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Small Kidney Stones May Be Safe in Renal Transplant

Incidental stones in donor kidney did not cause complications in transplant recipients

THURSDAY, Aug. 16 (HealthDay News) -- In patients undergoing live donor renal transplant, the presence of small asymptomatic renal calculi in the donor kidney does not appear to lead to obstructive complications, according to a small case series published in the August issue of Urology.

George Martin, M.D., of Indiana University School of Medicine in Indianapolis, and colleagues studied five patients who underwent living donor transplant in which small (less than 4 mm), asymptomatic renal calculi were detected in the donor kidney by computed tomography. The kidneys were transplanted with renal calculi in situ, and the recipients were followed by serial creatinine measurements, history-taking, and computed tomography scans.

Over the follow-up period (mean 711 days), no transplant recipients experienced symptoms consistent with obstruction, including hydronephrosis, renal failure or serum creatinine elevations. In three patients, computed tomography scans showed spontaneous passage of the stones, and in the other two patients the stones either remained stable in size or increased from 1 to 2 mm. In total, of eight stones transplanted, only three remained at follow-up.

"Transplantation of small (less than 4 mm), asymptomatic stones in situ can be safely performed with adequate follow-up and monitoring for the development of obstructing transplant stones," the authors conclude. An accompanying editorial urges that all cases be followed closely.

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