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Volume: 6 Issue: 4 November 2008 - Supplement - 1

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SYMPTOMATIC LYMPHOCELE AFTER RENAL TRANSPLANTATION; IN RECIPIENTS OF CADAVERIC AND LIVING DONOR GRAFT: A SINGLE CENTER EXPERIENCE

Lymphocele is a fluid collection between renal graft and bladder. It is an uncommon complication (0.6% to 18%) following renal transplantation. Most of the patients are asymptomatic and spontaneous resolution takes place after a few months. We evaluated retrospectively the incidence, clinical presentation and management of lymphocele in recipients after renal allograft transplantation in recipients of cadaveric and living donor graft. Between Feb 1989 and May 2008, 1513(905 male and 608 female) received renal allograft from living (1216) and cadaveric (297) donors. Diagnosis of lymphocele was established by ultrasound examination mainly in symptomatic patients. There were 28 cases of symptomatic lymphocele (18 females and 11 males), 11 cases (3.7%) in recipients of grafts from cadaveric donors and 19 cases (1.56%) in recipients of grafts from living donors. This difference is statistically significant (P=0.002). Lymphocele presented with rising serum creatinine (median: 2, 13 patients, 64.43%), pain and pelvic-abdominal swelling (6 patients, 21.42%), and lower extremities edema (9 patients, 32.15%). The average volume of lymphocele 133 ml. Percutaneous drainage was primarily performed in 5 patients but reaccumulation occurred in 4 of them that were managed with surgical approach. In 23 cases, the initial approach was surgical intraperitoneal drainage; All the cases were resolved successfully without graft loss. In conclusion, symptomatic lymphocele is a rare complication after kidney transplantation. In our assessment the incidence of symptomatic lymphocele is more in recipients graft from cadaveric donors camper to living donors. If it isn’t treated, ureteral compression and rise of serum creatinine may be resulted. Surgical intraperitoneal drainage is the most effective approach for the management of symptomatic lymphocele.



Volume : 6
Issue : 4
Pages : 144


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Urological and Renal transplantation Department, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran