Does Ultrasonic Energy for Surgical Dissection Reduce the Incidence of Renal Transplant Lymphocele?

Nelson, Edward William; Gross, Molly E.; Mone, Mary C.; Hansen, Heidi; Sheng, Xiaoming; Cannon, Kendell M.; Alder, Stephen C.

doi:10.1016/j.transproceed.2011.08.079

Cited by 14 publications

(8 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Different results were found by Nelson et al. , who demonstrated in the adult population that surgical dissection technique was not a factor in the development of post‐transplant lymphocele. While they found no statistical significant advantage to the use of ultrasonic dissection for lymphatic control, there was an obvious advantage in terms of speed and convenience when using this device.…”

Section: Discussionmentioning

confidence: 68%

Lymphocele after pediatric kidney transplantation: Incidence and risk factors

Giuliani

Gamba

Kiblawi

et al. 2014

Pediatric Transplantation

View full text Add to dashboard Cite

Lymphocele is a well-known postoperative complication after kidney transplantation. The aim of this study was to analyze time trend incidence, risk factors, and outcome of post-transplant lymphocele in a large pediatric cohort. This is a retrospective single institution review of 241 pediatric kidney transplants performed from 2000 to 2013. Etiology of end-stage renal disease, recipient age and gender, transplant year, BMI percentile for age, type of dialysis, living/non-living related donor, acute rejection, and multiple transplantations were analyzed in association with lymphocele formation. Fourteen of 241 (5.81%) children developed a postoperative lymphocele. There has been a reduction in the incidence of lymphocele after 2006 (3.22% vs. 8.55%, p < 0.05). Significant risk factors for lymphocele were older age (≥11 yr), transplant before 2006, male gender, BMI percentile for age ≥95%, and multiple transplantations (p < 0.05). The one-yr graft survival was significantly reduced in the group with lymphocele compared with control (81.2% vs. 92.51%, p < 0.04). This is the first pediatric report showing the following risk factors associated with post-transplant lymphocele: age ≥11 yr, male gender, BMI for age ≥95%, and multiple transplantations. A lymphocele can contribute to graft loss in the first-year post-transplant.

show abstract

Section: Discussionmentioning

confidence: 68%

Lymphocele after pediatric kidney transplantation: Incidence and risk factors

Giuliani

Gamba

Kiblawi

et al. 2014

Pediatric Transplantation

View full text Add to dashboard Cite

show abstract

“…Mazzucchi et al showed that grafts with more than one artery were associated with a lower incidence of lymphoceles (3.1% single artery versus 12.5% multiple arteries, P = 0.0015) and speculated that the cause of higher occurrence of lymphocele in transplanted patients with multiple arteries grafts depends to the presence of more abundant lymphatic vessels likely due to insufficient ligature [ 18 ]. On the contrary, other studies did not find any significant differences in the rate of lymphatic complication according to different surgical techniques and among patients transplanted by surgeons with a different grade of experience in transplantation [ 19 – 21 ]. Thus, it is reasonable to speculate that lymphatic disorders developing long after surgical intervention in recipients who underwent a careful ligation of the damaged iliac lymphatic vessels, are due to a leakage of lymph from the allograft lymphatics.…”

Section: Introductionmentioning

confidence: 93%

Lymphatic disorders after renal transplantation: new insights for an old complication

Ranghino¹,

Segoloni²,

Lasaponara

et al. 2015

Clin Kidney J

View full text Add to dashboard Cite

In renal transplanted patients, lymphoceles and lymphorrhea are well-known lymphatic complications. Surgical damage of the lymphatics of the graft during the procurement and of the lymphatic around the iliac vessels of the recipients has been associated with development of lymphatic complications. However, lymphatic complications may be related to medical factors such as diabetes, obesity, blood coagulation abnormalities, anticoagulation prophylaxis, high dose of diuretics, delay in graft function and immunosuppressive drugs. Consistently, immunosuppression regimens based on the use of mTOR inhibitors, especially in association with steroids and immediately after transplantation, has been associated with a high risk to develop lymphocele or lymphorrhea. In addition, several studies have demonstrated the association between rejection episodes and lymphatic complications. However, before the discovery of reliable markers of lymphatic vessels, the pathogenic mechanisms underlining the development of lymphatic complications during rejection and the influence of mTOR inhibitors remained not fully understood. The recent findings on the lymphatic systems of either native or transplanted kidneys together with the advances achieved on lymphangiogenesis shared some lights on the pathogenesis of lymphatic complications after renal transplantation. In this review, we describe the surgical and medical causes of lymphatic complications focusing on the rejection and immunosuppressive drugs as causes of lymphatic complications.

show abstract

“…). Eighty‐seven articles met the inclusion criteria and were included in the report. Seventy‐six articles reported on lymphoceles only, four articles on lymphorrhoea, and seven articles on lymphocele and lymphorrhoea.…”

Section: Resultsmentioning

confidence: 99%

Consensus on definition and severity grading of lymphatic complications after kidney transplantation

Mehrabi

Kulu

Sabagh

et al. 2020

British Journal of Surgery

View full text Add to dashboard Cite

Background: The incidence of lymphatic complications after kidney transplantation varies considerably in the literature. This is partly because a universally accepted definition has not been established. This study aimed to propose an acceptable definition and severity grading system for lymphatic complications based on their management strategy. Methods: Relevant literature published in MEDLINE and Web of Science was searched systematically. A consensus for definition and a severity grading was then sought between 20 high-volume transplant centres.Results: Lymphorrhoea/lymphocele was defined in 32 of 87 included studies. Sixty-three articles explained how lymphatic complications were managed, but none graded their severity. The proposed definition of lymphorrhoea was leakage of more than 50 ml fluid (not urine, blood or pus) per day from the drain, or the drain site after removal of the drain, for more than 1 week after kidney transplantation. The proposed definition of lymphocele was a fluid collection of any size near to the transplanted kidney, after urinoma, haematoma and abscess have been excluded. Grade A lymphatic complications have a minor and/or non-invasive impact on the clinical management of the patient; grade B complications require non-surgical intervention; and grade C complications require invasive surgical intervention.Conclusion: A clear definition and severity grading for lymphatic complications after kidney transplantation was agreed. The proposed definitions should allow better comparisons between studies.

show abstract

Does Ultrasonic Energy for Surgical Dissection Reduce the Incidence of Renal Transplant Lymphocele?

Cited by 14 publications

References 30 publications

Lymphocele after pediatric kidney transplantation: Incidence and risk factors

Lymphocele after pediatric kidney transplantation: Incidence and risk factors

Lymphatic disorders after renal transplantation: new insights for an old complication

Consensus on definition and severity grading of lymphatic complications after kidney transplantation

Contact Info

Product

Resources

About