title: Minimally invasive treatment of renal transplant nephrolithiasis.
abstract: OBJECTIVE
  Urolithiasis is a rare complication of renal transplantation, and there is limited evidence to guide treatment. Management of stones in the transplanted kidney can be challenging. We present our experience in treating upper urinary tract (UUT) allograft lithiasis using minimally invasive procedures, with the aim of demonstrating their efficacy and safety in renal transplant recipients.
  
  
  METHODS
  The records of 1615 patients undergoing kidney transplantation and follow-up in our center between August 2000 and July 2014 were reviewed. The mode of presentation, donor type, onset time, immunosuppression protocol, stone character, therapeutic intervention and outcomes of those with UUT allograft lithiasis were recorded. Extracorporeal shock wave lithotripsy (SWL), flexible ureteroscopy (F-URS) and percutaneous nephrolithotomy (PCNL) were used in the management of these calculi. Stone composition was analyzed after the procedure.
  
  
  RESULTS
  Nineteen renal transplant recipients (1.2 %, nine males and ten females) were found to have UUT allograft calculi. Of these, five underwent SWL (26.3 %), four had F-URS combined with lithotomy forceps extraction or holmium laser disruption (21.1 %), six had PNCL (31.6 %), one submitted to F-URS after two failed sessions of SWL (5.3 %), one combined PCNL and F-URS (5.3 %), and two spontaneously of stones (10.5 %). All patients were rendered stone-free with a combination of treatments, and none required a blood transfusion.
  
  
  CONCLUSIONS
  The incidence of calculi in the transplanted kidney is low. Minimally invasive procedures are safe and effective means of removing allograft calculi.
authors.affiliation: Department of Urology, Yantai Yuhuangding Hospital Affiliated to Medical College of Qingdao University, NO. 20 East Yuhuangding Road, Yantai, 264000, Shandong Province, China.
authors.forename: He-jia
authors.initials: HJ
authors.lastname: Yuan
authors.affiliation: Department of Urology, Yantai Yuhuangding Hospital Affiliated to Medical College of Qingdao University, NO. 20 East Yuhuangding Road, Yantai, 264000, Shandong Province, China.
authors.forename: Dian-dong
authors.initials: DD
authors.lastname: Yang
authors.affiliation: Department of Urology, Yantai Yuhuangding Hospital Affiliated to Medical College of Qingdao University, NO. 20 East Yuhuangding Road, Yantai, 264000, Shandong Province, China.
authors.forename: Yuan-shan
authors.initials: YS
authors.lastname: Cui
authors.affiliation: Department of Urology, Yantai Yuhuangding Hospital Affiliated to Medical College of Qingdao University, NO. 20 East Yuhuangding Road, Yantai, 264000, Shandong Province, China.
authors.forename: Chang-ping
authors.initials: CP
authors.lastname: Men
authors.affiliation: Department of Urology, Yantai Yuhuangding Hospital Affiliated to Medical College of Qingdao University, NO. 20 East Yuhuangding Road, Yantai, 264000, Shandong Province, China.
authors.forename: Zhen-li
authors.initials: ZL
authors.lastname: Gao
authors.affiliation: Department of Urology, Yantai Yuhuangding Hospital Affiliated to Medical College of Qingdao University, NO. 20 East Yuhuangding Road, Yantai, 264000, Shandong Province, China.
authors.forename: L
authors.initials: L
authors.lastname: Shi
authors.affiliation: Department of Urology, Yantai Yuhuangding Hospital Affiliated to Medical College of Qingdao University, NO. 20 East Yuhuangding Road, Yantai, 264000, Shandong Province, China. wujitaomedical@163.com.
authors.forename: Ji-tao
authors.initials: JT
authors.lastname: Wu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008096:Lithotripsy; D008297:Male; D008875:Middle Aged; D053040:Nephrolithiasis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D009403:Nephrostomy, Percutaneous; D012189:Retrospective Studies; D016896:Treatment Outcome; D018666:Ureteroscopy; D055815:Young Adult
keywords: Kidney transplantation; Lithotripsy; Minimally invasive surgical procedures; Urolithiasis
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