Donor-gifted allograft urolithiasis: early percutaneous management

Lu, Hsu‐Feng; Shekarriz, Bijan; Stoller, Marshall L.

doi:10.1016/s0090-4295(01)01490-x

Cited by 73 publications

(57 citation statements)

References 5 publications

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“…It was noteworthy that the rate of nephrolithiasis was not significantly higher after renal transplantation compared to patients undergoing maintenance dialysis on the renal transplant waiting list. It has generally been assumed that, due to careful donor selection to rule out possible stone formers (17,18), nephrolithiasis may be less common after renal transplantation than in the general population. However, the apparent increased risk shown in the present study could be due to several factors.…”

Section: Discussionmentioning

confidence: 99%

Hospitalized Nephrolithiasis after Renal Transplantation in the United States

Abbott

Schenkman²,

Swanson

et al. 2003

American Journal of Transplantation

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The national incidence of and risk factors for hospitalized nephrolithiasis (NEP) in renal transplant (RT) recipients has not been reported. We conducted a historical cohort study of 42 096 RT recipients in the United States Renal Data System between 1 July 1994 and 30 June 1998. The 1-year incidence of NEP (ICD-9 codes 592.x) after RT in 1997 was compared to the rate of NEP in the general population using the National Hospital Discharge Survey. Associations with time to hospitalizations for a primary diagnosis of nephrolithiasis were assessed by Cox Regression. NEP was uncommon after RT (104 cases per 100 000 person years in 1997). However, females, but not males, had a statistically significant increased risk of NEP compared to the general population (rate ratio for females, 2.84, 95% confidence interval, 2.35-3.58). Kidney stones were more common than ureteral stones, and percutaneous procedures were more common than ureteroscopy or extracorporeal shock wave lithotripsy (ESWL). The only risk factor identified for NEP was renal failure due to stone disease (only one case). NEP was uncommon after RT, but was still more common than in the general population. We identified differences in the presentation and management of NEP after RT in comparison to the general population.

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Section: Discussionmentioning

confidence: 99%

Hospitalized Nephrolithiasis after Renal Transplantation in the United States

Abbott

Schenkman²,

Swanson

et al. 2003

American Journal of Transplantation

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“…Furthermore, PNL has been performed in the early postoperative period with minimal morbidity. 28 Nevertheless, certain precautions have to be addressed. Ultrasonography guidance is mandatory, as fluoroscopy alone might be insufficient because of difficult retrograde access.…”

Section: Discussionmentioning

confidence: 99%

Untitled

2017

Exp Clin Transplant

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Objectives: We report on the long-term follow-up of managing allograft stones at a single tertiary referral institution and review the relevant literature. Materials and Methods: A retrospective analysis of renal allograft recipient charts was performed to identify patients who developed allograft lithiasis between 1974 and 2009. Patient and stone characteristics, diagnoses, treatments, and outcomes were described. Results: Sixteen patients developed 22 stones after a median follow-up of 170 months (range, 51-351 mo). The mean (standard deviation) and median diameter of the stones were 13.8 (8.5) mm and 11 mm. Among these, 3 stones were treated conservatively, 3 by shock-wave lithotripsy, and 7 by cystolitholapaxy. Seven patients underwent percutaneous treatment in the form of percutaneous nephrostomy tube fixation and spontaneous passage of stone (1 stone), shock-wave lithotripsy (1 stone), antegrade stenting (1 stone), and percutaneous nephrolithotomy (6 stones). All patients were stone free after treatment, except for 2 patients whose stones were stable and peripheral on long-term follow-up. Conclusions: Allograft lithiasis requires a multimodal treatment tailored according to stone and graft characteristics. Protocols regarding spontaneous passage can be adopted if there is no harm to the graft and the patient is compliant. Careful attention to the anatomy during percutaneous nephrostomy tube placement is mandatory to avoid intestinal loop injury. A more attentive follow-up is required for early stone management.

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“…Sunulan olguda PUV mesanesine bağlı üreter komplikasyonu riski düşünülerek DJS yerleştirilmiştir. Böbrek nakli hastalarında taş hastalığı için risk faktörleri fazla olmasına karşılık nakil böbrekte taş görülme oranı normal populasyondan daha düşük olup %0,2-%1,7 arasında rapor edilmektedir (6,7). Allograft böbrekte stent unutulması, taş ve obstrüksiyon oluşması çok ciddi morbiditeye, nadir de olsa mortaliteye sebep olabilir.…”

Section: Discussionunclassified

Management of Encrusted Ureteral Stent with Mini Percutaneous Nephrolithotomy in Patient with Kidney Transplantation

Aki¹,

Koni²,

Bilen³

et al. 2010

Turk Neph Dial Transpl

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ÖZÜreter stentleri böbrek nakli yapılan hastalarda ürolojik komplikasyonları azaltmak için sıklıkla kullanılmaktadır. Ancak böbrek nakilli hastalarda stent kullanımı ciddi komplikasyonlara neden olabilir. Stent enkrüstasyonu üreteral stentlerin en ağır komplikasyonudur. Bu yazıda böbrek nakli sırasında yerleştirilen bir üreteral stentte kısa sürede gelişen enkrüstasyon olgusu bildirilmiştir. Posterior üretral valv nedeni ile son dönem böbrek yetmezliği gelişen 12 yaşında bir hastaya kadavradan yapılan böbrek nakli sırasında üretere double J stent yerleştirilmiştir. Düşük moleküler ağırlıklı heparin ile antikoagülan tedavi alan hastanın 6 hafta sonra stenti çekilmek istendiğinde ciddi kalsifikasyon olduğu gözlenmiş ve stent çıkarılamamıştır. Bunun üzerine önce kateterin mesane tarafında oluşan taşlar in situ kırılarak temizlenmiş daha sonra mini perkütan nefrolitotomi uygulanmıştır. Stent etrafında ve böbrekte oluşan taşlar çıkarıldıktan sonra double J stent perkütan olarak çıkarılmıştır. Enkrüste üreter stentlerinin çıkarılması her zaman zordur. Antikoagülan tedavi alan hastalarda ve böbrek nakli hastalarında komplikasyon riski daha yüksektir. Mini perkütan nefrolitotomi bu hastalarda daha düşük komplikasyon riski ile birlikte başarı ile uygulanabilir. Üreter stentleri, komplikasyonlarından korunmak için kliniğimizde sadece komplikasyon riski yüksek seçilmiş olgularda kullanılmaktadır.ANAHTAR sÖZCüKLER: Böbrek nakli, Stent, Komplikasyon, Taş hastalığı ABsTRACTUreteric stents has been widely used in kidney transplantation practice to decrease major urologic complications. However ureteral stenting is associated with some specific complications in patients with kidney transplantation. A case of a renal transplantation patient whose ureteral stent was heavily encrusted is reported. A 12-year-old boy with end stage renal disease secondary to posterior urethral valve received a cadaveric renal transplantation. A ureteral double J stent was placed peroperatively. The patient was anticoagulated with low molecular weight heparin postoperatively. Stent encrustation was noticed during cystoscopy and the stent could not be removed. Following cystolithotripsy, the kidney stones and ureteric stents were removed successfully with mini percutaneous nephrolithotomy. The removal of an encrusted ureteric stent is always a urological challenge. The complication risk is even higher in patients receiving anticoagulation therapy and with kidney transplantation. Mini percutaneous nephrolitotomy techniques can be employed successfully with a lower complication risk. Selective stenting is preferred in our clinic to avoid the specific complications of ureteric stents. GİRİŞSon dönem böbrek yetmezliğinin günümüzde en iyi tedavi yöntemi böbrek naklidir. İdrar kaçağı, obstrüksiyon gibi major ürolojik komplikasyonlar nakil sonrası önemli morbidite nedenleri arasındadır. Son yıllarda yeni immünsupresif tedavi protokollerinin kliniklere girmesi ve cerrahi tekniklerin gelişmesi ile ürolojik komplikasyonların görülme sıklığı azalmış olup %5-%10...

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Donor-gifted allograft urolithiasis: early percutaneous management

Cited by 73 publications

References 5 publications

Hospitalized Nephrolithiasis after Renal Transplantation in the United States

Hospitalized Nephrolithiasis after Renal Transplantation in the United States

Untitled

Management of Encrusted Ureteral Stent with Mini Percutaneous Nephrolithotomy in Patient with Kidney Transplantation

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