Lymphocele after kidney transplantation.

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.

• Authors: Z Zietek, T Sulikowski, K Tejchman, J Sieńko, M Janeczek, I Iwan-Zietek, K Kedzierska, D Rość, K Ciechanowski, M Ostrowski
• Journal: Transplantation proceedings (Transplant Proc) Vol. 39 Issue 9 Pg. 2744-7 (Nov 2007) ISSN: 0041-1345 [Print] United States
• PMID: 18021975 (Publication Type: Journal Article)

Topics

• Diabetic Nephropathies (complications, surgery)
• Drainage
• Female
• Follow-Up Studies
• Humans
• Kidney Failure, Chronic (etiology, surgery)
• Kidney Transplantation (adverse effects)
• Laparoscopy
• Lymphocele (diagnosis, epidemiology, physiopathology, therapy)
• Male
• Pain
• Retrospective Studies
• Time Factors