Management of calculi in a donor kidney.
BACKGROUND
We evaluated the safety and efficacy of ex vivo ureteroscopy (ExURS) and extracorporeal shock wave lithotripsy (ESWL) as means of rendering a donated kidney stone-free in living related and deceased donor renal transplantation.


METHODS
Three cases with calculi in donor kidneys were managed; 1 was from a living related donor and 2 were from deceased donors. Immediately after cold perfusion, ExURS was performed with iced saline solution in 2 cases. Access to the collecting system was via the ureteral stump. Calculi were fragmented with pneumatic intracorporeal lithotripsy and fragments were removed with forceps. Posttransplantation ESWL was given to 1 patient for migration of a small lower caliceal calculus in the upper ureter in 1 allograft of a dual-kidney transplantation.


RESULTS
Access to the renal collecting system and stone fragmentation was technically successful in both cases. Indwelling ureteral stents were kept during transplantation in all cases. There were no intraoperative or postoperative ureteral complications. Following ESWL, stone was fragmented and cleared on its own within a week. At mean follow up of 2.2 years no new stone formed in any recipient or donor.


CONCLUSIONS
ExURS was technically feasible to render a stone-bearing kidney stone- free without compromising ureteral integrity or renal allograft function. ESWL could be performed at a later date.
Trivedi
A
A
Department of Urology and Transplantation, Dr H.L. Trivedi Institute Of Transplantation Sciences, Gulabben Rasiklal Doshi and Kamlaben Mafatlal Mehta Institute Of Kidney Diseases & Research Center, Ahmedabad, Gujarat, India.
Patel
S
S
Devra
A
A
Rizvi
J
J
Goel
R
R
Modi
P
P
D002102:Cadaver; D006801:Humans; D007669:Kidney Calculi / Q000175:diagnosis / Q000628:therapy*; D016030:Kidney Transplantation; D008096:Lithotripsy; D019520:Living Donors; D012449:Safety; D014019:Tissue Donors; D016896:Treatment Outcome; D018666:Ureteroscopy