[Urinary lithiasis in renal transplant recipient]

Abstract

Objectives: To report epidemiology and characteristics of urinary lithiasis and its management in kidney allograft at the time of organ procurement or after kidney transplantation.

Material and methods: An exhaustive systematic review of the scientific literature was performed in the Medline database (http://www.ncbi.nlm.nih.gov) and Embase (http://www.embase.com) using different associations of the following keywords (MESH): urinary lithiasis, stone, kidney transplantation. Publications obtained were selected based on methodology, language, date of publication (last 10 years) and relevance. Prospective and retrospective studies, in English or French, review articles; meta-analysis and guidelines were selected and analyzed. This search found 58 articles. After reading, 37 were included in the text based on their relevance.

Results: Frequency of urinary lithiasis in renal transplant recipient is similar to those observed in the general population. Generally, urinary lithiasis of the graft is asymptomatic because of renal denervation after organ procurement and transplantation. Nevertheless, this situation may be at high risk due to the immunosuppressed state of the recipient with a unique functioning kidney. Most of the time, the diagnosis is incidental during routine post-transplantation follow-up. Management of urolithiasis in renal transplant recipient is similar to that performed in general population.

Conclusion: Due to its potential severity in transplanted immunosuppressed patients with a sole kidney, urolithiasis requires expert urological management.

Keywords: Calcul; Kidney transplantation; Lithiase; Lithiasis; Stone; Transplantation rénale.