Management of renal transplant urolithiasis: a multicentre study by the French Urology Association Transplantation Committee

18 février 2018

Mots clés : Transplantation rénale, Lithiase urinaire
Auteurs : J. Branchereau, M. O. Timsit, Y. Neuzillet, T. Bessède, R. Thuret, M. Gigante, X. Tillou, R. Codas, J. Boutin, A. Doerfler, F. Sallusto, T. Culty, V. Delaporte, N. Brichart, B. Barrou, L. Salomon, G. Karam, J. Rigaud, L. Badet, F. Kleinklauss
Référence : World J Urol (2018) 36:105–109

Purpose Urolithiasis is rare among renal transplant recipients and its management has not been clearly defined.

Methods This multicentre retrospective study was organised by the Comité de Transplantation de l’Association Française d’Urologie (French Urology Association transplantation committee). Statistical analysis was performed with SPSS 19 software.

Results Ninety-five patients were included in this study. Renal transplant urolithiasis was an incidental finding in 55% of cases, mostly on a routine follow-up ultrasound examination. One half of symptomatic stones were due to urinary tract infection and the other half were due to an episode of acute renal failure. The initial management following diagnosis of urolithiasis was double J stenting (27%), nephrostomy tube placement (21%), or watchful waiting (52%). Definitive management consisted of: watchful waiting (48%), extracorporeal lithotripsy (13%), rigid or flexible ureteroscopy (26%), percutaneous nephrolithotomy (11%) and surgical pyelotomy (2%). All transplants remained functional following treatment of the stone. The main limitation is the retrospective design.

Conclusions The incidence of lithiasis could be higher in kidney transplanted patients due to a possible anatomical or metabolical abnormalities. The therapeutic management of renal transplant urolithiasis appears to be comparable to that of native kidney urolithiasis.