经输尿管镜下钬激光碎石术处理离体供肾结石两例报告并文献复习

Holmium Laser Lithotripsy under Ureteroscopes in Treatment of Ex-vivo Kidney Stone in Donor Kidneys: Two Case Reports and Literature Review

目的探讨含结石供肾移植的可行性和注意事项。方法解放军181医院全军器官移植与透析治疗中心实施2例心脏死亡器官捐献(DCD)含结石供肾经取石后移植手术,符合国际标准MaastrichtⅢ类,均为一侧供肾含结石,在工作台经输尿管镜下钬激光碎石术处理离体供肾结石,取石后采用Life Port肾脏转运器保存供肾后常规行肾移植术,共实施了4例肾移植。结果所有受者手术顺利,移植肾功能恢复良好,术后1、3、6、12个月复查彩色多普勒超声示无结石形成及其他并发症发生。结论采用经输尿管镜下钬激光碎石术处理离体供肾结石,手术后短期效果满意,有助于扩大供体池。

Objective To study the feasibility and precaution of donor kidneys with stones. Methods A total of 2 cases of cardiac death organ donation （DCD） after removing stones were the international standard Maastrieht III. The 2 donors had kidney stones in one side, and the stones were dealt with holmium laser lithotripsy under ureteroscopes in vitro on the workbench, and then renal transplantation was performed With donors kept in LifePort kidney transporter, and a renal transplantation was performed in 4 cases. Results The surgeries were successful in all cases, and the transplanted kidneys had good functions. The color doppler results on postoperative 1^st , 3^rd , 6^th and 12^th months showed that no stone formation or other complications were found. Conclusion The holmium laser lithotripsy under ureteroscopes in vitro in treatment of DCD with stones stone can achieve good short-term＇effect, and help to expand the donor range.