Percutaneous Nephrolithotomy of Transplanted Kidney

Francesca, F.; Felipetto, R.; Mosca, Franco; Boggi, Ugo; Rizzo, G; Puccini, R

doi:10.1089/089277902753752179

Cited by 55 publications

(23 citation statements)

References 5 publications

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“…Percutaneous management of stones in ectopic [10,11] and transplanted [4,6,7] kidneys with standard PCNL is a well-accepted treatment modality that has been described by various authors over the past decade.…”

Section: Discussionmentioning

confidence: 99%

“…PCNL in a transplant kidney was described in 1985 [1] and since that time has been performed at multiple centers with acceptable safety and efficacy [1,2,3,4,5,6,7]. Due to the potential incremental risk in a transplant kidney allograft, some feel that PCNL should be limited to treatment of only larger stone burden, and only at experienced centers.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Mini-Percutaneous Nephrolithotomy with Ureteral Access Sheath in a Transplanted Kidney: Case Report and Literature Review

Kadlec¹,

Ross²,

Milner³

2012

Urol Int

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This is the case of a 69-year-old woman with a history of right iliac fossa living-related kidney transplant that developed acute renal failure due to an obstructing stone in the proximal transplant ureter. She was successfully treated with mini-percutaneous nephrolithotomy wherein a 14-Fr tract was created with serial dilation and a 14-Fr ureteral access sheath was used for access. A flexible ureteroscope with holmium laser and a helical wire basket were used to fragment and extract the stone, respectively. A 10-Fr nephrostomy tube was left for postoperative drainage. There are only a few published reports of mini-percutaneous nephrolithotomy in transplant kidneys, but those reports suggest that the procedure is safe and effective.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Mini-Percutaneous Nephrolithotomy with Ureteral Access Sheath in a Transplanted Kidney: Case Report and Literature Review

Kadlec¹,

Ross²,

Milner³

2012

Urol Int

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“…Furthemore, there have been reports of allograft renal artery injury and arteriovenous fistulae after trans abdominal access. Theremore, tract dilatation can become difficult to perform because of the presence of a fibrous sheath and limited mobility of the kidney during rigid nephroscopy (15). In our experience percutaneous nephrolithotomy was only carried out in two patients, one with staghorn calculus located in the lower calyx and the other with multiple pielocaliceal calculi.…”

Section: Discussionmentioning

confidence: 90%

Urolithiasis in renal transplantation: Diagnosis and management

Cicerello

Merlo

Mangano

et al. 2014

Arch Ital Urol Androl

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Obiectives: To report our experience of diagnosis and multimodal management of urolithiasis in renal transplantation. Patients and Methods: From January 1995 to December 2012, 953 patients underwent renal transplantation in the Kidney Transplant Unit of Treviso General Hospital. Ten (10%) of them developed urinary calculi and were referred at our institution. Their mode of presentation, investigation and treatment were recorded. Results: Seven had renal and 3 ureteral calculi. Urolithiasis was incidentally discovered on routine ultrasound in 6 patients, 1 presented with oliguria, 1 with anuria and acute renal failure and in 2 urolithiasis was found at removal of the ureteral stent. Nephrostomy tube was placed in 5 patients. Hypercalcemia with hyperparathyroidism (HPT) was present in 5 patients and hyperuricemia in 3. Two patients were primary treated by shock wave lithotripsy (SWL) and one of them was stone-free after two sessions. Two patients, one with multiple pielocaliceal calculi and the other with staghorn calculus in the lower calyx, were treated with percutaneous nephrolitothotomy (PCNL). Three patients were treated by ureteroscopy (URS) and in one of them two treatments were carried out. One patient had calculus impacted in the uretero-vesical anastomosis and surgical ureterolithotomy with re-do ureterocystoneostomy was performed after failure of URS. Two patients with calculi discovered at removal of the ureteral stent were treated by URS. Conclusions: The incidence of urolithiasis in renal transplantation is uncommon. In the most of patients the condition occurs without pain. Metabolic anomalies and medical treatment after renal transplantation may cause stone formation. Advancements in endourology and interventional radiology have influenced the management of urolithiasis that can be actually treated with a minimal incidence of risk for the renal allograft.KEY WORDS: Urolithiasis management, Renal transplantation. In the most of cases stone formation appears to form "de novo" after renal transplantation, although some studies suggest that the calculi are more often transplanted with the graft to the recipient (1, 5, 6). Theremore, metabolic anomalies causing stone formation could be present in allograft rather than native kidneys (7). Urolithiasis is often asymptomatic and the clinicians are not able to diagnose urinary calculi in renal transplant at an earlier stage. Neverthless, the prompt diagnosis and the subsequently stone removal is necessary to prevent adverse effects on a solitary kidney whose renal function is often borderline. Today the development of endourological tecniques for calculi management and interventional radiology for the emergency management of acute obstruction have minimized the potential risk for renal graft. However, such minimally invasive procedures could be performed only in centers that are well equipped and have expertise to offer the appropriate treatment. We evaluated our experience of renal transplant patients with urolithiasis, regarding the risk factors associate...

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“…9 Transplant recipients are more predisposed to developing urolithiasis due to their conditions such as: hyperfiltration, excessively alkaline urine, renal tubular acidosis, obstructive uropathy, recurrent urinary tract infections, and increased serum calcium caused by persistent tertiary hyperparathyroidism. [10][11][12][13][14] Many series have reported the mean time of posttransplantation lithiasis between 1.6 to 3.6 years. 4,15,16 As, this complication is usually asymptomatic, the diagnosis is often made incidentally by ultrasound examination followed by symptoms such as hematuria, oliguria/anuria, fever, elevated creatinine level, and positive urine culture.…”

Section: Discussionmentioning

confidence: 99%

Tubeless percutaneous nephrolithotomy (pcnl) in renal allografts: a case report and mini-review

et al. 2016

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Urinary lithiasis in transplanted kidney is a relatively uncommon complication. However, it may lead to a significant morbidity and loss of renal function. The report presents the case of a 32-year-old male renal-transplant recipient, with a stone in renal pelvis who was treated successfully by tubeless percutaneous nephrolithotomy (PCNL). The patient is currently stone free with no complication. This article also reviews in brief the treatment of this rare complication. Reviewing the literature showed, it could be noticed that PCNL is a safe and feasible procedure for treating nephrolithiasis in a transplanted kidney.

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Percutaneous Nephrolithotomy of Transplanted Kidney

Cited by 55 publications

References 5 publications

Mini-Percutaneous Nephrolithotomy with Ureteral Access Sheath in a Transplanted Kidney: Case Report and Literature Review

Mini-Percutaneous Nephrolithotomy with Ureteral Access Sheath in a Transplanted Kidney: Case Report and Literature Review

Urolithiasis in renal transplantation: Diagnosis and management

Tubeless percutaneous nephrolithotomy (pcnl) in renal allografts: a case report and mini-review

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