Bessede T, Branchereau J, Goujon A, Boissier R, Alezra E, Verhoest G, Culty T, Matillon X, Doerfler A, Tillou X, Sallusto F, Terrier N, Thuret R, Drouin S, Timsit M-O
Comité de transplantation et d'insuffisance rénale chronique de l'association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, université Paris Saclay, hôpital de Bicêtre, AP-HP, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France.
Comité de transplantation et d'insuffisance rénale chronique de l'association française d'urologie (CTAFU), maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation, CHU de Nantes, 5, allée de l'Ile Gloriette, 44093 Nantes cedex 01, France.
Prog Urol. 2021 Jan;31(1):57-62. doi: 10.1016/j.purol.2020.03.014.
To define guidelines for the management of kidney stones in kidney transplant (KTx) donor or recipients.
Following a systematic approach, a review of the literature (Medline) was conducted by the CTAFU to report kidney stone epidemiology, diagnosis and management in KTx donors and recipients with the corresponding level of evidence.
Prevalence of kidney stones in deceased donor is unknown but reaches 9.3% in living donors in industrialized countries. Except in Maastrich 2 donors, diagnosis is done on systematic pre-donation CT scan according to standard french procedure. No prospective study has compared therapeutic strategies available for the management of kidney stones in KTx donor: ureteroscopy or an extra corporeal lithotripsy in case of living donor prior to donation, ex vivo approach (pyelotomy or ureteroscopy), ureterocopy in the KTx recipient or surveillance. De novo kidney stones result from a lithogenesis process to be identified and treated in order to avoid recurrences. The context of solitary functional kidney renders the prevention of recurrence of great importance. Diagnosis is suspected when identification of a renal graft dysfunction, hematuria or urinary tract infection with renal pelvis dilatation. Stone size and location are determined by computed tomography. There are no prospective, controlled studies on kidney stone management in the KTx. The therapeutic strategies are similar to standard management in general population.
These French recommendations should contribute to improve kidney stones management in KTx donor and recipients.
确定肾移植（KTx）供体或受体肾结石管理的指南。
采用系统方法，CTAFU对文献（Medline）进行回顾，以报告KTx供体和受体肾结石的流行病学、诊断和管理情况及相应证据水平。
deceased donor中肾结石的患病率未知，但在工业化国家的活体供体中达到9.3%。除马斯特里赫特2供体（Maastrich 2 donors）外，根据法国标准程序，在系统的捐赠前CT扫描时进行诊断。尚无前瞻性研究比较KTx供体肾结石的可用治疗策略：活体供体在捐赠前采用输尿管镜检查或体外冲击波碎石术，离体方法（肾盂切开术或输尿管镜检查），KTx受体采用输尿管镜检查或监测。新发肾结石源于有待识别和治疗的结石形成过程，以避免复发。单肾功能的情况使预防复发极为重要。当识别出肾移植功能障碍、血尿或伴有肾盂扩张的尿路感染时，怀疑有诊断。结石大小和位置由计算机断层扫描确定。尚无关于KTx中肾结石管理的前瞻性对照研究。治疗策略与一般人群的标准管理相似。
这些法国建议应有助于改善KTx供体和受体的肾结石管理。
