Strictures and Stones: Ex Vivo Ureteroscopy to Salvage Donor Kidney with Extensive Stone Burden: A Case Report

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings Pub Date : 2025-09-01 DOI:10.1016/j.transproceed.2025.06.018

SriGita Krishna Madiraju , Kunal Yadav , Natalie Mainland , Advait Deshmukh , Snehi Shah , Stephen Hong , Puneet Sindhwani

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引用次数: 0

Abstract

Background

The waiting list for kidney transplants far exceeds the pool of available donors. A significant population in the United States is living with end-stage renal disease (ESRD) yet many procured donor kidneys are not utilized. Significant renal stone disease has often been a relative contraindication to transplantation and a reason to discard these “high-risk” kidneys due to the possibility of post-transplant complications and suboptimal graft function. Salvaging these kidneys presents a chance to increase the availability of transplantable kidneys and assist with the critical shortage of organs.

Methods

We present a case of successful transplantation of a donor kidney with substantial stone burden that underwent ex vivo ureteroscopy with stone extraction and treatment of a ureteral stricture during pre-transplant preparation. Utilizing standard ureteroscopy instruments, we successfully cleared the donor kidney of its renal stone burden.

Results

At the 2- and 12-month marks, the recipient had no radiographic signs of ureteral obstruction or stone recurrence with excellent graft function.

Conclusions

Salvage of a donor kidney with concomitant heavy stone burden and ureteral stricture has not been reported before in the literature. This case report demonstrates that pre-transplant stone extraction with ex vivo ureteroscopy is an effective strategy for salvaging a kidney that would otherwise be discarded.

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狭窄与结石：体外输尿管镜术抢救结石负担大的供肾一例报告。

背景：等待肾脏移植的名单远远超过了可用的供体。在美国，有相当多的人患有终末期肾病（ESRD），但许多获得的供体肾脏没有得到利用。严重的肾结石疾病通常是移植的相对禁忌症，并且由于移植后并发症和移植功能不理想的可能性，放弃这些“高风险”肾脏的原因。抢救这些肾脏为增加可移植肾脏的可用性提供了机会，并有助于解决器官严重短缺的问题。方法：我们报告一例移植成功的供体肾结石负担，通过体外输尿管镜取石和治疗输尿管狭窄在移植前准备。使用标准输尿管镜检查工具，我们成功地清除了供肾的肾结石负担。结果：2个月和12个月时，受者无输尿管梗阻或结石复发的影像学征象，移植物功能良好。结论：在以前的文献中没有报道过伴有重结石负担和输尿管狭窄的供肾抢救。本病例报告表明，在体外输尿管镜下进行移植前结石取出是挽救肾脏的有效策略，否则肾脏将被丢弃。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transplantation proceedings 医学-免疫学

CiteScore

1.70

自引率

0.00%

发文量

502

审稿时长

60 days

期刊介绍： Transplantation Proceedings publishes several different categories of manuscripts, all of which undergo extensive peer review by recognized authorities in the field prior to their acceptance for publication. The first type of manuscripts consists of sets of papers providing an in-depth expression of the current state of the art in various rapidly developing components of world transplantation biology and medicine. These manuscripts emanate from congresses of the affiliated transplantation societies, from Symposia sponsored by the Societies, as well as special Conferences and Workshops covering related topics. Transplantation Proceedings also publishes several special sections including publication of Clinical Transplantation Proceedings, being rapid original contributions of preclinical and clinical experiences. These manuscripts undergo review by members of the Editorial Board. Original basic or clinical science articles, clinical trials and case studies can be submitted to the journal?s open access companion title Transplantation Reports.