Abstract：
BACKGROUND: Lithiasis in renal graft recipients might be a dangerous condition with a potential risk of organ function impairment.
METHODS: A systematic literature search was conducted through February 2023. The primary objective was to assess the incidence of lithiasis in kidney transplant (KT) recipients. The secondary objective was to assess the timing of stone formation, localization and composition of stones, possible treatment options, and the incidence of graft loss.
RESULTS: A total of 41 non-randomized studies comprising 699 patients met our inclusion criteria. The age at lithiasis diagnosis ranged between 29-53 years. Incidence of urolithiasis ranged from 0.1-6.3%, usually diagnosed after 12 months from KT. Most of the stones were diagnosed in the calyces or in the pelvis. Calcium oxalate composition was the most frequent. Different treatment strategies were considered, namely active surveillance, ureteroscopy, percutaneous/combined approach, or open surgery. 15.73% of patients were submitted to extracorporeal shock wave lithotripsy (ESWL), while 26.75% underwent endoscopic lithotripsy or stone extraction. 18.03% of patients underwent percutaneous nephrolithotomy whilst 3.14% to a combined approach. Surgical lithotomy was performed in 5.01% of the cases. Global stone-free rate was around 80%.
CONCLUSIONS: Lithiasis in kidney transplant is a rare condition usually diagnosed after one year after surgery and mostly located in the calyces and renal pelvis, more frequently of calcium oxalate composition. Each of the active treatments is associated with good results in terms of stone-free rate, thus the surgical technique should be chosen according to the patient\'s characteristics and surgeon preferences.
METHODS: A systematic literature search was conducted through February 2023. The primary objective was to assess the incidence of lithiasis in kidney transplant (KT) recipients. The secondary objective was to assess the timing of stone formation, localization and composition of stones, possible treatment options, and the incidence of graft loss.
RESULTS: A total of 41 non-randomized studies comprising 699 patients met our inclusion criteria. The age at lithiasis diagnosis ranged between 29-53 years. Incidence of urolithiasis ranged from 0.1-6.3%, usually diagnosed after 12 months from KT. Most of the stones were diagnosed in the calyces or in the pelvis. Calcium oxalate composition was the most frequent. Different treatment strategies were considered, namely active surveillance, ureteroscopy, percutaneous/combined approach, or open surgery. 15.73% of patients were submitted to extracorporeal shock wave lithotripsy (ESWL), while 26.75% underwent endoscopic lithotripsy or stone extraction. 18.03% of patients underwent percutaneous nephrolithotomy whilst 3.14% to a combined approach. Surgical lithotomy was performed in 5.01% of the cases. Global stone-free rate was around 80%.
CONCLUSIONS: Lithiasis in kidney transplant is a rare condition usually diagnosed after one year after surgery and mostly located in the calyces and renal pelvis, more frequently of calcium oxalate composition. Each of the active treatments is associated with good results in terms of stone-free rate, thus the surgical technique should be chosen according to the patient\'s characteristics and surgeon preferences.
摘要：
背景：肾移植受者的结石可能是一种危险的疾病，具有器官功能受损的潜在风险。
方法：到2023年2月进行了系统的文献检索。主要目的是评估肾移植（KT）受者结石的发生率。次要目标是评估结石形成的时间，石头的本地化和成分，可能的治疗选择，和移植物丢失的发生率。
结果：共有41项非随机研究包括699名患者符合我们的纳入标准。诊断为结石的年龄在29-53岁之间。尿石症的发病率为0.1%至6.3%,通常在KT12个月后诊断。大多数结石是在肾盂或骨盆中诊断出的。草酸钙组成是最常见的。考虑了不同的治疗策略，即主动监测，输尿管镜检查,经皮/联合入路，或者开腹手术.15.73%的患者接受了体外冲击波碎石术(ESWL),26.75％的人接受了内镜碎石术或取石。18.03％的患者接受了经皮肾镜取石术，而3.14％的患者接受了联合治疗。5.01%的病例进行了手术取石术。全球无石率约为80%。
结论：肾移植中的结石是一种罕见的疾病，通常在手术后一年后被诊断出来，主要位于肾盏和肾盂。更常见的是草酸钙成分。每一种积极的治疗都与无结石率方面的良好结果相关，因此，应根据患者的特点和外科医生的喜好选择手术技术。
方法：到2023年2月进行了系统的文献检索。主要目的是评估肾移植（KT）受者结石的发生率。次要目标是评估结石形成的时间，石头的本地化和成分，可能的治疗选择，和移植物丢失的发生率。
结果：共有41项非随机研究包括699名患者符合我们的纳入标准。诊断为结石的年龄在29-53岁之间。尿石症的发病率为0.1%至6.3%,通常在KT12个月后诊断。大多数结石是在肾盂或骨盆中诊断出的。草酸钙组成是最常见的。考虑了不同的治疗策略，即主动监测，输尿管镜检查,经皮/联合入路，或者开腹手术.15.73%的患者接受了体外冲击波碎石术(ESWL),26.75％的人接受了内镜碎石术或取石。18.03％的患者接受了经皮肾镜取石术，而3.14％的患者接受了联合治疗。5.01%的病例进行了手术取石术。全球无石率约为80%。
结论：肾移植中的结石是一种罕见的疾病，通常在手术后一年后被诊断出来，主要位于肾盏和肾盂。更常见的是草酸钙成分。每一种积极的治疗都与无结石率方面的良好结果相关，因此，应根据患者的特点和外科医生的喜好选择手术技术。
