TY - JOUR
T1 - Intra-operative Postperfusion Micronephrolithotomy for Renal Allograft Lithiasis
T2 - A Case Report
AU - Favi, E.
AU - Raison, N.
AU - Zanetti, S.
AU - Sampogna, G.
AU - Montanari, E.
AU - Ferraresso, M.
PY - 2018/12/1
Y1 - 2018/12/1
N2 - Increasing demand drives the expansion of criteria for kidney donation, and nephrolithiasis is now considered a relative contraindication. We report for the first time a case of intra-operative, postperfusion kidney allograft micronephrolithotomy. A 64-year-old man with end-stage renal disease secondary to Alport syndrome underwent primary deceased donor kidney transplantation at our center. Pre-operative ultrasound of the donor identified a 7-mm calculus in the anterior, lower pole calyx. The kidney was extra-peritoneally implanted in the right iliac fossa and reperfused homogenously. Stone retrieval with a flexible ureteroscope failed due to the narrow calyceal infundibulum. Instead, the calculus was removed using the micropercutaneous nephrolithotomy system under ultrasonographic guidance. The calyx was punctured using a 4.85 Fr needle and the stone was fragmented to dust using a Holmium laser. No bleeding was observed. The post-operative course was uneventful. Outpatient follow up demonstrated good function of the graft which was stone free on ultrasound. Postperfusion micropercutaneous nephrolithotomy for kidney allograft calculi offers a safe and feasible option when pre-operative or intra-operative retrograde intrarenal surgery fails.
AB - Increasing demand drives the expansion of criteria for kidney donation, and nephrolithiasis is now considered a relative contraindication. We report for the first time a case of intra-operative, postperfusion kidney allograft micronephrolithotomy. A 64-year-old man with end-stage renal disease secondary to Alport syndrome underwent primary deceased donor kidney transplantation at our center. Pre-operative ultrasound of the donor identified a 7-mm calculus in the anterior, lower pole calyx. The kidney was extra-peritoneally implanted in the right iliac fossa and reperfused homogenously. Stone retrieval with a flexible ureteroscope failed due to the narrow calyceal infundibulum. Instead, the calculus was removed using the micropercutaneous nephrolithotomy system under ultrasonographic guidance. The calyx was punctured using a 4.85 Fr needle and the stone was fragmented to dust using a Holmium laser. No bleeding was observed. The post-operative course was uneventful. Outpatient follow up demonstrated good function of the graft which was stone free on ultrasound. Postperfusion micropercutaneous nephrolithotomy for kidney allograft calculi offers a safe and feasible option when pre-operative or intra-operative retrograde intrarenal surgery fails.
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U2 - 10.1016/j.transproceed.2018.05.017
DO - 10.1016/j.transproceed.2018.05.017
M3 - Article
C2 - 30577293
AN - SCOPUS:85058536403
VL - 50
SP - 3950
EP - 3953
JO - Transplantation Proceedings
JF - Transplantation Proceedings
SN - 0041-1345
IS - 10
ER -