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

Area of Science:

• Nephrology
• Urology
• Transplant Surgery

Background:

• Nephrolithiasis (kidney stones) is a relative contraindication for kidney donation due to potential complications.
• Expanding donor criteria necessitates managing incidental findings like kidney stones in allografts.

Observation:

• A 7-mm kidney stone was identified in a deceased donor kidney during pre-transplant evaluation.
• Standard retrograde intrarenal surgery failed to remove the stone due to calyceal anatomy.
• The kidney allograft was successfully treated with micropercutaneous nephrolithotomy post-reperfusion.

Findings:

• Postperfusion micropercutaneous nephrolithotomy successfully removed the kidney stone using ultrasonography and a Holmium laser.
• The procedure was performed without observed bleeding and resulted in a stone-free allograft.
• The patient experienced an uneventful post-operative recovery with good graft function.

Implications:

• This technique provides a safe and feasible alternative for treating kidney allograft calculi when traditional methods are unsuccessful.
• It expands the utility of kidneys with pre-existing stones, potentially increasing donor organ availability.
• This approach may improve outcomes for kidney transplant recipients by addressing intraoperative stone burdens.