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Case Reports
. 2023 Jul;62(Suppl2):132-137.
doi: 10.20471/acc.2023.62.s2.19.

DIFFERENT APPROACHES TO MANAGING UROLITHIASIS IN KIDNEY TRANSPLANT PATIENTS - A CASE REPORT

Ivana Peko  1 , Josip Španjol  1   2 , Romano Oguić  1   2 , Antun Gršković  1   2 , Dražen Rahelić  2 , Nino Rubinić  2 , Mauro Materljan  2 , Ante Jakšić  2 , Dean Markić  1   2
Affiliations
Case Reports

DIFFERENT APPROACHES TO MANAGING UROLITHIASIS IN KIDNEY TRANSPLANT PATIENTS - A CASE REPORT

Ivana Peko et al. Acta Clin Croat. 2023 Jul.

Abstract

Urolithiasis is a rare urologic complication after kidney transplantation, and its diagnosis and treatment can be challenging for clinicians. In our 52-year-old male patient, graft hydronephrosis was found six months after transplantation. The patient had recurrent urinary tract infections followed by macrohematuria and an increase in creatinine levels. Computerized tomography revealed a 13-mm diameter stone in the ureter of the transplanted kidney as the cause of obstruction. Percutaneous nephrostomy was placed in the graft to solve the obstruction. Initial endoscopic treatment with a retrograde approach failed. An antegrade approach through a previously placed nephrostomy was not successful either. By a repeated retrograde approach, laser lithotripsy was performed successfully. The patient has been monitored for six months and has stable graft function without hydronephrosis or stones. As in our patient's case, the diagnosis and treatment of urolithiasis in kidney transplant patients is challenging, and minimally invasive procedures are the treatment of choice.

Keywords: Kidney transplantation; Laser lithotripsy; Ureterolithiasis; Ureteroscopy.

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Figures

Fig. 1
Fig. 1
Antegrade pyeloureterography demonstrating a visible defect of contrast filling (horizontal arrow) and narrowing in the distal part of the ureter (vertical arrow).
Fig. 2
Fig. 2
Axial computerized tomography of the pelvis demonstrating a stone in the right ureter.
Fig. 3
Fig. 3
Coronal computerized tomography urography demonstrating a stone in the distal part of the ureter of the transplanted kidney.
See this image and copyright information in PMC

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