Functional significance and risk factors for lymphocele formation after renal transplantation
| Autor: | Kerrin Palazzi, Philip Sprott, Paul Trevillian, David Clark, A. D. Hibberd, Munish Kumar Heer |
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| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
business.industry Incidence (epidemiology) 030232 urology & nephrology Renal function General Medicine Perioperative 030230 surgery medicine.disease Venous Obstruction Surgery Transplantation 03 medical and health sciences Lymphocele 0302 clinical medicine medicine Risk factor business Adverse effect |
| Zdroj: | ANZ Journal of Surgery. 88:597-602 |
| ISSN: | 1445-1433 |
| Popis: | Background Lymphocele development following renal transplantation is a significant adverse event. It may cause acute graft dysfunction or venous obstruction. There are no consistent risk factors reported in literature. Perioperative fluid balance may lead to increased lymphocele formation and has never been studied. We aimed to analyse incidence and risk factors for lymphocele formation. We hypothesized that overhydration in perioperative period is a risk factor. Methods We analysed 250 consecutive renal transplant recipients from 2006 to 2014. All recipients had undergone protocol screening by computerized tomography and ultrasound scan at 3 months post-transplant. We analysed risk factors for lymphocele formation. Comparisons between lymphocele and no-lymphocele groups were made with binary logistic regression analyses. Renal function was compared between treated, untreated and no-lymphocele groups with linear regression analyses. Results Thirty-one of 250 (12.4%) transplant recipients developed lymphocele. Fourteen of 31 (45.4%) recipients required intervention due to symptoms (venous obstruction being the most common). Surgical drainage was done in all symptomatic patients (11 laparoscopic and three open). Two of 11 (18%) recipients had recurrence after laparoscopic drainage. There were no significant differences in risk factors between the lymphocele and no-lymphocele groups. Renal function was comparable between no-lymphocele and treated lymphocele groups. Untreated lymphocele group trended towards better graft function at 1 year (P = 0.051). Conclusion Post-transplant lymphocele developed one in eight transplant recipients and tended to occur in those with good renal function. Around half of the recipients with lymphocele required intervention with good recovery of long-term renal function. No risk factor for lymphocele development was established. |
| Databáze: | OpenAIRE |
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