<i>Ex vivo</i> stone surgery in donor kidneys at renal transplantation

Sarıer, Mehmet; Duman, İbrahim; Yüksel, Yücel; Tekin, S.; Özer, Mustafa; Yücetin, L.; Yavuz, Alpaslan; Demirbaş, A.; Kukul, Erdal

doi:10.1111/iju.13755

Cited by 20 publications

(15 citation statements)

References 17 publications

(56 reference statements)

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“…The main advantage of CT is that precontrast imaging enables the detection of asymptomatic kidney stones. Donor kidney stones are known to be a relative contraindication for transplantation [9]. Ultrasonography has a low sensitivity, especially in the detection of kidney stones <5 mm, and noncontrast CT is currently the gold standard for visualizing stones of this size [10].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Renal Arteries of 2,144 Living Kidney Donors Using Computed Tomography Angiography and Comparison with Intraoperative Findings

et al. 2020

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Objectives: A carefully chosen and suitably prepared kidney donor is essential in living-donor kidney transplantation. Computed tomography angiography (CTA) is an effective imaging method for evaluating the renovascular morphology of donor candidates. The aim of this study was to evaluate renal artery variations in kidney donors using CTA and compare the findings with the number of arteries detected during laparoscopic donor nephrectomy. Materials and Methods: The study included 2,144 living donors who underwent pretransplant renovascular assessment using CTA and laparoscopic donor nephrectomy in our center between August 2012 and October 2018. The number of renal arteries to the donor kidney detected on CTA was compared with the number of arteries discovered intraoperatively. Results: The mean age of the 2,144 living kidney donors included in the study was 47.19 ± 13.3 (18-87) years. According to CTA findings, 81.1% (n = 1,738) had a single renal artery, 17.2% (n = 369) had double renal arteries, 1.6% (n = 35) had triple renal arteries, and 0.1% (n = 2) had quadruple renal arteries. The same number of renal arteries were detected by CTA and in laparoscopic donor nephrectomy in 97.9% (n = 2,099) of the donors. In the other 2.1% (n = 45), fewer renal arteries were detected intraoperatively compared to their CTA findings. None of the donors included in the study had a greater number of renal arteries discovered during nephrectomy than by CTA. Conclusion: CTA is a highly accurate method for the evaluation of renovascular variations in donor candidates for living-donor kidney transplantation. However, it must be kept in mind that double or multiple renal artery variations may be detected on CTA in 18.9% of donor candidates.

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Section: Discussionmentioning

confidence: 99%

Evaluation of the Renal Arteries of 2,144 Living Kidney Donors Using Computed Tomography Angiography and Comparison with Intraoperative Findings

et al. 2020

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“…The stonefree rates of ex vivo stone surgery reported in the literature range between 89.5 and 100% [45,46]. A recently published series of 13 donors with 4-15 mm stones who underwent ex vivo ureteroscopy (n = 6) or ex vivo pyelolithotomy (n = 7) further demonstrated the safety and efficacy of both procedures in live donor kidney transplantation [47]. The authors recommended ex vivo ureteroscopy as the first choice because it is easy to perform and has a low risk for morbidity, and they also recommended using a pediatric cystoscope for the procedure because it allows better handling and maneuvering.…”

Section: Allograft Urolithiasismentioning

confidence: 99%

Update on the Management of Urological Problems Following Kidney Transplantation

Sarıer

Yayar²,

Yavuz³

et al. 2021

Urol Int

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Urological problems in kidney transplant recipients are not limited only to posttransplantation urological complications. These problems are a cause of significant patient mortality and morbidity that have wide-ranging effects on graft survival throughout the entire life of the graft. Ultimately, the transplant comprises a major portion of the urinary system; therefore, the transplant team should be prepared for foreseeable and unforeseeable urological problems in the short and long terms. These mainly include postoperative urological complications (urine leakage, ureteral stenosis, and vesicoureteral reflux), bladder outlet obstruction, and graft urolithiasis. In recent years, significant advances have been made in the management of urological complications, especially due to advances in endourologic interventions. The aim of this review is to summarize the management of urological problems after kidney transplantation in the context of the current literature.

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“…An urgent problem and challenge for organ transplant physicians is how to maximize the use of organs available for transplantation. Many transplant centers have reported success using a kidney with stones as a donor kidney, and all have achieved good results (5,6). A previous study has shown that minimally invasive treatment of kidney stones in vitro can minimize the damage to the donor kidney, and donor kidney stones are no longer an absolute contraindication for kidney transplantation (7).…”

Section: B C Amentioning

confidence: 99%

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

Liu¹,

Li²,

Zhang³

et al. 2022

Transl Androl Urol

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Background: Donors with incidentally discovered asymptomatic renal stones was considered a relative contraindication to the kidney donation because of a potential increased morbidity risk for renal transplant recipients. Stone clearance from the donors should be done before donation to ensure safety of the recipient. This study aimed to observe the safety and efficacy of kidney transplantation from donors with nephrolithiasis who received pyelolithotomy before transplantation.

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Ex vivo stone surgery in donor kidneys at renal transplantation

Abstract: Our experience suggests that both ex vivo ureteroscopy and ex vivo pyelolithotomy procedures can safely and effectively be carried out in stone-bearing living donor kidneys, without compromising renal allograft function.

Cited by 20 publications

References 17 publications

Evaluation of the Renal Arteries of 2,144 Living Kidney Donors Using Computed Tomography Angiography and Comparison with Intraoperative Findings

Evaluation of the Renal Arteries of 2,144 Living Kidney Donors Using Computed Tomography Angiography and Comparison with Intraoperative Findings

Update on the Management of Urological Problems Following Kidney Transplantation

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

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