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Purpose <p>This study aimed to evaluate the feasibility, outcomes, and intraoperative strategies of endoscopic management for de novo kidney allograft stones, focusing on decision-making and safety considerations unique to the transplant recipients.</p> Methods <p>We retrospectively reviewed six kidney transplant recipients who underwent endoscopic treatment for de novo kidney allograft stones between June 2018 and October 2024. Surgical approaches, intraoperative modifications, and perioperative outcomes were analyzed based on operative records and imaging studies.</p> Results <p>Retrograde ureteroscopy (URS) was successfully completed in three patients, whereas two required antegrade URS and one required intraoperative conversion from a retrograde to a percutaneous approach due to difficult ureteral access. The median operative time was 119&#xa0;min. All patients achieved a stone-free status, confirmed by postoperative computed tomography, with no deterioration in graft function or major complications. No infectious or hemorrhagic events were observed.</p> Conclusion <p>Endoscopic lithotripsy is a feasible and safe treatment for de novo kidney allograft stones when surgical planning accounts for graft anatomy and intraoperative flexibility. A tailored approach allowing switching between retrograde and percutaneous access is essential for ensuring procedural safety and preserving graft function. Although the small sample size limits generalizability, the findings provide practical insights for optimizing graft-preserving kidney stone surgery.</p>

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Feasibility and strategic endoscopic management of de novo kidney allograft stones: a retrospective study

  • 期刊论文

  • 发表日期：

    2025年10月19日

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  • Takafumi Yagisawa,
  • Momoko Akasaki,
  • Ayane Tachiki,
  • Satoshi Kubota,
  • Eri Sekido,
  • Shoichi Iida,
  • Tomokazu Shimizu,
  • Hideki Ishida,
  • Toshio Takagi

摘要

Purpose

This study aimed to evaluate the feasibility, outcomes, and intraoperative strategies of endoscopic management for de novo kidney allograft stones, focusing on decision-making and safety considerations unique to the transplant recipients.

Methods

We retrospectively reviewed six kidney transplant recipients who underwent endoscopic treatment for de novo kidney allograft stones between June 2018 and October 2024. Surgical approaches, intraoperative modifications, and perioperative outcomes were analyzed based on operative records and imaging studies.

Results

Retrograde ureteroscopy (URS) was successfully completed in three patients, whereas two required antegrade URS and one required intraoperative conversion from a retrograde to a percutaneous approach due to difficult ureteral access. The median operative time was 119 min. All patients achieved a stone-free status, confirmed by postoperative computed tomography, with no deterioration in graft function or major complications. No infectious or hemorrhagic events were observed.

Conclusion

Endoscopic lithotripsy is a feasible and safe treatment for de novo kidney allograft stones when surgical planning accounts for graft anatomy and intraoperative flexibility. A tailored approach allowing switching between retrograde and percutaneous access is essential for ensuring procedural safety and preserving graft function. Although the small sample size limits generalizability, the findings provide practical insights for optimizing graft-preserving kidney stone surgery.