scholarly journals Experience of percutaneous access under ultrasound guidance in renal transplant patients with allograft lithiasis

2016 ◽  
Vol 88 (4) ◽  
pp. 337 ◽  
Author(s):  
Silvano Palazzo ◽  
Ottavio Colamonico ◽  
Saverio Forte ◽  
Matteo Matera ◽  
Giuseppe Lucarelli ◽  
...  
Keyword(s):  
Renal Function ◽  
Percutaneous Nephrolithotomy ◽  
Ultrasound Guidance ◽  
Laser Energy ◽  
Renal Calculi ◽  
Optimal Choice ◽  
Transplanted Kidney ◽  
Transplant Patients ◽  
First Case ◽  
Ultrasound Study

Objective: Urolithiasis of the transplanted kidney has an incidence of 0.2 to 1.7%, it increases the risk of infection in immunosuppressed patients and it can lead to ureteral obstruction that is often associated with deterioration of renal function. Urolithiasis of the transplanted kidney has different characteristics compared to the native kidney, due to the absence of innervation, which does not lead to colic pain. Percutaneous approach is an optimal choice in transplant patients. Material and methods: Here we report our experience in two cadaveric transplant patients with urolithiasis. The first case was a patient of 68 years with a 20 mm stone located in the transplanted kidney pelvis and another smaller in a lower calyx. The second case was a patient of 65 years with a 15 mm stone in the distal part of the transplanted ureter. In both cases the patients were asymptomatic, but they had a reduction in urine output associated with worsening of the transplanted kidney function. The diagnosis was performed in both cases with ultrasound study, showing a severe hydronephrosis and it was confirmed by computed tomography scan. In both cases, we performed a Percutaneous Nephrolithotomy (PCNL). Access was made after targeting the stone, through a lower pole puncture under ultrasound guidance. The first case was treated with pneumatic and laser energy, breaking stones through a nephroscope. In the second case we performed a laser lithotripsy of the ureteral stone, using a flexible videoureteroscope. At the end of both procedures a Double-J stent and a 14 Fr Malecot nephrostomy were positioned, that were removed at 6 weeks and 10 days, respectively. Results: Both patients achieved a resolution of the worsening of renal function, recovering the spontaneous diuresis. The surgical procedure using ultrasound guidance was safe and allowed quick access to the renal pelvis. Both patients experienced no bleeding or infection during hospitalization. Conclusions: Percutaneous Nephrolithotomy (PCNL) is an established safe and effective surgical treatment option for larger renal calculi in renal allografts. The ultrasound guided access to the transplanted kidney in percutaneous treatment of urolithiasis is useful and fast, minimizing patient exposure to ionizing radiation.

scholarly journals Outpatient percutaneous nephrolithotomy in a renal transplant patient: World’s first case

2015 ◽  
Vol 9 (5-6) ◽  
pp. 324 ◽  
Author(s):  
Kristen McAlpine ◽  
Michael J. Leveridge ◽  
Darren Beiko
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Renal Transplant Patient ◽  
Transplant Patient ◽  
Stable Condition ◽  
Renal Calculi ◽  
Renal Allografts ◽  
Transplanted Kidney ◽  
First Case ◽  
Successful Case ◽  
Tubeless Pcnl

Percutaneous nephrolithotomy (PCNL) is an established safe and effective surgical treatment option for renal calculi in renal allografts. The advent of tubeless PCNL has led to reports of ambulatory or outpatient PCNL. This case report describes the successful outpatient management of a 49-year-old female with a symptomatic renal pelvic calculus in her transplanted kidney. Tubeless PCNL successfully removed the stone, free of complication, and the patient was discharged 2 hours and 17 minutes after the procedure in stable condition with minimal pain. This is, to the best of our knowledge, the first successful case of outpatient tubeless PCNL in a transplanted kidney.

scholarly journals Concomitant management of renal calculi and recurrent ureteropelvic junction obstruction with percutaneous nephrolithotomy and antegrade balloon dilation

2020 ◽  
Vol 48 (5) ◽  
pp. 030006052091125
Author(s):  
Chunxiao Wei ◽  
Tengteng Wang ◽  
Shaoan Chen ◽  
Xiangbin Ren ◽  
Xiude Chen
Keyword(s):  
Renal Function ◽  
Success Rate ◽  
Percutaneous Nephrolithotomy ◽  
Ureteropelvic Junction Obstruction ◽  
Balloon Dilation ◽  
Renal Calculi ◽  
Ureteropelvic Junction ◽  
High Grade ◽  
Free Status ◽  
Grade Iii

Objective This study aimed to present our experience of concomitant management of renal calculi and recurrent ureteropelvic junction obstruction (UPJO) with percutaneous nephrolithotomy (PCNL) and antegrade balloon dilation. Methods We retrospectively reviewed 31 patients who underwent PCNL and antegrade balloon dilation for treatment of renal calculi and recurrent UPJO. The inclusion criterion was the presence of UPJO after failed pyeloplasty with ipsilateral renal calculi. Success was defined as achievement of both symptomatic and radiographic resolution of any stones and obstruction. Results All operations were successful without grade III or higher postoperative complications. A stone-free status was observed in all patients and the overall success rate of the procedure was 87.1% (27/31). The success rate of the procedure was significantly higher in patients with mild or moderate preoperative hydronephrosis (96%) than in those with high-grade preoperative hydronephrosis (50%). Moreover, the success rate of the procedure was lower in patients with poor preoperative renal function (0%) than in those with good or moderate renal function (93.1%). Conclusion Combined PCNL and antegrade balloon dilation management represents a safe and effective approach for patients with renal calculi and recurrent UPJO after failed pyeloplasty.

scholarly journals Tubeless percutaneous nephrolithotomy (pcnl) in renal allografts: a case report and mini-review

2016 ◽  
Vol 10 ◽  
Author(s):  
Siavash Falahatkar ◽  
Gholamreza Mokhtari ◽  
Samaneh Esmaeili ◽  
Seyed Morteza Bashiri Ebrahimian ◽  
Nadia Rastjou Herfeh
Keyword(s):  
Renal Function ◽  
Case Report ◽  
Percutaneous Nephrolithotomy ◽  
Rare Complication ◽  
Significant Morbidity ◽  
Renal Allografts ◽  
Transplanted Kidney ◽  
Urinary Lithiasis ◽  
Tubeless Percutaneous Nephrolithotomy ◽  
Uncommon Complication

Urinary lithiasis in transplanted kidney is a relatively uncommon complication. However, it may lead to a significant morbidity and loss of renal function. The report presents the case of a 32-year-old male renal-transplant recipient, with a stone in renal pelvis who was treated successfully by tubeless percutaneous nephrolithotomy (PCNL). The patient is currently stone free with no complication. This article also reviews in brief the treatment of this rare complication. Reviewing the literature showed that PCNL is safe and feasible procedure for treating nephrolithiasis in a transplanted kidney.

scholarly journals Percutaneous Nephrolithotomy under Ultrasound Guidance in Patients with Renal Calculi and Autosomal Dominant Polycystic Kidney Disease: A Report of 11 Cases

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Xiao Wang ◽  
Xuecheng Yang ◽  
Xiulong Zhong ◽  
Zhenlin Wang ◽  
Senyao Xue ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Polycystic Kidney Disease ◽  
Percutaneous Nephrolithotomy ◽  
Ultrasound Guidance ◽  
Autosomal Dominant ◽  
Renal Stones ◽  
Renal Calculi ◽  
Lateral Position ◽  
Polycystic Kidney ◽  
Autosomal Dominant Polycystic Kidney

Nephrolithiasis accelerates the renal failure in the patients with ADPKD. In order to evaluate the role of percutaneous nephrolithotomy in management of calculus in these patients, 11 patients with autosomal dominant polycystic kidney disease and renal stones were included in the study. Two patients had bilateral renal stones. All patients were treated by percutaneous nephrolithotomy under ultrasound guidance. 13 percutaneous nephrolithotomy procedures were performed in 1 stage by the urology team under ultrasound guidance. 5 people received second operation with flexible nephroscopy in lateral position. The success rate and morbidity and mortality of the technique and hospital stay were recorded.Results. The puncture procedure was fully successful in all cases. The renal function improved in these patients. 5 patients had moderate fever after the surgery. 5 patients received flexible nephroscopy to take out the residual calculi. 2 persons had ESWL therapy after the surgery.Conclusion. PCNL is an ideal, safe, and effective method to remove the stones from those patients with no definite increase in the risk of complication. The outcome and stone-free rate are satisfactory comparable to the PCNL in the patients without ADPKD.

Renal function changes after percutaneous nephrolithotomy in patients with renal calculi with a solitary kidney compared to bilateral kidneys

2018 ◽  
Vol 122 (4) ◽  
pp. 633-638 ◽  
Author(s):  
Xiaolei Shi ◽  
Yonghan Peng ◽  
Ling Li ◽  
Xiao Li ◽  
Qi Wang ◽  
...  
Keyword(s):  
Renal Function ◽  
Percutaneous Nephrolithotomy ◽  
Renal Calculi ◽  
Solitary Kidney

scholarly journals Twelve-month effects of everolimus on renal and lung function in lung transplantation: differences in chronic lung allograft dysfunction phenotypes

2021 ◽  
Vol 12 ◽  
pp. 204062232199344
Author(s):  
Filippo Patrucco ◽  
Elias Allara ◽  
Massimo Boffini ◽  
Mauro Rinaldi ◽  
Cristina Costa ◽  
...  
Keyword(s):  
Renal Function ◽  
Lung Function ◽  
Lung Transplant ◽  
Bronchiolitis Obliterans Syndrome ◽  
Forced Expiratory Volume ◽  
Chronic Lung Allograft Dysfunction ◽  
Allograft Dysfunction ◽  
Transplant Patients ◽  
Restrictive Allograft Syndrome ◽  
Trend Data

Background: Chronic lung allograft dysfunction (CLAD), a complication affecting the survival of lung transplanted patients, includes two clinical phenotypes: bronchiolitis obliterans syndrome (BOS) and restrictive allograft syndrome (RAS). Everolimus is used in CLAD because of its antiproliferative mechanism. In lung transplant patients treated with everolimus, the clinical course of renal and lung function has not yet been assessed systematically in CLAD, BOS and RAS patients for more than 6 months. Methods: We retrospectively evaluated the 12-month follow-up of renal and lung function of lung-transplanted patients switched to everolimus and evaluated the reduction in immunosuppressant dosage (ISD) and mortality. Subgroups were based on indication for everolimus treatment: CLAD and non-CLAD patients, BOS and RAS among CLAD patients. Results: We included 26 patients, 17 with CLAD (10 BOS, seven RAS). After 1 year from the everolimus switch, we observed renal function improvement (serum creatinine −17%, estimated glomerular filtration rate +24%) and stable pulmonary function [forced expiratory volume in the first second (FEV1) −0.5%, forced vital capacity (FVC) +0.05%]. RAS patients had progressive functional loss, whereas BOS patients had FEV1 improvement and FVC stability. All-cause mortality was higher in the CLAD versus non-CLAD group (41% versus 11%), without differences between BOS and RAS patients ( p > 0.05). All patients had significant and persistent ISD reduction. Conclusion: Lung transplant patients treated with everolimus had improvements in renal function and reduced ISD. We observed sustained improvements in lung function for CLAD related to BOS subgroup results, whereas RAS confirmed the 1-year worsening functional trend. Data seem to suggest one more piece of the puzzle in CLAD phenotyping.

Pregnancy in renal transplant patients: Renal function markers and maternal–fetal outcomes

2019 ◽  
Vol 15 ◽  
pp. 108-113 ◽  
Author(s):  
Jussara Leiko Sato Tebet ◽  
Gianna Mastroianni Kirsztajn ◽  
Thais Alquezar Facca ◽  
Sonia K. Nishida ◽  
Amelia Rodrigues Pereira ◽  
...  
Keyword(s):  
Renal Function ◽  
Renal Transplant ◽  
Fetal Outcomes ◽  
Transplant Patients ◽  
Renal Transplant Patients

Perioperative Outcomes of Percutaneous Nephrolithotomy in Septuagenarians and Beyond

2021 ◽  
Vol 104 (9) ◽  
pp. 1497-1502
Keyword(s):  
Renal Function ◽  
Percutaneous Nephrolithotomy ◽  
Age Groups ◽  
Length Of Hospital Stay ◽  
The Elderly ◽  
Renal Calculus ◽  
Perioperative Outcomes ◽  
Kidney Calculi ◽  
Operative Outcomes ◽  
Estimated Blood Loss

Background: Life expectancy has continuously risen worldwide. Because the elderly may tolerate complications poorly, the risks and benefits of percutaneous nephrolithotomy (PCNL) in those patients should be discussed thoroughly. Objective: To analyze utility and operative outcomes of PCNL with respect to age. Materials and Methods: A retrospective study of PCNL was performed at Ramathibodi Hospital between 2011 and 2020. The patients were divided into two age groups, 1) below 70 years old and 2) 70 years old and above. Comparison of demographics, operative data, and postoperative outcomes were analyzed. Results: Of the 253 patients, the overall stone-free rate (SFR) was 59.7%. The SFR in younger groups and older groups were 59.4% (126/212) and 61.0% (25/41), respectively, which was not significantly different (p=0.999). There was a similar in-stone burden between the two groups (p=0.573). Patients in the older group had worse renal function, higher American Society of Anesthesiologists score, and more comorbidities, including hypertension and ischemic heart disease. However, estimated blood loss, length of hospital stay, operative time, percent change in eGFR, and complications were comparable between the groups. Conclusion: PCNL is a safe and effective treatment of kidney calculi in septuagenarians and older patients, even with the risk of higher comorbidities and poorer renal function than in younger patients. Keywords: Percutaneous nephrolithotomy; Renal calculus; Stone-free status; Septuagenarians

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