Treatment of Kidney Stone in a Kidney-Transplanted Patient with Mini-Percutaneous Laser Lithotripsy: A Case Report

Abstract

We report a case of a kidney-transplanted patient with urolithiasis treated with mini-percutaneous laser lithotripsy. The patient presented with renal dysfunction and graft hydronephrosis. Diagnostic procedures revealed ureterolithiasis as a cause of obstruction, and percutaneous nephrostomy was inserted as a temporary solution. Before surgery, the stone migrated to the renal pelvis. Mini-percutaneous laser lithotripsy was successfully performed, and during surgery, all stone fragments were removed. Six months after successful treatment, the patient has good functioning and stone-free graft.

Experience of percutaneous access under ultrasound guidance in renal transplant patients with allograft lithiasis

“…Furthermore, because of the relative superficial position of transplanted kidneys, percutaneous management is favored. Indeed PCNL has the best success rate, but it is an invasive procedure on a single functioning kidney (14). Krambeck, who described the largest series of PCNL in transplant kidneys, reported perioperative complications in about ¼ of patients (15).…”

Minimal-invasive management of urological complications after kidney transplantation

“…For larger calculi, percutaneous nephrolithotomy (PCNL) can be performed via easy access because of the position of the allograft in the iliac fossa and the short puncture distance between skin and renal pelvis [ 85 , 86 ]. Using mini- PCNL, the tissue damage to the graft can be reduced [ 87 ]. In 2018, Emiliani et al reported that in 51 cases of urolithiasis therapies in transplanted kidneys including active surveillance, ante- and retrograde ureteroscopy, ESWL, PCNL and the open approach they found no loss of renal function through intervention and no case of allograft loss [ 88 ].…”

Urološke komplikacije nakon transplantacije bubrega – iskustvo Referentnog centra u Hrvatskoj

“…U današnje vrijeme se u liječenju urolitijaze u transplantiranih pacijenata, kao i u standardne populacije, koriste minimalno-invazivne metode. Ove metode uključuju ureterorenoskopiju (prvenstveno fleksibilnu ureterorenoskopiju), perkutanu nefrolitotripsiju i ESWL 42,[44][45][46][47] . U manjeg broja pacijenata urolitijaza se rješava laparoskopskim ili otvorenim pristupom.…”