Ex Vivo Removal of Stones in Donor Kidneys by Flexible Ureteroscopy Prior to Renal Transplantation: A Case Report

BACKGROUND Because of the shortage of grafts, many attempts have been made to treat calculi in donor kidneys and have achieved successful management. This case report is the first to present removal of stones from bilateral kidneys from a single donor through flexible ureteroscopy before transplantation. CASE REPORT The present case report shows the clinical management of bilateral donor kidneys with calculi, which were taken from a 33-year-old man through donation after cardiac death (DCD). Computed tomography showed 2 stones in the right donor kidney and 1 in the left donor kidney. Two stones were removed ex vivo using a flexible ureteroscope before transplantation, and the third one turned out to be a renal papillae calcification, which was left in place without surgical treatment. The bilateral donor kidneys were transplanted to 2 recipients. CONCLUSIONS There is a possibility of increasing the kidney pool by using donor kidneys containing calculi, which should be removed before transplantation.