Lymphocele After Kidney Transplantation

• Published in: Transplantation proceedings 2007-11, Vol.39 (9), p.2744-2747
• Main Authors: Ziȩtek, Z, Sulikowski, T, Tejchman, K, Sieńko, J, Janeczek, M, Iwan-Ziȩtek, I, Kȩdzierska, K, Rość, D, Ciechanowski, K, Ostrowski, M
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Diabetic Nephropathies - complications; Diabetic Nephropathies - surgery; Drainage; Female; Follow-Up Studies; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Humans; Kidney Failure, Chronic - etiology; Kidney Failure, Chronic - surgery; Kidney Transplantation - adverse effects; Laparoscopy; Lymphocele - diagnosis; Lymphocele - epidemiology; Lymphocele - physiopathology; Lymphocele - therapy; Male; Medical sciences; Pain; Retrospective Studies; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the urinary system; Time Factors; Tissue, organ and graft immunology
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2007.08.041

Abstract Background One of the most often occurring complications after a kidney transplantation is a lymphocele. Materials The examined group consisted of 118 patients (70 males and 48 females) with end-stage renal disease (ESRD). Results Fourteen patients (12%) developed symptoms of lymphocele within an average time of 34 weeks. The clinical symptoms included the following: decreased 24-hour urine collection and increased creatinine level, abdominal discomfort, lymphorrhoea with surgical wound dehiscence, urgency, vesical tenesmus, and/or fever. Increased appearance of lymphocele was noticed in patients with diabetic nephropathy, congenital malformations of the urinary tract, and inflammatory diseases, including glomerulopathy and extraglomerular ones, after high-voltage radiotherapy and after removal of the renal graft. The methods of treatment and their efficacy were as follows: percutaneous aspiration with the ratio of recurrence 100%; ultrasound guided percutaneous drainage 50%; laparoscopic intraabdominal marsupialization 75%; and surgical intervention with favorable results. Conclusions Ultrasound-guided percutaneous drainage with a success rate greater than 50% should be recommended as the first line of treatment. As a minimal invasive surgery this kind of treatment does not interfere with subsequent internal drainage through an open or a laparoscopic surgery. Laparoscopy, a feasible, safe technique with a success rate of more than 80%, should be used routinely after unsuccessful percutaneous drainage.