Urological issues in renal transplants Urological and Genital Diseases Urological issues
Conditions
Interventions
There are two potential study arms to which patients are allocated:
Group 1: Standard technique for Transplant Ureteric Stent removal (sTUSr), or
Group 2: New technique with early Transplant Ureteric
Sponsors
Guy's and St Thomas' NHS Foundation Trust (UK)
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Children aged 2 - 16 years, either sex 2. Adults aged 17 - 75 years, either sex 3. Needing kidney transplant
Exclusion criteria
Exclusion criteria: 1. Urinary Tract exclusion: 1.1. Urinary diversion e.g. ileal conduit, cutaneous ureterostomy, mitrofanoff 1.2. Duplex transplant ureter 1.3. Pelviureteric junction obstruction 1.4. Surgical concern regarding the vascularity of the transplant ureter 1.5. Donor kidney stone and use of bench (ex-vivo) ureteroscopy 1.6. Early use of mammalian target of rapamycin (mTOR) inhibitors (early use is very uncommon as the drug has well documented concerns regarding worse tissue healing) 2. Risk of bleeding: 2.1. Kidney capsule removed at retrieval 2.2. Need for post-operative systemic heparinisation 2.3. Greater than 3 cycles of pre-operative plasma exchange (DFFP) as part of transplant desensitisation program 3. Simultaneous kidney and pancreas transplant (SPK)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Stent-related complications, specifically urinary infection, pain and migration. Information collected at each OP visit for 3 months. | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Rate of transplant ureteric leak or stenosis: information collected at each OP visit for up to 6 months 2. Patient acceptability, measured with quality of life questionnaires at week 1 and week 6 3. Economic costs (hospital and patient): Patient diary card on day of stent removal, hospital costs can be evaluated at 6 months | — |
Countries
United Kingdom
Outcome results
None listed