Lithiasis of the renal allograft, a rare urological complication following renal transplantation: a single-center experience of 2,045 renal transplantations.

Urinary lithiasis represents an unusual urologic complication in renal transplantation, with an incidence of 0.17%-1.8%.We present our experience with renal graft lithiasis in our series of renal transplantations.We reviewed the medical records for 2045 patients who underwent kidney transplantation from January 1983 to July 2013. Among the grafts, 9 patients were found to have allograft lithiasis. In 6 cases, the calculi were localized within the renal unit, and in 3 cases in the ureter. Two of the patients had relapsed after a few years from the first treatment. In both of them the stones were localized again in the ureter.In our series, incidence of graft lithiasis was 0.44% (n = 9). Three of the 9 patients (33.3%) were treated via percutaneous nephrolithotripsy (PCNL), 3 (33.3%) underwent extracorporeal shockwave lithotripsy (ESWL), 2 (22.2%) passed their stones spontaneously, and 1 (11.1%) underwent PCNL after 2 failed ESWL interventions. All patients are currently stone free but still remain under close urologic surveillance.Urinary stone formation can lead to significant morbidity and graft loss. The treatment options should be similar to those for patients in the general population. Long-term follow-up is substantial to determine the outcome and to prevent the recurrence.

Duke Scholars

Author Dimitrios Moris