Massive Ascites in a Renal Transplant Patient after Laparoscopic Fenestration of a Lymphocele

Kawaguchi, Shohei; Nohara, Takahiro; Shima, Takashi; Matsuyama, Satoko; Nose, Chikako; Yamahana, Junya; Kadono, Yoshifumi; Seto, Chikashi; Kurabayashi, Masahiko; Mizokami, Atsushi

doi:10.1155/2016/7491627

Cited by 3 publications

(1 citation statement)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…4 There are reports of cases associated with problems such as rejection, graft decapsulation, urinary or vascular leakage, lymphocytosis, transudation, or infection. 7,8 In rare cases, ascites and hepatotoxicity is associated with immunosuppressive drugs such as and pathophysiological. We have not found published cases of post-RT ascites secondary to this pathology, described as possibly associated with drugs, immune alterations, infections, hypercoagulability and genetic predisposition.…”

Section: Introductionmentioning

confidence: 99%

Refractory ascites and graft dysfunction in early renal transplantation

et al. 2019

View full text Add to dashboard Cite

The occurrence of ascites after Renal Transplant (RT) is infrequent, and may be a consequence of surgical or medical complications. Case report: 61 year-old, male, history of arterial hypertension, tongue carcinoma and alcoholic habits 12-20g/day. He had chronic kidney disease secondary to autosomal dominant polycystic kidney disease, without hepatic polycystic disease. He underwent cadaver donor RT in September 2017. He had delayed graft function by surgically corrected renal artery stenosis. He was admitted in January 2018 for ascites de novo, with no response to diuretics. HE had visible abdominal collateral circulation. Graft dysfunction, adequate tacrolinemia, Innocent urinary sediment, mild anemia, without thrombocytopenia. Serum albumin 4.0g / dL. Normal hepatic biochemistry. Peritoneal fluid with transudate characteristics and serum albumin gradient > 1.1. Ultrasound showed hepatomegaly, permeable vascular axes, without splenomegaly. Mycophenolate mofetil was suspended, with reduced remaining immunosuppression. He maintained refractory ascites: excluded infectious, metabolic, autoimmune and neoplastic etiologies. No nephrotic proteinuria and no heart failure. MRI: micronodules compatible with bile cysts. Upper Digestive Tract Endoscopy did not show gastroesophageal varicose veins. Normal abdominal lymphoscintigraphy. He underwent exploratory laparoscopy with liver biopsy: incomplete septal cirrhosis of probable vascular etiology some dilated bile ducts. He maintained progressive RT dysfunction and restarted hemodialysis. The proposed direct measurement of portal pressure was delayed by ascites resolution. There was further recovery of the graft function. Discussion: Incomplete septal cirrhosis is an uncommon cause of non-cirrhotic portal hypertension. Its definition is not well known, morphological and pathophysiological. We have not found published cases of post-RT ascites secondary to this pathology, described as possibly associated with drugs, immune alterations, infections, hypercoagulability and genetic predisposition.

show abstract

Section: Introductionmentioning

confidence: 99%

Refractory ascites and graft dysfunction in early renal transplantation

et al. 2019

View full text Add to dashboard Cite

show abstract

Abdominal distention and continuous feeding intolerance after intraperitoneal kidney transplant: Answers

Feygina

Kotru

2017

Pediatr Nephrol

View full text Add to dashboard Cite

A Case Report of Chyloretroperitoneum Post Living-Donor Transplantation

et al. 2019

View full text Add to dashboard Cite

Chyloretroperitoneum is a rare complication of urological surgery. Here we report a case of chyloretroperitoneum that occurred in a 28-year-old man post living-donor transplantation. Twenty-nine days post transplantation, perirenal fluid collection and hydronephrosis were detected and percutaneous drainage was performed. The fluid was chylous and revealed a very high triglyceride concentration (1,197 mg/dL). Total parenteral nutrition and administration of octreotide were performed, but the leakage did not improve. On the contrary, the drainage fluid gradually increased to 1,600 mL/day, and a laparoscopic fenestration was performed owing to a concern about the adverse effects of massive lymph loss. Ascites temporarily appeared but disappeared 3 months post fenestration. To our knowledge, this is the first case report of pelvic chyloretroperitoneum post living-donor transplantation. Furthermore, if chyloretroperitoneum treatment using diet control or octreotide is ineffective, laparoscopic fenestration can be considered as a treatment option.

show abstract

Massive Ascites in a Renal Transplant Patient after Laparoscopic Fenestration of a Lymphocele

Cited by 3 publications

References 8 publications

Refractory ascites and graft dysfunction in early renal transplantation

Refractory ascites and graft dysfunction in early renal transplantation

Abdominal distention and continuous feeding intolerance after intraperitoneal kidney transplant: Answers

A Case Report of Chyloretroperitoneum Post Living-Donor Transplantation

Contact Info

Product

Resources

About