Percutaneous treatment of obstructive uropathy in renal transplant recipients: outcomes of nephrostomy tube placement within and after 30 days of transplantation

PurposeTo evaluate outcomes of percutaneous nephrostomies (PCN) in renal transplant recipients, and compare outcomes of PCN placement before and after 30 days from transplant.Material and methodsA retrospective audit of 1041 transplants undergoing PCN was performed. PCN population was classified into early-PCN and late-PCN groups (<30/>30 days from transplant). Graft survival (GS) was compared between early/late groups and transplants with and without PCN.Results79 (7.6%, n = 79/1041) transplants underwent 89 PCN procedures. 67 (75%, n = 67/89) underwent nephroureteral stent (NUS) placement and 12 (25%, n = 12/89) were simple PCN placements. Procedure-related complications in early-vs. late-PCN were 4.3%, (n = 1/23) and 3.0% (n = 2/66) p > 0.05. Catheter-related complications in early-PCN vs. late-PCN were 13%, (n = 3/23) and 11% (n = 7/66) p > 0.05. Graft survival at 12, 36, and 48 months after PCN placement for early-PCN vs. late-PCN was 86% ± 7, 81 ± 8, and 81 ± 10 vs. 93% ± 3, 75 ± 8, and 66 ± 9, respectively (p = 0.50). Graft survival at 1, 4, and 10 years after transplant in early-PCN vs. late-PCN was 86% ± 7, 86 ± 8, and 29% ± 17 vs. 96% ± 2, 81 ± 6, and 61 ± 13, respectively (p = 0.01). Graft survival for all PCN vs. no-PCN transplants at 1, 4, and 10 years were 94% ± 3, 83% ± 5, and 55% ± 11 vs. 92% ± 1, 80% ± 1, and 59% ± 3, respectively (p = 0.50).ConclusionPCN in renal transplantation is safe and effective with no effect on graft survival. Early PCN poses no additional risk to the graft; however, it is a poor prognostic indicator for long-term graft survival.