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Endourological Management of Urolithiasis in Donor Kidneys prior to Renal Transplant

机译:肾脏移植前供体肾脏尿石症的内科治疗

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摘要

Background. We present our centres successful endourological methodology of ex vivo ureteroscopy (EVFUS) in the management of these kidneys prior to renal transplantation. Patient and Methods. A retrospective analysis was performed of all living donors (n = 157) identified to have asymptomatic incidental renal calculi from January 2004 until December 2008. The incidence of asymptomatic renal calculi was 3.2% (n = 5). Donors were subdivided into 2 groups depending on whether theydonated the kidney with the renal calculus (Group 1) versus the opposite calculus-free kidney (Group 2). Results. All donors in Group 1 underwent a left laparoscopic donor nephrectomy. The calculi were extracted in all 3 cases using a 7.5 Fr flexible ureteroscope either prior to transplant (n = 2) or on revascularization (n = 1). There were no urological complications in either group. At a mean followup at 64 months there was no recurrent calculi formation in the recipient in Group 1. However, 1 recipient formed a calculus in group 2 at a follow up of 72 months. Conclusions. Renal calculi can be successfully retrieved during living-related transplantation at the time of transplant itself using EVUS. This is technically feasible and is associated with no compromise in ureteral integrity or renal allograft function.
机译:背景。我们介绍了我们的中心成功的体外输尿管镜(EVFUS)内分泌学方法在这些肾脏移植前的肾脏管理中的应用。病人和方法。从2004年1月至2008年12月,对所有确定为无症状的偶然肾结石的活体供体(n = 157)进行了回顾性分析。无症状的肾结石的发生率为3.2%(n = 5)。根据是否将肾脏结石(第1组)捐赠给相对的无结石的肾脏(第2组),将捐赠者分为两组。结果。第一组的所有供体均接受了左腹腔镜供体肾切除术。在全部3例病例中,均在移植前(n = 2)或在血管重建术(n = 1)时使用7.5 Fr柔性输尿管镜提取了结石。两组均无泌尿外科并发症。在平均随访时间为64个月时,第1组的受者没有复发性结石形成。但是,在第72组的随访中,第2组中有1位接受者形成了结石。结论。使用EVUS进行移植时,在与生活相关的移植过程中,肾结石可以成功恢复。这在技术上是可行的,并且不会影响输尿管的完整性或同种异体肾功能。

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