2316 DOES THE USE OF URETERAL STENTS IN RENAL TRANSPLANT ALLOGRAFTS INCREASE THE RISK OF MULTI-DRUG RESISTANT URINARY TRACT INFECTIONS OR DECREASE LONG TERM FUNCTION OF THE ALLOGRAFT?

Abstract

INTRODUCTION AND OBJECTIVES: Post renal transplant infectious complications are largely due to urinary tract infections (UTIs). We determined whether the use of a stent increased the risk of developing a multi-drug resistant urinary tract infection in renal transplant patients or affected long term function of the allograft. METHODS: We retrospectively analyzed our transplant cases from 2006-2009 (N 172). We divided our cohort into stented or nonstented. We analyzed the cases for development of first post transplant UTI. We further analyzed these positive urine cultures for the presence of multidrug resistance. Of the patients that developed infections we looked at gender, race, ethnicity, preoperative GU anatomic anomalies, and postoperative complications and whether these variables had any significance in the development of postoperative multidrug resistant UTI. Stents were removed at 3 weeks posttransplant. Comparisons of variables between the two cohorts were evaluated using the SAS statistical software. T-test and Chi square were utilized to compare the 2 cohorts with p 0.05 considered significant. RESULTS: Our data analysis found that there was no significant difference in the development of a multidrug resistant UTI in stented versus non-stented patients. Factors having significance in posttransplant multidrug resistant UTI development were female gender (p 0.02) and postoperative complications (p 0.001). Patients with prior GU abnormalities had an increased incidence of postoperative UTI however this did not reach statistical significance. There was no significant difference by race or age. The graft function was the same whether patients had a stent or no stent. CONCLUSIONS: Our data shows that the risk of development of a multidrug resistant UTI was not increased by the use of a stent at the time of transplant. The risk of multidrug resistant UTI is increased if the patient is female, has had prior GU anomalies, or had postoperative complications.