Ex vivo Renal Bench Pyelolithotomy for Renal Calculi in Live Related Kidney Transplant: A Prospective Observational Study

Background and Objectives: Bench surgery performed just after donor nephrectomy is known as ex vivo Bench Surgery. We present a case series of Bench Pyelolithotomy in donor's kidney just before transplantation with our surgical experience and follow-up results. Patients and Methods: Fifteen ex vivo Bench Pyelolithotomy on renal graft was performed by an experienced surgeon from January 2018 to August 2020. All these patients underwent standard donor evaluation and metabolic workup. Pre- and post-operative parameters were analyzed for technical feasibility, intraoperative and postoperative complications, stone clearance, and stone recurrence rate. Results: All 15 donors were females with a mean age of 44 years. The mean stone size was 14.3 mm (range 5-30 mm). Stone extraction by pyelolithotomy on the bench was successfully performed, and a stone-free status was accomplished just before the transplantation. Complete stone clearance was achieved in all cases. Mean cold ischemia time was 32 min. Postoperatively, patients were stable with average urine output of 490 ml/h. All patients are in regular follow-up with graft functioning well measured with respect to serial serum creatinine and urine output. Conclusions: Bench surgery is safe, less time-consuming, and equally effective for a stone-bearing renal donor kidney without compromising renal allograft function.