Post transplant lymphocele: a single centre experience

Abstract

The occurrence of post renal transplant lymphocele is variable and the best approach to treatment is not well defined. The purpose of this study was to find out the incidence of post transplant lymphocele at our centre, identify demographic or surgical factors that may have influenced lymphocele formation, and distinguish the best approach to treatment. The charts of 138 consecutive renal transplant recipients from 1996 to 2001 were retrospectively reviewed. The demographic characteristics, comorbid illnesses, occurrence of lymphocele and its treatment modality were recorded. A total of 36 (26%) patients developed lymphoceles. There was a significant relationship between an increased body mass index (BMI) and lymphocele occurrence (P > 0.01). The recurrence rate with drainage alone was 33%, which decreased to 25% with sclerotherapy. In comparison, both laparoscopic and open surgical marsupialization had a much lower but similar recurrence rate of 12%. The laparoscopic method had less morbidity, a shortened hospital stay, and less infection than open surgery.

Lymphocoele: a rare and little known complication of anterior lumbar surgery

“…It consists on internal peritoneal drainage of the lymphocoele through a peritoneal window large enough to remain patent and allow reabsorption by the peritoneal tissues of the produced fluid. The failure rate in transplant patients (12%) has been lower than using other techniques such as drainage (25%) alone or sclerotherapy (33%) [2].…”

“…Absence of those risk factors might explain a significantly lower incidence in anterior spinal surgery. Increased body mass index has also been linked with the occurrence of lymphocoele in renal transplant patients [2].…”

“…Liver function tests can be performed in order to rule out liver dysfunction causing ascites. Treatment of lymphocoele has been by continuous drainage or by aspiration and injection of sclerosing agents such as doxyclycline or povidone iodine although both these techniques can have high recurrence rates [2]. Their application in spinal surgery in the presence of implants raises the question of possible secondary infection.…”

Complicaciones quirúrgicas en el trasplante renal y su influencia en la supervivencia del injerto

“…La incidencia media de linfoceles publicada oscila ente el 0,5 y el 20% 27 . La causa del linfocele se encuentra en un exceso de disecció n de los vasos ilíacos, lesionando los vasos linfá ticos circundantes o a un sellado deficiente de los linfá ticos del hilio renal durante la cirugía de banco.…”

Laparoscopic Repair of Incisional Hernia in Solid Organ Transplanted Patients: The Method of Choice?

“…Our data support these findings. The impact of these immunosuppressive effects may be demonstrated/examplified by the fact that lymphocele/lymph leakage is a major problem after allograft kidney transplantation (KTx) (3-18% requiring re-interventions) [27], while in renal auto-transplantation, this problem is almost nonexistent [28]. During recent years, the immunosuppressive treatments have been increased and optimized, resulting in fewer rejection episodes, but probably with more severe adverse effects also regarding wound healing.…”