[Management of lithiasis of kidney transplant].

INTRODUCTION

Urolithiasis in kidney transplants is rare but not exceptional (0,20-3%). Dealing with it is complex: abstention, lithotripsy or surgery? The aim of this study is to find out what can be done about it.

METHOD

A retrospective study about 420 kidney transplants performed in our institution between 1990 et 2005 revealed nine cases of lithiasis. Among the factors leading to lithiasis were urinary flow obstruction in six cases and hyperparathyroidy in three cases.

RESULTS

Five grafts with calculi whose diameter do not exceed 5mm were kept under medical supervision. Two of them were in chronic rejection without residual diuresis. Extra shockwawe lithotripsy was performed for a 13 mm diameter calical calculi. Two percutaneous extraction were performed: one for a 20mm diameter "pyelic" calculi and one for three kidney stones and among them one was 12 mm. A 20mm calculi was extracted by open pyelotomy during the repairing of the ureteral anastomosis on a Bricker diversion.

CONCLUSION

Consequently, dealing with calculi on kidney transplants is similar to dealing with a unique native kidney.