{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T12:47:10Z","timestamp":1785934030641,"version":"3.56.0"},"reference-count":13,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,7,24]]},"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:p>Urolithiasis in renal allografts is rare, but large or complex stones present unique surgical challenges due to altered pelvic anatomy and proximity to vascular and visceral structures. Percutaneous nephrolithotomy (PCNL) is the gold-standard treatment for staghorn calculi but is technically demanding in transplanted kidneys. This complexity is amplified in recipients of simultaneous pancreas-kidney (SPK) transplants, where both grafts drain into the bladder. We describe a man in his 40s with type 1 diabetes and end-stage renal disease who underwent SPK transplantation in 2018. He presented with intermittent haematuria, and imaging demonstrated an 18\u2009mm partial staghorn calculus in the transplanted kidney located in the left iliac fossa. Antegrade access was obtained under fluoroscopic guidance, and the stone was fragmented. Stone fragments were extracted, achieving complete clearance. This case highlights the potential value of tailored access planning, image guidance and multidisciplinary involvement when considering stone clearance in anatomically complex transplant recipients.<\/jats:p>","DOI":"10.1136\/bcr-2025-271458","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T11:55:13Z","timestamp":1785930913000},"page":"e271458","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Percutaneous nephrolithotomy for a partial staghorn calculus in a renal allograft following simultaneous pancreas\u2013kidney transplantation"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2563-5056","authenticated-orcid":false,"given":"Donnacha","family":"Hogan","sequence":"first","affiliation":[{"name":"Department of Urology and Transplantation, Beaumont Hospital, Dublin, Ireland"},{"name":"Department of Urology, Connolly Hospital Blanchardstown, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Sheehan","sequence":"additional","affiliation":[{"name":"Department of Interventional Radiology, Beaumont Hospital, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ponnusamy","family":"Mohan","sequence":"additional","affiliation":[{"name":"Department of Urology and Transplantation, Beaumont Hospital, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niall F","family":"Davis","sequence":"additional","affiliation":[{"name":"Department of Urology and Transplantation, Beaumont Hospital, Dublin, Ireland"},{"name":"Department of Urology, Connolly Hospital Blanchardstown, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,8,5]]},"reference":[{"key":"2026080504550512000_19.8.e271458.1","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1097\/MPA.0000000000000119","article-title":"Predictors of 10-year pancreas allograft survival after simultaneous pancreas and kidney transplantation","volume":"43","author":"Davis","year":"2014","journal-title":"Pancreas"},{"key":"2026080504550512000_19.8.e271458.2","doi-asserted-by":"crossref","DOI":"10.3389\/ti.2023.11792","article-title":"Multi-Centre UK Analysis of Simultaneous Pancreas and Kidney (SPK) Transplant in Recipients With Type 2 Diabetes Mellitus","volume":"36","author":"Owen","year":"2023","journal-title":"Transpl Int"},{"key":"2026080504550512000_19.8.e271458.3","doi-asserted-by":"publisher","DOI":"10.1089\/end.2011.0049"},{"key":"2026080504550512000_19.8.e271458.4","doi-asserted-by":"crossref","first-page":"790","DOI":"10.5500\/wjt.v6.i4.790","article-title":"Incidence of kidney stones in kidney transplant recipients: A systematic review and meta-analysis","volume":"6","author":"Cheungpasitporn","year":"2016","journal-title":"World J Transplant"},{"key":"2026080504550512000_19.8.e271458.5","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1016\/j.ijsu.2016.11.032","article-title":"Urolithiasis in renal transplant donors and recipients: An update","volume":"36","author":"Harraz","year":"2016","journal-title":"Int J Surg"},{"key":"2026080504550512000_19.8.e271458.6","doi-asserted-by":"publisher","DOI":"10.1097\/00005392-199501000-00008"},{"key":"2026080504550512000_19.8.e271458.7","doi-asserted-by":"crossref","first-page":"934","DOI":"10.1002\/bco2.436","article-title":"Renal transplant nephrolithiasis: Presentation, management and follow-up with control comparisons","volume":"5","author":"Sandberg","year":"2024","journal-title":"BJUI Compass"},{"key":"2026080504550512000_19.8.e271458.8","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.1994.tb16576.x"},{"key":"2026080504550512000_19.8.e271458.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2015.07.041"},{"key":"2026080504550512000_19.8.e271458.10","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1089\/end.2023.0398","article-title":"Percutaneous Nephrolithotomy for De Novo Urolithiasis After Kidney Transplantation: A Systematic Review of the Literature","volume":"38","author":"Cerrato","year":"2024","journal-title":"J Endourol"},{"key":"2026080504550512000_19.8.e271458.11","first-page":"694","article-title":"Radiological imaging in renal transplantation","volume":"57","author":"Sjekavica","year":"2018","journal-title":"Acta Clin Croat"},{"key":"2026080504550512000_19.8.e271458.12","doi-asserted-by":"crossref","unstructured":"MacCraith E , Davis NF , Browne C , et al . Simultaneous pancreas and kidney transplantation: Incidence and risk factors for amputation after 10-year follow-up. 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