We present a case of a 32-year-old hypertensive and obese male who had bilateral obstructive uropathy, and who was diagnosed as having pelvic lipomatosis on the basis of clinicoradiological findings. Cystoscopy and biopsy revealed cystitis cystica. He was successfully managed with bilateral extravesical modified Lich-Gregoir ureteric reimplantation by intraperitoneal approach. At 5 months follow-up, the patient had normal serum creatinine and was clinically asymptomatic.

Encountering a foreign body (FB) in the kidney is uncommon. Most of the time a FB is introduced externally (violence or accident) or through endourological interventions. An ingested FB reaching the kidneys is extremely rare. This article includes an interesting case of FB, which apparently reached the kidney through the gastrointestinal tract as well as a brief review of the relevant literature. The case was successfully managed laparoscopically.

Context:In India, there are a large number of end-stage renal disease (ESRD) patients waiting for renal transplant. Deceased donor organ transplantation (DDOT) is the possible solution to bridge the disparity between organ supply and demand. The concept of expanded criteria donors (ECDs) was developed to combat the huge discrepancy between demand and organ availability. However, ECD kidneys have a higher propensity for delayed graft function (DGF), and therefore worse long-term survival. We present our experience of deceased donor renal transplantation.Aims:We report single centre experience on DDOT including ECDs vis-à-vis patient/graft survival, graft function in terms of serum creatinine (SCr), rejection episodes, and delayed graft function in 44 DDOTMaterials and Methods:Between August 1998 and April 2011, 44 renal transplants from 35 deceased donors were performed, of which 37.2% were expanded criteria donors. Results were analyzed in terms of age of donor, terminal SCr, graft ischemia time, graft function, post-transplant complications, and graft and patient survival. All recipients received sequential triple drug immunosuppression and induction with rabbit antithymocyte globulin (rATG). The induction is commenced by giving first dose of rATG intraoperatively (dose 1.5 mg/kg) and subsequent rATG infusions were administered daily for a minimum of 5 and maximum of 7 doses depending on initial graft function.Results:We have been able to achieve a mean cold ischemia time of 6.25 ± 2.55 h due to the coordinated team efforts. Delayed graft function occurred in 34% patients and 31.8% had prolonged drainage. There were no urinary leaks. Seven (16%) patients had biopsy-proven rejection episodes, all of which were reversed with treatment. Two patients underwent graft nephrectomy. One of these was due to hyperacute rejection and another due to anastomotic hemorrhage. One-year graft survival was 92.4% and the patient survival was 83.8%.Conclusion:Deceased donor renal transplants have satisfactory graft function and patient survival despite the high incidence of delayed graft function. Retrieving kidneys from marginal donors can add to the donor pool.

Introduction. Donor workup in renal transplantation is extensive. Despite this, chyle leakage following donor nephrectomy, a rare complication, has been reported in the literature. We encountered two cases of chyle leak in kidney donors in our series of open donor nephrectomies. Summary of Cases. After complete workup, standard open retroperitoneal donor nephrectomy with drain placement was performed in 684 living renal donors. We encountered chyle leak in two cases. The first case was a 33-year-old female who underwent an otherwise uneventful left donor nephrectomy but continued to have high drain output (upto 300–400 mL/24 hrs) in the postoperative period. The drain fluid was milky, raising the suspicion of chyle which was confirmed on biochemical analysis. The second case was a 42-year-old female with a similar case history. Both were managed conservatively with low-fat diet. The leak subsided spontaneously in three weeks and one week in the first and second patients, respectively. The drain was removed, and the patients remained symptom-free on followup. Conclusions. Both of our cases of chyle leak following open donor nephrectomy were managed successfully with conservative management. The management options and the experience of other centers are reviewed and discussed.

Renal autotransplantation is a safe and effective procedure to reconstruct the urinary tract. The current indications for autotransplantation include renal vascular disease, severe ureteral damage, tumours of the kidney and ureter, complex nephrolithiasis and retroperitoneal fibrosis. We report a rare case where we had to perform renal autotransplantation along with hybrid surgery for aortic aneurysm repair. To our knowledge, this is the first case report of its kind for this specific condition.

Emphysematous pyelonephritis (EP) is a rare, severe gas forming infection of renal parenchyma and its surrounding areas and potentially life threatening condition that requires prompt evaluation and treatment. Although it commonly present with a fulminant clinical picture of sepsis, relatively mild symptoms can also be encountered. To our knowledge, incidentally detected emphysematous pyelonephritis has not been reported so far. We report a case of EP that was incidentally detected during evaluation for diabetes.

We present a rare case of renal perforation by a ureteric stent. A 62 yr old patient presented with repeated episodes of febrile urinary tract infections following double J stent placement. A CT scan revealed the upper end of the stent lying outside the kidney, having pierced through the cortex. Removal of the stent cystoscopically resulted in cure of the symptoms. Post insertion of stents, it should be mandatory to confirm correct deployment of the stent via X–ray.

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