes remains a primary challenge and KTx ureter JJ stenting has been used to prevent urological complications. There is no consensus about EJJR timing, and literature regarding routine US imaging after EJJR to detect complications is lacking.

Methods

We retrospectively analysed all routine KTx US done in our Unit from 2016-2020 by an experienced interventional nephrologist. US post EJJR findings were compared with previous US. KTx characteristics, treatment and outcomes were recorded. We aimed to define incidence of urological complications diagnosed, US utility and best time interval to perform it.

Results

345 KTx were done: 62.9% were male receptors, 81.7% had a first KTx and 91.5% of the organs were from a deceased donor. No routine US post EJJR was done in 20.9% due to COVID pandemic. Mean timing to elective JJ stent removal was 36.4 ± 25 days (SD).
Mean time from EJJR to US was 16.3 ± 28.8 days (SD).
Urinary tract ectasia was not considered pathological. Of those with an US, 45.1% (123) had a complication detected: 41.4% had a newly diagnosed collection and 21% had urinary tract dilatation (UTD):
10% grade I UTD.
6% grade II UTD.
5% grade III UTD.
Of the 123 patients with a complication, 3 required a surgical approach, 2 had a drainage inserted, 2 nephrostomies, 11 required admission without surgical intervention and 51 had US follow up.
Cumulative frequency analysis of complications post EJJR showed the highest diagnostic yield of US imaging was around day 10 post removal (figure 1).

Conclusion

Routine US after EJJR allowed timely diagnosis and early treatment of urological complications, a key factor for successful transplantation.
KTx US is an effective, cheap and reproducible test that provides crucial information to guide clinical decisions, being most effective when performed 10 days post stent removal. Interventional nephrologists could do this examination promptly.

Figure 1. Cumulative frequency of complications