Surgical Management of Urolithiasis in Transplanted Kidneys

Urolithiasis is an uncommon complication in transplant kidneys. The use of computed tomography to evaluate living donors can detect calculi in kidneys and such kidneys should be avoided for transplantation, unless a small asymptomatic stone can be removed. Calculi may form de novo after transplant. The principles of treatment of calculi in transplant kidneys are similar to that of calculi in solitary kidneys. The major differences are the clinical manifestations and the anatomy. Since the treatment goal is stone-free status with one procedure with minimal morbidity and risk to the transplant kidney, advances in endoscopic equipment and techniques have shifted treatments from shockwave lithotripsy (SWL) to percutaneous nephrostolithotomy and ureteroscopy.