Olympus reviewed the following literature titled "living donor-gifted allograft lithiasis: surgical experience after bench surgery stone removal and follow-up." literature summary: this retrospective study presents the surgical experience and long-term outcomes of living donor kidney transplantations involving asymptomatic kidney stones, using ex vivo flexible ureterorenoscopy (f-urs) during bench surgery for stone removal.A total of six living kidney transplants were analyzed.The median (iqr) size was 6 (4¿13) mm.The median (iqr) stone density was 715 (189¿1700) hu.Four lithiasis (67%) were in the lower calyx.Kidney stone analysis was performed in all cases, most of the calculi contained whewellite as the main component (66.7%).Median cold ischemia time was 41.6 (37¿46) minutes with complete stone removal in all cases.During follow-up, six years later, the patient still presented good kidney function, with 1.63 mg/dl creatinine levels and a stone-free status.After a median (iqr) follow-up of 120 (2.75¿359.2) none of the recipients or living donors presented urinary stone recurrence.The findings suggest that bench f-urs is a safe approach for managing urinary stones in kidney grafts, providing good functional outcomes without stone recurrence in selected cases.Median cold ischemia time was 41.6 (37¿46) minutes with complete stone removal in all cases.Neither nonimmediate bleeding nor acute rejection was observed (table 2).As immediate postoperative complications, one patient developed paralytic ileus managed with mobilization and prokinetics.Another patient developed delayed graft function, being the two-stage case, with the longest cold ischemia time of the series.During follow-up, six years later, the patient still presented good kidney function, with 1.63 mg/dl creatinine levels and a stone-free status.Another patient presented good postoperative evolution, but seven days later presented signs of arterial thrombosis, confirmed by echo-doppler, therefore, a transplantectomy was performed.Type of adverse events/number of patients: event1: paralytic ileus - 1 patient (recipient#1/ 63 years old/ male).Event2: arterial thrombosis - 1 patient (recipient#2/ 45 years old/ male).Event3: wall hematoma - 1 patient (recipient#4/ 34 years old/ female).This literature article requires 6 reports.The related patient identifiers are as follows: (b)(6): for urf-p7/event1 (recipient#1).(b)(6): for 5920002bx/event1 (recipient#1).(b)(6): for urf-p7/event2 (recipient#2).(b)(6): for 5920002bx/event2 (recipient#2).(b)(6): for urf-p7/event3 (recipient#4).(b)(6): for 5920002bx/event3 (recipient#4).This medical device report is for patient identifier (b)(6).There is no report of any olympus device malfunction in any procedure described in this study.
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This report is being supplemented to provide additional information based on the legal manufacturer's final investigation.The device history record was unable to be reviewed for this device since the serial and/or lot number was not provided.However, olympus only releases products to market that meet all manufacturing specifications and final product release criteria.Based on the results of the investigation, the relationship between the device and the adverse event cannot be confirmed.There was no complaint reported on the subject device.There is no evidence of an olympus device malfunction.Therefore, the root cause cannot be determined.This supplemental report includes a correction to g2 to provide information that was inadvertently not included in the initial medwatch.Olympus will continue to monitor field performance for this device.
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