Asymptomatic Urolithiasis in Living Donor Transplant Kidneys: Initial Results

George Martin, Chandru Sundaram, Asif Sharfuddin, Mahendra Govani

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Objectives: During the preoperative evaluation of potential kidney donors, the increased sensitivity of spiral computed tomography (CT) could detect more asymptomatic small (less than 4 mm) renal calculi. However, whether these stones will be of consequence later has yet to be determined. We evaluated the rate of spontaneous passage, development of symptoms, and change in the size of asymptomatic renal calculi in donor kidneys transplanted without removal of the calculi. Methods: Five donor kidneys from living donors were transplanted with small (less than 4 mm), asymptomatic renal calculi incidentally detected on CT (eight stones). No donors had any metabolic derangements or history of previous lithiasis. Each kidney was laparoscopically removed and transplanted with the calculi in situ. The recipients were followed up with serial creatinine measurements, history taking, and CT scans. Results: None of the recipients had had any symptoms consistent with the progression of disease, including hydronephrosis, renal failure, or the elevation of serum creatinine at a mean follow-up of 711 ± 334 days. The follow-up CT scans showed spontaneous passage of the stones in 3 patients. In the remaining 2 patients, two of the stones remained stable, and one had increased in size from 1 to 2 mm. Those with the stones remaining had had a significantly shorter length of follow-up (204 ± 72 versus 711 ± 200 days, P <0.05). Conclusions: In our series of 5 patients with small asymptomatic renal calculi, none of the patients have had complications, and only three of the eight stones were still in situ at the latest follow-up visit. Transplantation of small (less than 4 mm), asymptomatic stones in situ can be safely performed with adequate follow-up and monitoring for the development of obstructing transplant stones.

Original languageEnglish
Pages (from-to)2-5
Number of pages4
JournalUrology
Volume70
Issue number1
DOIs
StatePublished - Jul 2007

Fingerprint

Urolithiasis
Kidney Calculi
Living Donors
Tissue Donors
Transplants
Kidney
Tomography
Calculi
Creatinine
Lithiasis
Hydronephrosis
Spiral Computed Tomography
Renal Insufficiency
Disease Progression
Transplantation
Serum

ASJC Scopus subject areas

  • Urology

Cite this

Asymptomatic Urolithiasis in Living Donor Transplant Kidneys : Initial Results. / Martin, George; Sundaram, Chandru; Sharfuddin, Asif; Govani, Mahendra.

In: Urology, Vol. 70, No. 1, 07.2007, p. 2-5.

Research output: Contribution to journalArticle

@article{478ab7aba7bb4107a533d61c6742636f,
title = "Asymptomatic Urolithiasis in Living Donor Transplant Kidneys: Initial Results",
abstract = "Objectives: During the preoperative evaluation of potential kidney donors, the increased sensitivity of spiral computed tomography (CT) could detect more asymptomatic small (less than 4 mm) renal calculi. However, whether these stones will be of consequence later has yet to be determined. We evaluated the rate of spontaneous passage, development of symptoms, and change in the size of asymptomatic renal calculi in donor kidneys transplanted without removal of the calculi. Methods: Five donor kidneys from living donors were transplanted with small (less than 4 mm), asymptomatic renal calculi incidentally detected on CT (eight stones). No donors had any metabolic derangements or history of previous lithiasis. Each kidney was laparoscopically removed and transplanted with the calculi in situ. The recipients were followed up with serial creatinine measurements, history taking, and CT scans. Results: None of the recipients had had any symptoms consistent with the progression of disease, including hydronephrosis, renal failure, or the elevation of serum creatinine at a mean follow-up of 711 ± 334 days. The follow-up CT scans showed spontaneous passage of the stones in 3 patients. In the remaining 2 patients, two of the stones remained stable, and one had increased in size from 1 to 2 mm. Those with the stones remaining had had a significantly shorter length of follow-up (204 ± 72 versus 711 ± 200 days, P <0.05). Conclusions: In our series of 5 patients with small asymptomatic renal calculi, none of the patients have had complications, and only three of the eight stones were still in situ at the latest follow-up visit. Transplantation of small (less than 4 mm), asymptomatic stones in situ can be safely performed with adequate follow-up and monitoring for the development of obstructing transplant stones.",
author = "George Martin and Chandru Sundaram and Asif Sharfuddin and Mahendra Govani",
year = "2007",
month = "7",
doi = "10.1016/j.urology.2007.01.105",
language = "English",
volume = "70",
pages = "2--5",
journal = "Urology",
issn = "0090-4295",
publisher = "Elsevier Inc.",
number = "1",

}

TY - JOUR

T1 - Asymptomatic Urolithiasis in Living Donor Transplant Kidneys

T2 - Initial Results

AU - Martin, George

AU - Sundaram, Chandru

AU - Sharfuddin, Asif

AU - Govani, Mahendra

PY - 2007/7

Y1 - 2007/7

N2 - Objectives: During the preoperative evaluation of potential kidney donors, the increased sensitivity of spiral computed tomography (CT) could detect more asymptomatic small (less than 4 mm) renal calculi. However, whether these stones will be of consequence later has yet to be determined. We evaluated the rate of spontaneous passage, development of symptoms, and change in the size of asymptomatic renal calculi in donor kidneys transplanted without removal of the calculi. Methods: Five donor kidneys from living donors were transplanted with small (less than 4 mm), asymptomatic renal calculi incidentally detected on CT (eight stones). No donors had any metabolic derangements or history of previous lithiasis. Each kidney was laparoscopically removed and transplanted with the calculi in situ. The recipients were followed up with serial creatinine measurements, history taking, and CT scans. Results: None of the recipients had had any symptoms consistent with the progression of disease, including hydronephrosis, renal failure, or the elevation of serum creatinine at a mean follow-up of 711 ± 334 days. The follow-up CT scans showed spontaneous passage of the stones in 3 patients. In the remaining 2 patients, two of the stones remained stable, and one had increased in size from 1 to 2 mm. Those with the stones remaining had had a significantly shorter length of follow-up (204 ± 72 versus 711 ± 200 days, P <0.05). Conclusions: In our series of 5 patients with small asymptomatic renal calculi, none of the patients have had complications, and only three of the eight stones were still in situ at the latest follow-up visit. Transplantation of small (less than 4 mm), asymptomatic stones in situ can be safely performed with adequate follow-up and monitoring for the development of obstructing transplant stones.

AB - Objectives: During the preoperative evaluation of potential kidney donors, the increased sensitivity of spiral computed tomography (CT) could detect more asymptomatic small (less than 4 mm) renal calculi. However, whether these stones will be of consequence later has yet to be determined. We evaluated the rate of spontaneous passage, development of symptoms, and change in the size of asymptomatic renal calculi in donor kidneys transplanted without removal of the calculi. Methods: Five donor kidneys from living donors were transplanted with small (less than 4 mm), asymptomatic renal calculi incidentally detected on CT (eight stones). No donors had any metabolic derangements or history of previous lithiasis. Each kidney was laparoscopically removed and transplanted with the calculi in situ. The recipients were followed up with serial creatinine measurements, history taking, and CT scans. Results: None of the recipients had had any symptoms consistent with the progression of disease, including hydronephrosis, renal failure, or the elevation of serum creatinine at a mean follow-up of 711 ± 334 days. The follow-up CT scans showed spontaneous passage of the stones in 3 patients. In the remaining 2 patients, two of the stones remained stable, and one had increased in size from 1 to 2 mm. Those with the stones remaining had had a significantly shorter length of follow-up (204 ± 72 versus 711 ± 200 days, P <0.05). Conclusions: In our series of 5 patients with small asymptomatic renal calculi, none of the patients have had complications, and only three of the eight stones were still in situ at the latest follow-up visit. Transplantation of small (less than 4 mm), asymptomatic stones in situ can be safely performed with adequate follow-up and monitoring for the development of obstructing transplant stones.

UR - http://www.scopus.com/inward/record.url?scp=34447543928&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34447543928&partnerID=8YFLogxK

U2 - 10.1016/j.urology.2007.01.105

DO - 10.1016/j.urology.2007.01.105

M3 - Article

C2 - 17656194

AN - SCOPUS:34447543928

VL - 70

SP - 2

EP - 5

JO - Urology

JF - Urology

SN - 0090-4295

IS - 1

ER -