Abstract
Objectives: Ureteral stend use is a risk factor for BK
nephropathy (BKVN). In 2015, we compared the patients with anti-reflux
mechanism DJS (ARD-DJS) and those used standard DJS (st-DJS) in terms of
BKV and BKVN frequency in 90 kidney transplant patients in two centers.
With the increase in the number of our patients over time and
lengthening of the follow-up duration, we needed to re-evaluate the data
in one center.
Materials and Methods: We retrospectively evaluated 211
patients who underwent kidney transplantation at Diyarbakır Gazi
Yaşargil Training and Research Hospital between September 2012 and
September 2019. The following parameters were recorded, demographic
data, immunosuppression protocols, presence of rejection, graft loss,
plasma BKV levels, and presence of BKVN.
Median and IQR follow-up time for ARD-DJS and St-DJS patients was 72
months (62,5-80,3 months) and 27,8 months (17,4-39,6 months)
respectively.
Results: Thirteen patients (6,1%) had BKV viremia. BKVN was
revealed by kidney biopsy in 3 of 13 patients. However, graft loss due
to BKVN was observed in only one patient. ARD-DJS was used in 4 of these
cases and standard DJS was used in 9 of these cases. Patients in whom
BKV revealed in the first 3 months were compared in the aspect of DJS
technique, BKV was significantly less observed in the ARD-DJS group
(ARD-DJS: 2 patients; St-DJS:9 patients), (p=0,046).
Conclusions: In our study, BKV was observed less in patients
with ARD-DJS that were clinically significant but not statistically
significant. Therefore, prospective randomized studies with high patient
numbers are needed to determine the effectiveness of ARD-DJS.