Extracorporeal Shock Wave Lithotripsy of Urinary Calculi in Transplanted Kidneys

Abstract

Renal lithiasis in a transplanted kidney is a rare, usually late, complication occurring in approximately 1% of all allografts. This report outlines the treatments for and the problems and success rates of calculi in transplanted kidneys.

From March 1985 to August 1987, fourpatients with opaque renal calculi measuring greater than 1 cm, including a staghorn calculus, were treated at the UCLA Stone Center. Extracorporeal shock wave lithotripsy (ESWL) was utilized in all four patients, two were positioned prone on the gantry; the other two, supine. All patients were stone free at eight weeks as documented by KUB and ultrasound. One patient with a staghorn calculus underwent several sessions of treatment, including percutaneous nephrostomy tube placement and was stone free six weeks after the last treatment. All four patients showed no diminished kidney function as evidenced by serum creatinine and BUN with a follow-up period of three to 18 months. No postoperative auxiliary procedures were required. Based on this experience, although transplanted kidneys require a different technique and handling, ESWL is technically feasible and advantageous in such cases.