title: Urolithiasis in Renal Allografts: Complications and Outcomes.
abstract: OBJECTIVE
  Urinary calculi rarely occur in renal transplant. However, because of peculiarities shown with renal allografts, a prudent approach is necessary to prevent further complications or even graft failure. There are no well-established guidelines for uro?ithiasis in renal grafts regarding adequate therapy selection. In the present article, different therapeutic interventions are discussed, including in 1 case a pyelovesicostomy as an uncommon intervention.
  
  
  METHODS
  We retrospectively reviewed data of 1115 patients who underwent renal transplant between January 2002 and December 2014 for urolithiasis in different databases.
  
  
  RESULTS
  Eight patients in our study group formed urinary calculi after renal transplant. Only 5 patients were included, with incidence rate of 0.45%, since 3 patients received transplants elsewhere. Time between transplant and diagnosis ranged from 2 to 98 months. Extracorporeal shock wave lithotripsy (50%) was the most common intervention, followed by ureterorenoscopy (29%) and percutaneous nephrolithotomy (16%). One patient required 20 interventions due to recurrent urinary stones, necessitating an alternative procedure. In this case, a pyelovesicostomy was performed (an uncommon and previously not performed procedure for urolithiasis after renal graft). All patients were stone free at last follow-up.
  
  
  CONCLUSIONS
  In contrast to other studies, renal stones from donors were not observed. Treatment took into account stone size, number, and localization, similar to the approach in the general population. However, alternative procedures, especially pyelovesicostomy, could be considered in patients with recurrent urolithiasis and who require multiple interventions.
authors.affiliation: >From the Department of Urology, Charité University Hospital, Berlin, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Friedersdorff
authors.forename: Nasrin
authors.initials: N
authors.lastname: El-Bandar
authors.forename: Jonas
authors.initials: J
authors.lastname: Busch
authors.forename: Barbara
authors.initials: B
authors.lastname: Erber
authors.forename: Kurt
authors.initials: K
authors.lastname: Miller
authors.forename: Tom Florian
authors.initials: TF
authors.lastname: Fuller
authors.forename: Kurt
authors.initials: K
authors.lastname: Miller
mesh_terms: D000328:Adult; D000368:Aged; D064591:Allografts; D003559:Cystostomy; D016208:Databases, Factual; D005260:Female; D005858:Germany; D006801:Humans; D015907:Hysteroscopy; D016030:Kidney Transplantation / Q000009:adverse effects*; D008096:Lithotripsy; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous; D012008:Recurrence; D019233:Retreatment; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D052878:Urolithiasis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*