Renal transplant lithiasis is a rather unusual disease, and the recurrence of lithiasis presents a\nchallenging situation.\nMethods: We retrospectively analyzed the medical history of one patient who suffered renal transplant lithiasis\ntwice, reviewed the relevant literature, and summarized the characteristics of this disease.\nResults: We retrieved 29 relevant studies with an incidence of 0.34 to 3.26% for renal transplant lithiasis. The\nsummarized incidence was 0.52%, and the recurrence rate was 0.082%. The mean interval after transplantation was\n33.43 ± 56.70 mo. Most of the patients (28.90%) were asymptomatic. The management included percutaneous\nnephrolithotripsy (PCNL, 22.10%), ureteroscope (URS, 22.65%), extracorporeal shockwave lithotripsy (ESWL, 18.60%)\nand conservative treatment (17.13%). In our case, the patient suffered from renal transplant lithiasis at 6 years\nposttransplantation, and the lithiasis recurred 16 months later. He presented oliguria, infection or acute renal failure\n(ARF) during the two attacks but without pain. PCNL along with URS and holmium laser lithotripsy were performed.\nThe patient recovered well after surgery, except for a 3mm residual stone in the calyx after the second surgery. He\nhad normal renal function without any symptoms and was discharged with oral anticalculus drugs and strict\nfollow-up at the clinic. Fortunately, the calculus passed spontaneously about 1 month later.\nConclusions: Due to the lack of specific symptoms in the early stage, patients with renal transplant lithiasis may\nhave delayed diagnosis and present ARF. Minimally invasive treatment is optimal, and the combined usage of two\nor more procedures is beneficial for patients. After surgery, taking anticalculus drugs, correcting metabolic disorders\nand avoiding UIT are key measures to prevent the recurrence of lithiasis.
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