Urolithiasis in donor kidneys is a relatively uncommon clinical entity. Recently, The use of screening computerized tomography has resulted in the increased detection of incidental nephrolithiasis in potential living renal donor candidates.

Material and methods. A retrospective analysis was performed of all living donors identified to have asymptomatic incidental renal calculi on preoperative CT from April 2008 until July 2012. At Japanese Red Cross Nagoya-dini Hospital we performed a total of 344 renal transplants during this period. Among this cohort the incidence of asymptomatic renal calculi was 4.2%(n=15). 7 cases were performed ex vivo ureteroscope(ExURS), 7 cases were performed ureteroscope before renal transplantation, and the rest one was performed ESWL before renal transplantation and ex vivo pyelolithotomy at the time of renal transplantation.

Result. All donors underwent hand assisted laparoscopic donor nephrectomy. We found stone in five cases who were underwent ureteroscopy before renal transplantation. They were underwent flexible transurethral ureterolithotripsy (fTUL), and all patient became stone free. The five of seven patients were removed stones with stone retrieval device during ExURS. There were no complications in the graft function and no urological complicatons such as ischemic stricture, urinary leak.

Conclusion. Renal calculi can be successfully retrieved during living – related transplantation at the time of transplantation at the time of transplant itself using ExURS. fTUL is also successfully done for living related donor candidate. Long-term follow-up is essential to determine the outcome, as well as to prevent recurrence.

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