Ex vivo removal of stones in donor kidneys by pyelotomy prior to renal transplantation: a single-center case series

Liu, Luhao; Li, Guanghui; Zhang, Peng; Chen, Rongxin; Guo, Yuhe; Zhang, Lei; Fang, Jiali; Ma, Junjie; Chen, Zheng

doi:10.21037/tau-22-335

Cited by 3 publications

(2 citation statements)

References 9 publications

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“…The incision was closed with absorbable suture. All patients were followed with ultrasounds performed at 1, 3, and 6 months postoperatively with no recurrences of stone 18 . The series from both Bosio et al and Sarier et al also included patients who underwent pyelotomy.…”

Section: Discussionmentioning

confidence: 99%

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Ex‐vivo ureteroscopy, laser lithotripsy, and stone basketing extraction of deceased donor kidney stones during machine perfusion preservation

et al. 2023

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The incidence of nephrolithiasis in kidney donors is rare. The timing and treatment of nephrolithiasis in deceased donor kidneys are not well established. While some programs have proposed ex‐situ rigid or flexible ureteroscopy treatment before transplantation, we report on two cases of kidney stones in the same deceased donor that we treated by flexible ureteroscopy and laser lithotripsy performed during the storage time on a hypothermic perfusion machine. Two deceased donor kidneys were found to have multiple kidney stones discovered on preprocurement CT imaging. The right kidney had less than five 2–3 mm stones, whereas the left had five to ten 1 mm stones with a single 7 mm stone. Both organs were placed on a hypothermic perfusion machine and maintained at a temperature of 4°C. An ex‐vivo flexible ureteroscopy with laser lithotripsy and basket extraction was performed while the kidneys were maintained on Lifeport* perfusion machine. The cold ischemia time was 16.9 and 23.1 h. After 12 months of observational follow‐up, neither recipient had nephrolithiasis, UTI, or other urologic complications. The creatinine values now are 1.17 and 2.44 mg/dL (103.4 and 215.7 μmol/L), respectively. Ex‐vivo flexible ureteroscopy with laser lithotripsy and stone removal on machine‐perfused kidneys appears to be safe and offers a good option to treat graft nephrolithiasis and prevent posttransplant complications. Ureteroscopy serves as a minimally invasive treatment option with direct stone removal. Performing this while on machine perfusion minimizes the ischemic time of the kidney and resultant complications or delays in graft function.

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Section: Discussionmentioning

confidence: 99%

“…All patients were followed with ultrasounds performed at 1, 3, and 6 months postoperatively with no recurrences of stone. 18 The series from both Bosio et al and Sarier et al also included patients who underwent pyelotomy. Bosio et al 13 included four patients who required ureteroscopic-guided pyelotomy.…”

Section: Discussionmentioning

confidence: 99%