Early ureteral stent removal reduces urinary tract infection risk without increasing complications in living donor kidney transplantation - a systematic review and meta-analysis

Sep 30, 2026

Uploaded by James

Ureteral stenting after ureteral neoimplantation is standard in living donor kidney transplantation to lower major urological complications, yet prolonged stent duration may increase urinary tract infection (UTI) risk. This systematic review and meta-analysis compares early removal (≤3 weeks) versus late removal (>3 weeks) and evaluates UTI and major urological complications. Eight studies with 2,148 recipients were analyzed, showing early removal significantly reduces UTIs without increasing major urological complications, including obstruction and urinary leakage.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages9

Reading Time23 min

AccessFree to download

Background

Rationale for stenting and uncertainty on optimal removal timing

Methods

Literature search strategy and study selection

Outcomes and meta-analysis approach

Results

Included studies and effect on UTIs

Effect on major urological complications

Subgroup analyses for obstruction and urinary leakage

Conclusions

Clinical implication of early stent removal

Original Article Clin Transplant Res 2025;39:308-316 [https://doi.org/10.4285/ctr.24.0069](https://doi.org/10.4285/ctr.24.0069) pISSN 3022-6783 eISSN 3022-7712 Received December 13, 2024 Revised March 1, 2025 Accepted April 2, 2025 Corresponding author: Tanaya Ghinorawa Division of Urology, Department of Surgery, Dr. Sardjito General Hospital, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Kesehatan No. 1, Senolowo, Sinduadi, Mlati, Sleman, Daerah Istimewa, Yogyakarta 55281, Indonesia E-mail: [tanaya.ghinorawa@ugm.ac.id](tanaya.ghinorawa@ugm.ac.id) © The Korean Society for Transplantation This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ([http://creativecommons.org/licenses/](http://creativecommons.org/licenses/)[ ](http://creativecommons.org/licenses/)[by-nc/4.0/](by-nc/4.0/)) [which](which) permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Early ureteral stent removal reduces urinary tract infection risk without increasing complications in living donor kidney transplantation: a systematic review and meta-analysis Muhammad Halim Hanindya Kusuma, Tanaya Ghinorawa, Indrawarman Soero Hardjo Division of Urology, Department of Surgery, Dr. Sardjito General Hospital, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia Background: Ureteral stenting is commonly performed after ureteral neoimplantation during kidney transplantation to reduce major urological complications (MUCs) . However, the optimal duration of ureteral stent removal remains unclear, as longer stenting is associated with increased risk of urinary tract infection (UTI) . This study compared UTI and MUC incidence between early (≤3 weeks) and late (>3 weeks) stent removal following living donor kidney transplantation (LDKT) . Methods: We systematically searched the PubMed/MEDLINE, Science Direct, Cochrane, and EMBASE databases through January 2024 for randomized and observational studies comparing early (≤3 weeks) and late (>3 weeks) ureteral stent removal in LDKT recipients. The following Medical Subject Headings were used for the search: “kidney transplantation,” “renal transplantation,” and “ureteral stent” or “stent”. Stenting duration, UTI incidence, and MUCs (obstruction and urinary leakage) were recorded, and a meta-analysis was performed to pool odds ratios (ORs) . Results: Eight studies (five randomized controlled trials and three cohort studies) comprising 2,148 LDKT recipients were included. Early removal significantly reduced the incidence of UTIs compared with late removal (OR, 0. 53; 95% confidence interval [CI], 0.32–0.87) . Six studies assessed MUC incidence, revealing no significant difference between early and late removal (OR, 0.69; 95% CI, 0.28–1.65) . Subgroup analysis demonstrated that early stent removal does not increase the risk of obstruction (OR, 0.76; 95% CI, 0 .22–2.66) or urinary leakage (OR, 0.62; 95% CI, 0 .18–2.14) compared with late removal. Conclusions: Performing ureteral stent removal less than 3 weeks after LDKT reduces UTI risk without increasing MUCs relative to later removal. Keywords: Kidney transplantation; Ureteral stent; Urinary tract infections, Urological complications; Renal transplantation 308 [https://doi.org/10.4285/ctr.24.0069](https://doi.org/10.4285/ctr.24.0069) Kusuma MHH et al. Early ureteral stent removal reduces UTIs in LDKT HIGHLIGHTS • Removing ureteral stents early (≤3 weeks) reduces urinary tract infection risk in living donor kidney transplantation (LDKT) recipients. • No significant differences in major urological complications were observed between early and late stent removal in patients after LDKT. • Subgroup analyses indicated that early stent removal does not increase the risk of obstruction or urinary leakage compared to late removal in L

FAQs

What does the study compare regarding ureteral stents after living donor kidney transplantation?

It compares early ureteral stent removal (≤3 weeks) versus late removal (>3 weeks) after living donor kidney transplantation and evaluates UTI and major urological complications.

What is the main finding about UTI risk?

Early stent removal significantly reduces UTI incidence compared with late removal, with an odds ratio of 0.53 and a 95% confidence interval of 0.32–0.87.

Does early stent removal increase major urological complications like obstruction or urinary leakage?

No. The meta-analysis found no significant difference in major urological complications overall, and subgroup analyses showed early removal does not increase risk of obstruction or urinary leakage compared with late removal.

Sep 30, 2026

Uploaded by James