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.

Intra-operative Postperfusion Micronephrolithotomy for Renal Allograft Lithiasis: A Case Report / E. Favi, N. Raison, S. Zanetti, G. Sampogna, E. Montanari, M. Ferraresso. - In: TRANSPLANTATION PROCEEDINGS. - ISSN 0041-1345. - 50:10(2018 Dec), pp. 3950-3953. [10.1016/j.transproceed.2018.05.017]

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

E. Favi
Primo
Writing – Original Draft Preparation
;
S. Zanetti;G. Sampogna;E. Montanari
Penultimo
Supervision
;
M. Ferraresso
Ultimo
Writing – Review & Editing
2018-12

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.
Settore MED/18 - Chirurgia Generale
Settore MED/24 - Urologia
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/611343
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