Intra-operative Postperfusion Micronephrolithotomy for Renal Allograft Lithiasis: A Case Report

E. Favi, N. Raison, S. Zanetti, G. Sampogna, E. Montanari, M. Ferraresso

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)3950-3953
Number of pages4
JournalTransplantation Proceedings
Volume50
Issue number10
DOIs
Publication statusPublished - Dec 1 2018

ASJC Scopus subject areas

  • Surgery
  • Transplantation

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