Renal transplantationComplication: MetabolicLithiasis in 1,313 Kidney Transplants: Incidence, Diagnosis, and Management
Section snippets
Materials and Methods
We retrospectively reviewed the records of 1,313 patients undergoing renal allotransplantation from February 1968 to February 2011. The transplants were performed in the right or left iliac fossa with vascular anastomoses to the iliac artery and vein. Ureteral implantation (ureteroneocystostomy) was performed using the modified extravesical technique of Lich-Gregoir, without routine use of a ureteral catheter. Immunosuppression varied with the transplantation era. For the diagnosis of
Results
Among the 1,313 transplants, 17 (1.29%) showed nephrolithiasis in the renal graft. Nine recipients were female and 8 male. Ages ranged from 32 to 63 years (mean 45.6 years). Fifteen patients received kidneys from cadaveric donors and only 2 from living related donors. Two stones, both located inside the ureter, were identified during transplant surgery (11.7%); 3 cases of lithiasis were incidentally diagnosed by US during graft evaluation before the 7th day after surgery (17.6%); all 3 in the
Discussion
More than one-half of the patients with stones in a kidney transplantation did not show any symptom of pain. The plausible explanation for this observation is denervation of the transplanted graft.2, 5, 10, 11 In some cases, concomitant elevation of serum creatinine should be considered with caution to avoid a mistake episode of acute rejection.4 The presence of an uncomplicated calculus is not a contraindication for surgery; however, when there is associated infection the transplantation
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Kidney stones in renal transplant recipients: A systematic review
2024, Actas Urologicas EspanolasEvaluation of the Effectiveness of Interventions on Nephrolithiasis in Transplanted Kidney
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2020, Nephrologie et TherapeutiqueEvaluation of the Renal Transplant Recipient in the Emergency Department
2019, Emergency Medicine Clinics of North AmericaCitation Excerpt :Relevant to emergency medicine, many patients do not experience pain, owing to denervation of the transplanted graft. Therefore, stones tend to be found incidentally or during work-up for other symptoms, such as oliguria, renal failure, gross hematuria, and infection.25,26 Because of the lack of typical pain and atypical presentation, nephrolithiasis can be mistaken for acute rejection.25
Over 30-yr Experience on the Management of Graft Stones After Renal Transplantation
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2016, International Journal of SurgeryCitation Excerpt :An update of the different modalities used in the treatment of de novo renal transplant urolithiasis is summarized in Table 2. SWL is eventually the most pleasant and least invasive modality for the management of graft calculi [4,34]. It is recommended that patients harboring stones less than 1.5 cm should be optimum candidates; additionally, combining the SWL with flexible ureteroscopy might clear the remaining stones if SWL failed [21].