Advertisement

Extracorporeal Shock Wave Lithotripsy of Urinary Calculi in Transplanted Kidneys

  • Anna M. Fuchs
  • Gerhard J. Fuchs
  • Arnulf Stenzl

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.

Keywords

Extracorporeal Shock Wave Lithotripsy None None Renal Calculus Renal Tubular Acidosis Primary Hyperoxaluria 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Chaussy C and Fuchs G: World experience with extracorporeal shock wave lithotripsy for the treatment of urinary stones: assessment of its role after five year’s clinical use. Endourol Newsletter 1: 5, 1985.Google Scholar
  2. 2.
    Starzl TE, Groth CG, et al: Urological complications in 216 human recipients of renal transplants. Ann Surg 172: 1, 1970.PubMedCrossRefGoogle Scholar
  3. 3.
    Mundy AR, Podesta M, et al: The urological complications of 1,000 renal transplants. Brit J Urol 53: 397, 1981.PubMedCrossRefGoogle Scholar
  4. 4.
    Normann E, Fryjordet A, Halvorsen S: Stones in renal transplants. Scand J Urol Nephrol 14: 73, 1980.PubMedCrossRefGoogle Scholar
  5. 5.
    Rutkowski B and Zdrojewski A: Pol Tyg Lek 41: 1253, 1986.PubMedGoogle Scholar
  6. 6.
    Jain AB, Angrisani L, McMaster P: Staghorn calculus in a renal allograft. Trans Proc 18: 959, 1986.Google Scholar
  7. 7.
    Rosenberg JC, Arnstein AR, et al: Calculi complicating a renal transplant. Am J Surg 129: 326, 1975.PubMedCrossRefGoogle Scholar
  8. 8.
    Boyce NW, Holdworth SR, et al: Acute renal transplant failure resulting from obstruction with a calculus. Trans Proc 16: 1364, 1984.Google Scholar
  9. 9.
    Brien G, Scholz H, et al: Urolithiasis after kidney transplantation: clinical and mineralogical aspects. Urol Res 8: 211, 1980.PubMedCrossRefGoogle Scholar
  10. 10.
    Gansbeke D, Lalcman M, et al: Lithiasic complications of renal transplantation: the donor graft lithiasis concept. Urol Radiol 7: 157, 1985.PubMedCrossRefGoogle Scholar
  11. 11.
    Hulbert JC, Reddy P, et al: The percutaneous removal of calculi from transplanted kidneys. J Urol 134: 324, 1985.PubMedGoogle Scholar
  12. 12.
    Cardella JF, Hunter DW, et al: Obstructed calycocystostomy site in association with a transplanted kidney: percutaneous management. Radiol 156: 67, 1985.Google Scholar
  13. 13.
    Eshagi M and Smith AD: Endourologic approach to transplant kidney. Urology 28: 504, 1986.CrossRefGoogle Scholar
  14. 14.
    Wilson RE, Bernstein DS, et al: Effects of parathyroidectomy and kidney transplantation on renal osteodystrophy. Am J Surg 110: 384, 1964.CrossRefGoogle Scholar
  15. 15.
    Latimer RG, Renning J, et al: Tertiary hyperparathyroidism following successful renal allografting. Ann Surg 172: 137, 1970.PubMedGoogle Scholar
  16. 16.
    David DS, Cheigh JS, et al: Successful renal transplantation in a patient with primary hyperoxaluria. Trans Proc 15: 2168, 1983.Google Scholar
  17. 17.
    Whelchel JD, Alison DV, et al: Successful renal transplantation in hyperoxaluria. Transplantation 35: 101, 1983.CrossRefGoogle Scholar
  18. 18.
    David DS, Sahai S, et al: Hypercalcemia after renal transplantation: long-term follow-up data. NEJM 289: 398, 1973.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1988

Authors and Affiliations

  • Anna M. Fuchs
    • 1
  • Gerhard J. Fuchs
    • 1
  • Arnulf Stenzl
    • 1
  1. 1.Division of UrologyUCLA Medical CenterLos AngelesUSA

Personalised recommendations