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Implementing a Ureteric Magnetic Stent in the Kidney Transplant Setting

Report of 100 Consecutive Cases

Capocasale, Enzo MD1; Cremaschi, Elena MD, PhD1; Valle, Raffaele Dalla MD1; Ferretti, Stefania MD2; Pellegrino, Carlo MD1; Iaria, Maurizio MD, PhD1; Puliatti, Carmelo MD1

doi: 10.1097/TP.0000000000002855
Original Clinical Science—General
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Background. Kidney transplantation (KT) is the treatment of choice for end-stage kidney disease. The double-J-stent has been used to prevent urological complications (UCs), but it requires cystoscopy extraction. The novel magnetic black star (MBS) stent provided with a customized retrieval device (9 or 15 Fr) has been developed to spare cystoscopy. Scope of the paper is to analyze MBS in 100 consecutive KTs.

Methods. We report a retrospective analysis of 100 consecutive KT performed between April 2015 and September 2018 using MBS (4.8 Fr, 15 cm) to protect Lich-Gregoir ureteroneocystotomy. MBS was removed 4 weeks after KT by either the 9 Fr (61 cases) or the 15 Fr (39 cases) retrieval device.

Results. Intraoperative MBS insertion was straightforward in all cases, and its extraction was carried out in the outpatient setting in 93 patients. Extraction time was <30 seconds in 45 out of 61 patients (73.8%) and in 38 out of 39 patients (97.4%) using the 9 Fr and the 15 Fr retrieval device, respectively. In 15 patients, MBS removal took between 30 seconds and 3 minutes. Only 2 cases required extraction by cystoscopy. We observed 2 UC (ureteric leak and stenosis), 8 urinary tract infections, and 9 stent-related symptoms. 7 patients experienced distressing pain according to Visual Analog Scale for Pain.

Conclusions. In our cohort, MBS appeared to be safe and cost-effective. We advocate its routine implementation in KT because of an easy and comfortable extraction in the outpatient setting even by nondedicated staff, without detrimental impact on UC and urinary tract infection rates.

1 Division of General Surgery and Organ Transplantation, Azienda Ospedaliero-Universitaria di Parma, Parma, Emilia-Romagna, Italy.

2 Division of Urology, Azienda Ospedaliero-Universitaria di Parma, Parma, Emilia-Romagna, Italy

Received 9 March 2019. Revision received 17 May 2019.

Accepted 7 June 2019.

The authors declare no funding or conflicts of interest.

E.C., E.C., M.I., and C.P. participated in research design, writing of the paper, and data analysis. R.D.V and S.F. participated in research design. C.P. participated in research design and data analysis.

Supplemental digital content (SDC) is available for this article. Direct URL citations appear in the printed text, and links to the digital files are provided in the HTML text of this article on the journal’s Web site (www.transplantjournal.com).

Correspondence: Elena Cremaschi, MD, PhD, viale Duca Alessandro 27, 43123 Parma, Italy (elena.cremaschi@yahoo.com)

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.