Lechevallier E, Saussine C, Traxer O
Service d'urologie, hôpital La-Conception, 147, boulevard Baille, 13005 Marseille, France.
Prog Urol. 2008 Dec;18(12):1024-6. doi: 10.1016/j.purol.2008.09.026. Epub 2008 Oct 16.
Renal lithiasis in renal donors is rare. A renal stone in a donor, or in a renal transplant, is not a contraindication for harvesting nor transplantation. If possible, the stone must be removed at the time of the transplantation. The risk of lithiasis is increased in the renal transplant recipient, with a frequency of 2-6%. Metabolic abnormalities for lithiasis are frequent and can be induced by the immunosuppressive treatment, anticalcineurins. Lithiasis can have a poor prognosis in the renal recipient with a risk for infection or renal dysfunction. Small (<4-5mm) stones in a renal transplant can be followed-up. Stones of 0.5-1.5cm need an extracorporeal lithotripsy with a previous safety JJ stent. Stones greater than 1.5cm can be treated by ureteroscopy or percutaneous surgery.
肾移植供体中肾结石很少见。供体或肾移植受者体内有肾结石并非采集或移植的禁忌证。如有可能,在移植时必须取出结石。肾移植受者患结石的风险增加,发生率为2% - 6%。结石的代谢异常很常见,可能由免疫抑制治疗(抗钙调神经磷酸酶药物)诱发。肾结石在肾移植受者中预后可能较差,存在感染或肾功能障碍风险。肾移植中较小(<4 - 5mm)的结石可进行随访。0.5 - 1.5cm的结石需要先放置安全的双J支架,然后进行体外冲击波碎石术。大于1.5cm的结石可通过输尿管镜检查或经皮手术治疗。