Mamarelis G et al, 2015: Lithiasis of the renal allograft, a rare urological complication following renal transplantation: a single-center experience of 2045 renal transplantations.
Mamarelis G, Vernadakis S, Moris D, Altanis N, Perdikouli M, Stravodimos K, Pappas P, Zavos G
Transplantation Unit, "Laikon" General Hospital, Athens, Greece
BACKGROUND AND PURPOSE: Urinary lithiasis represents an unusual urologic complication in renal transplantation, with an incidence of 0.17%-1.8%. We present our experience with renal graft lithiasis in our series of renal transplantations.
MATERIAL AND METHODS: We reviewed the medical records for 2045 patients who underwent kidney transplantation from January 1983 to July 2013. Among the grafts, 9 patients were found to have allograft lithiasis. In 6 cases, the calculi were localized within the renal unit, and in 3 cases in the ureter. Two of the patients had relapsed after a few years from the first treatment. In both of them the stones were localized again in the ureter.
RESULTS: In our series, incidence of graft lithiasis was 0.44% (n = 9). Three of the 9 patients (33.3%) were treated via percutaneous nephrolithotripsy (PCNL), 3 (33.3%) underwent extracorporeal shockwave lithotripsy (ESWL), 2 (22.2%) passed their stones spontaneously, and 1 (11.1%) underwent PCNL after 2 failed ESWL interventions. All patients are currently stone free but still remain under close urologic surveillance.
CONCLUSIONS: Urinary stone formation can lead to significant morbidity and graft loss. The treatment options should be similar to those for patients in the general population. Long-term follow-up is substantial to determine the outcome and to prevent the recurrence.
Transplant Proc. 2014;46(9):3203-5. doi: 10.1016/j.transproceed.2014.09.166.