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Urolithiasis in allograft kidneys.

H C Klingler1, G Kramer, M Lodde

  • 1Department of Urology, University of Vienna, Vienna, Austria.

Urology
|March 7, 2002
PubMed
Summary
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Allograft stones, often found in kidney transplant recipients, require careful management. Intraoperative screening and endoscopic stone removal are recommended, with ESWL suitable for certain kidney stones and antegrade procedures for larger or ureteral stones.

Area of Science:

  • Nephrology
  • Urology
  • Transplantation Medicine

Background:

  • Allograft stones are an infrequent complication in kidney transplant recipients.
  • Management strategies are often based on limited data and anecdotal evidence.

Purpose of the Study:

  • To analyze the management and outcomes of allograft stones in kidney transplant patients.
  • To evaluate the effectiveness of different treatment modalities for allograft stones.

Main Methods:

  • Retrospective analysis of 19 patients treated for renal and ureteral stones over 8 years.
  • Included patients with transplanted stones, de novo stones, and stones detected pre-transplant.
  • Treatment modalities comprised extracorporeal shock wave lithotripsy (ESWL), percutaneous nephrolithotomy, ureteroscopy, and spontaneous passage.

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Main Results:

  • Endoscopic stone removal during transplantation was successful in 3 of 4 patients.
  • Transplanted stones had a higher complication rate, including the need for emergency nephrostomy.
  • Extracorporeal shock wave lithotripsy (ESWL) was effective for caliceal stones, achieving stone-free status in all treated patients.
  • Endoscopic procedures resulted in complete stone clearance without renal impairment.

Conclusions:

  • Intraoperative ultrasonography and endoscopic stone removal are advisable for allograft stones.
  • Small stones (<4 mm) may be managed conservatively with close follow-up.
  • ESWL is effective for caliceal stones (5-15 mm), while antegrade endoscopic procedures are favored for larger or ureteral stones.