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2025, Number 1

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Rev Mex Urol 2025; 85 (1)

Management of lymphocele after kidney transplantation: twenty years’ experience in a high-complexity clinic

Guachetá-Bomba PL, Suso-Palau D, Ramírez G, García-Perdomo HA
Full text How to cite this article

Language: Spanish
References: 16
Page: 1-8
PDF size: 167.59 Kb.


Key words:

Lymphocele, renal transplant, percutaneous drainage, marsupialization, laparoscopy.

ABSTRACT

Objective: To describe the 20-year experience of a high-complexity clinic in southwestern Colombia regarding the percutaneous and laparoscopic management of post-kidney transplant lymphocele (PKTL).
Methods: We conducted a retrospective, descriptive, and observational study to identify patients diagnosed with lymphocele through the kidney transplant program database. Demographic and clinical data were collected, including comorbidities, risk factors for lymphocele development, and treatment outcomes. Inclusion criteria included patients aged ≥18 years with a diagnosis of lymphocele following kidney transplantation and with complete medical records available. Data were compiled using Excel and analyzed with Stata 14.0®.
Results: We included 31 patients with post-kidney transplant lymphocele between 2000 and 2020. Of these, 19 were male and 12 female; the median age was 46 years, and the median body mass index was 22.7 kg/m². The most common comorbidities were hypertension and type 2 diabetes mellitus. The median time to initial diagnosis was 41 days, and the median lymphocele volume was 240 mL. Recurrence following percutaneous treatment occurred in 77 % of cases, while no recurrence was observed in patients who underwent laparoscopic marsupialization.
Conclusions: PKTL is a common complication occurring within the first 45 days post-transplantation. Although percutaneous management is linked to a high recurrence rate, it may be utilized as a first-line treatment. In cases of treatment failure, the laparoscopic approach should be regarded as the standard of care due to its favorable outcomes.


REFERENCES

  1. Singh AG, Jai SJ, Ganpule AP, VijayKumarM, Sabnis RB, Desai MR. Critical appraisal ofconsecutive 36 cases of post renal transplantlymphocele: a proposed algorithm. World Journalof Urology. 2017;35(9): 1443–1450. https://doi.org/10.1007/s00345-016-1997-x.

  2. Nelson EW, Gross ME, Mone MC, Hansen HJ,Sheng X, Cannon KM, et al. Does ultrasonicenergy for surgical dissection reduce theincidence of renal transplant lymphocele?Transplantation Proceedings. 2011;43(10): 3755–3759. https://doi.org/10.1016/j.transproceed.2011.08.079.

  3. Dubeaux VT, Oliveira RM, Moura VJ, PereiraJMS, Henriques FP. Assessment of lymphoceleincidence following 450 renal transplantations.International Braz J Urol: Official Journal ofthe Brazilian Society of Urology. 2004;30(1):18–21. https://doi.org/10.1590/s1677-55382004000100004.

  4. Krajewski W, Dembowski J, Kołodziej A,Małkiewicz B, Tupikowski K, MatuszewskiM, et al. Urological complications after renaltransplantation – a single centre experience.Central European Journal of Urology. 2016;69(3):306–311. https://doi.org/10.5173/ceju.2016.833.

  5. Ahmed RR, Halabi E, Fathi T, Al-Mousawi M.Postoperative Surgical Complications of LiveUnrelated Renal Transplants for Patients of EndStage Renal Disease Needing Renal ReplacementTherapy. Journal of the College of Physicians andSurgeons--Pakistan: JCPSP. 2018;28(12): 941–944.https://doi.org/10.29271/jcpsp.2018.12.941.

  6. Shaver TR, Swanson SJ, Fernandez-BuenoC, Kocandrle V. The optimal treatment oflymphoceles following renal transplantation.Transplant International: Official Journal of theEuropean Society for Organ Transplantation.1993;6(2): 108–110. https://doi.org/10.1007/BF00336654.

  7. Smyth GP, Beitz G, Eng MP, Gibbons N,Hickey DP, Little DM. Long-term outcomeof cadaveric renal transplant after treatmentof symptomatic lymphocele. The Journal ofUrology. 2006;176(3): 1069–1072. https://doi.org/10.1016/j.juro.2006.04.014.

  8. Heer MK, Clark D, Trevillian PR, Sprott P,Palazzi K, Hibberd AD. Functional significanceand risk factors for lymphocele formation afterrenal transplantation. ANZ journal of surgery.2018;88(6): 597–602. https://doi.org/10.1111/ans.14343.

  9. Khauli RB, Stoff JS, Lovewell T, Ghavamian R,Baker S. Post-transplant lymphoceles: a criticallook into the risk factors, pathophysiologyand management. The Journal of Urology.1993;150(1): 22–26. https://doi.org/10.1016/s0022-5347(17)35387-9.

  10. Giuliani S, Gamba P, Kiblawi R, Midrio P,Ghirardo G, Zanon GF. Lymphocele afterpediatric kidney transplantation: incidenceand risk factors. Pediatric Transplantation.2014;18(7): 720–725. https://doi.org/10.1111/petr.12341.

  11. Zietek Z, Sulikowski T, Tejchman K, Sieńko J,Janeczek M, Iwan-Zietek I, et al. Lymphoceleafter kidney transplantation. TransplantationProceedings. 2007;39(9): 2744–2747. https://doi.org/10.1016/j.transproceed.2007.08.041.

  12. Kim N, Juarez R, Levy AD. Imaging nonvascularcomplications of renal transplantation.Abdominal Radiology (New York). 2018;43(10):2555–2563. https://doi.org/10.1007/s00261-018-1566-4.

  13. Lucewicz A, Wong G, Lam VWT, HawthorneWJ, Allen R, Craig JC, et al. Managementof primary symptomatic lymphocele afterkidney transplantation: a systematic review.Transplantation. 2011;92(6): 663–673. https://doi.org/10.1097/TP.0b013e31822a40ef.

  14. Rivera Astorga H, León López P L, VazquezTabares M P, Martínez Valeriano D A,Gurrola Ortega A, Jaspersen Gastelum J, et al.Tratamiento quirúrgico de hipospadias lisiadaen el adulto. Revista Mexicana de Urología.2024;84(1): 1–14.

  15. Choudhrie AV, Kumar S, Gnanaraj L, DevasiaA, Chacko N, Kekre NS. Symptomaticlymphocoeles post renal transplant. SaudiJournal of Kidney Diseases and Transplantation:An Official Publication of the Saudi Center forOrgan Transplantation, Saudi Arabia. 2012;23(6):1162–1168. https://doi.org/10.4103/1319-2442.103554.

  16. Williams G, Howard N. Management oflymphatic leakage after renal transplantation.Transplantation. 1981;31(2): 134. https://doi.org/10.1097/00007890-198102000-00009.




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Rev Mex Urol. 2025;85