A rare twist after Ex-vivo RIRS: graft parenchymal urine leak in a living donor kidney.

Authors

Asad Bashir, Nasrum Minallah, Fiaz Ahmed Touqeer, Ali Asad, Muhammad Shan, Zeeshan Zafar, Aamir Khan, Ammar Yousaf

Published in

CEN case reports. Volume 15. Issue 6. Oct 26, 2026. Epub Oct 26, 2026.

Abstract

Retrograde intrarenal surgery (RIRS) is performed ex-vivo on donor kidneys prior to transplantation. Upto our knowledge, after the review of existing literature, this is the first reported case of graft parenchymal urine leakage following ex-vivo RIRS in a living donor kidney transplant. Parenchymal urine leaks following ex-vivo retrograde intrarenal surgery (RIRS) in donor kidneys are exceptionally rare. To the best of our knowledge, this represents the first reported case of graft parenchymal urine leakage following ex-vivo RIRS in a living donor kidney transplant. A 29-year-old man was transplanted with a donor kidney following removal of 5 mm upper pole calculus via ex-vivo RIRS. Postoperatively, the patient had bloody drain output, and re-exploration showed a capsular tear. The subsequent clear drain output was confirmed to be a parenchymal urine leak based on drain fluid creatinine concentration and CT urogram. The bleed was managed surgically, and the parenchymal urine leak was treated conservatively using prolonged drainage and double-J stenting. Graft function was stable. Irrigation pressure should be well-controlled during ex-vivo RIRS, and complications should be promptly diagnosed to save the graft function even with rare parenchymal urine leaks.

PMID:
42932125
Bibliographic data and abstract were imported from PubMed on 27 Oct 2026.

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