The technigue of lithotripsy on donor kidney stone
10.3760/cma.j.cn421203-202000418-00123
- VernacularTitle:供肾结石工作台碎石手术技巧
- Author:
Yichen ZHU
1
;
Jingcheng LYU
;
Jian ZHANG
;
Zhipeng WANG
;
Ye TIAN
;
Lei ZHANG
Author Information
1. 首都医科大学附属北京友谊医院泌尿外科，北京 100050
- Keywords:
Kidney transplantation;
Organ donation;
Nephrolithiasis;
Semi-rigid ureteroscope
- From:
Chinese Journal of Organ Transplantation
2021;42(5):283-286
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To summarize the experience and skills of ex-vivo ureteroscopy that performed on deceased donor kidneys with gifted lithiasis on bench prior to transplantation.Methods:From January 2018 to December 2019, a total of 7 death donors in Capital Medical University Beijing Friendship Hospital were found to have donor gifted lithiasis during pre-donation evaluation, and all of them underwent ureteroscope laser lithotripsy on bench before transplantation. We retrospectively analysied the demographic information of donors, stone size, location, operative complications and stone clearance rate of the total 7 donor kidneys. The mean age of donors was (49.6±6.8) years. The 7 gifted lithiasis consisted of 6 cases of simple pyelolithiasis and 1 case of upper ureteral calculi.Results:The mean diameter of the stones was (1.2±0.5)cm (0.4~2.1 cm). The 5 cases of pyelolithiasis and 1 case of ureteral calculi were examined with semi-rigid ureteroscopy and then underwent holmium laser lithotripsy. The other 1 case had not found the stone during the bench operation. The mean lithotripsy time was (23.0±6.1)min, and all donor kidneys underwent hypothermic machine perfusion after lithotripsy. The initial resistance index (RI) of donor kidney with gifted lithiasis was higher than the other side of the same donor ( P<0.05), but there was no statistical difference in end-point RI between the both sides. None of the 7 recipients had severe hematuria after operation and their renal function recovered well. CT scan at 1 month after the operation showed the clearance of stone was satisfied in all 7 recipients. Conclusions:Bench surgery is a minimally invasive method for donor gifted lithiasis management, and it is relatively safe and effective. For most cases, the semi-rigid ureteroscopy can handle it well, but the long-term effect still needs to be further evaluated.
