Donor and post-transplant ureteroscopy for stone disease in patients with renal transplant: evidence from a systematic review

Reeves, Thomas, Agarwal, Vineet and Somani, Bhaskar K (2019) Donor and post-transplant ureteroscopy for stone disease in patients with renal transplant: evidence from a systematic review. Current Opinion in Urology, 29 (5), 548-555. (doi:10.1097/MOU.0000000000000618).

Abstract

PURPOSE OF REVIEW: Renal transplant is needed for end-stage renal disease. Although treatment of donor stones may be needed pretransplant and increases the pool available for renal transplant, posttransplant stone disease may also need treatment to maintain the allograft function. A Cochrane style review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines to evaluate the outcomes of donor and posttransplant ureteroscopy (URS) for stone disease, including all English language articles between January 1996 and December 2018.

RECENT FINDINGS: Eighteen articles (167 patients), seven ex-vivo or donor URS and 11 posttransplant URS met inclusion criteria and were included in the review. A pretransplant URS showed a stone-free rate (SFR) of 100% with an overall complication rate of 7.5% (four Clavien I and one Clavien ≥3), where as a posttransplant URS showed SFR of 100% in five studies and 60-91% in four studies with an overall complication rate of 12.9% (10 Clavien I and three Clavien ≥3).

SUMMARY: Advancements in endourological technique has made URS for donor and posttransplant urolithiasis a safe and effective procedure. Although data were based on small retrospective caser series, it shows that in experienced centres it can be performed with low morbidity and a high SFR.

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