2020, Number 3
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Rev Nefrol Dial Traspl 2020; 40 (3)
Evaluation of patients with lympocele after renal transplantation
Sapmaz A, Kozan R, Ozgür KM, Dalgic A, Sozen H
Language: English
References: 20
Page: 194-199
PDF size: 144.32 Kb.
ABSTRACT
Introduction: The lymphocele is a common
complication following renal transplantation
and may cause significant clinical problems
especially when reachs to big volumes. The
aim of this study is to present the clinical
characteristics, diagnostic approaches, and
therapeutic strategies of lymphocele formations
in a group of Turkish patients.
Methods: A total
of 244 renal transplantations were included in
this retrospective study. Data of patients who
were diagnosed with lymphocele during the
postoperative period were analyzed.
Results:
Ten (2.4%) patients have been diagnosed with
lymphocele. There were six males and 4 females,
with a mean age of 46 years. The median onset
was 19 days posttransplantation. The median size
of the lymphoceles was 53 mm. All lymphoceles
were localizated between the lower pole of the
transplanted kidney and urine bladder. On
presentation, one patient had hydronephrosis
and three patients had elevated serum creatinine
while the remaining six ones were asymptomatic.
Five patients were successfully treated by
percutaneous aspiration whereas two patients
required surgery. Three patients’ lymphoceles
dissolved spontaneously.
Conclusion: Preventive
strategies including preserving the lymphatics of
the recipient, careful organ retrieval and ‘back
table’ work are of great importance to reduce
the incidence of lymphocele. Early decision
of radiological or surgical intervention should
be considered in patients with symptomatic
lymphoceles in order to prevent further
complications.
REFERENCES
Atray NK, Moore F, Zaman F, Caldito G, Abreo K,Maley W, et al. Post transplant lymphocele: a singlecentre experience. Clin Transplant. 2004;18(Suppl.12):46-9.
Adani GL, Baccarani U, Bresadola V, Lorenzin D,Montanaro D, Risaliti A, et al. Graft loss due topercutaneous sclerotherapy of a lymphocele using aceticacid after renal transplantation. Cardiovasc InterventRadiol. 2005;28(6):836-8.
Zietek Z, Sulikowski T, Tejchman K, Sieńko J, JaneczekM, Iwan-Zietek I, et al. Lymphocele after kidneytransplantation. Transplant Proc. 2007;39(9):2744-7.
Sözen, H., Fidan, K., Onaran, M, Arinsoy T, DalgiçA. Outcome of the using older donors for kidneytransplantation. Transplant Proc. 2010;42(7):2477-8.
Hamza A, Fischer K, Koch E, Wicht A, ZachariasM, Loertzer H, et al. Diagnostics and therapy oflymphoceles after kidney transplantation. TransplantProc. 2006;38(3):701-6.
Smyth GP, Beitz G, Eng MP, Gibbons N, Hickey DP,Little DM. Long-term outcome of cadaveric renaltransplant after treatment of symptomatic lymphocele.J Urol. 2006;176(3):1069-72.
Ebadzadeh MR, Tavakkoli M. Lymphocele after kidneytransplantation: where are we standing now? Urol J.2008;5(3):144-8.
Singh AG, Jai SJ, Ganpule AP, VijayKumar M, SabnisRB, Desai MR. Critical appraisal of consecutive 36cases of post renal transplant lymphocele: a proposedalgorithm. World J Urol. 2017;35(9):1443-50.
Bzoma B, Kostro J, Dębska-Ślizień A, Hellmann AR,Zadrożny D, Śledziński Z, et al. Treatment of theLymphocele after kidney transplantation: a singlecenterexperience. Transplant Proc. 2016;48(5):1637-40.
Heer MK, Clark D, Trevillian PR, Sprott P, Palazzi K,Hibberd AD. Functional significance and risk factorsfor lymphocele formation after renal transplantation.ANZ J Surg. 2018;88(6):597-602.
Joosten M, d’Ancona FC, van der Meijden WA, PoyckPP. Predictors of symptomatic lymphocele after kidneytransplantation. Int Urol Nephrol. 2019;51(12):2161-7.
Martínez-Ocaña JC, Lauzurica R, Castellote E, BonetJ, Tenesa M, Jiménez JA, et al. Adult polycystic kidneydisease: a risk factor for lymphocele formation after renaltransplantation? Transplant Proc. 1995;27(4):2246-7.
Choudhrie AV, Kumar S, Gnanaraj L, Devasia A,Chacko N, Kekre NS. Symptomatic lymphocoelespost renal transplant. Saudi J Kidney Dis Transpl.2012;23(6):1162-8.
Zagdoun E, Ficheux M, Lobbedez T. Complicatedlymphoceles after kidney transplantation. TransplantProc. 2010;42(10):4322-5.
Goel M, Flechner SM, Zhou L, Mastroianni B,Savas K, Derweesh I, et al. The influence of variousmaintenance immunosuppressive drugs on lymphoceleformation and treatment after kidney transplantation. JUrol. 2004;171(5):1788-92.
Ranghino A, Segoloni GP, Lasaponara F, BianconeL. Lymphatic disorders after renal transplantation:new insights for an old complication. Clin Kidney J.2015;8(5):615-22.
Gray DWR. Vascular and lymphatic complicationsafter renal transplantation. En: Morris PJ, ed. Kidneytransplantation, principles and practice. 5th ed.Philadelphia: WB Saunders; 2001, p. 424-6.
Khauli RB, Stoff JS, Lovewell T, Ghavamian R, BakerS. Post-transplant lymphoceles: a critical look into therisk factors, pathophysiology and management. J Urol. 1993;150(1):22-6.
Iwan-Zietek I, Zietek Z, Sulikowski T, Nowacki M,Zair L, Romanowski M, et al. Minimally invasivemethods for the treatment of lymphocele after kidneytransplantation. Transplant Proc. 2009;41(8):3073-6.
Lucewicz A, Wong G, Lam VW, Hawthorne WJ,Allen R, Craig JC, et al. Management of primarysymptomatic lymphocele after kidney transplantation: asystematic review. Transplantation. 2011;92(6):663-73.