Endoscopic Combined Intrakidney Surgery to Remove a Large Renal Calculus in a Transplanted Kidney: A Case Report.

Background: Large nephrolithiasis in a transplanted kidney is a rare situation and an associated risk from postoperative allograft dysfunction. We present our first experience with the implementation and successful result of an endoscopic combined intrakidney surgery (ECIKS) performed to remove a large donor-gifted stone after kidney transplant.

Case Presentation: A 47-year-old female recipient with end-stage kidney disease with no identifiable cause underwent deceased donor kidney transplant at our center. Immediately after the operation, her kidney function slowly improved, and noncontrast computed tomography illustrated a large nephrolithiasis without hydronephrosis. After 6 weeks, the patient was treated successfully by ECIKS, and the stone was totally removed. The patient recovered well after surgery without additional adverse events. There were no residual fragments assessed by computed tomography as of 3 months after the surgery.

Conclusions: A large allograft nephrolithiasis can be successfully retrieved using ECIKS. This is technically feasible, safe, and associated with low morbidity.