>Cirugía y Cirujanos
>Year 2010, Issue 4
Flores-Gama F, Bochicchio-Riccardelli T, Mondragón-Ramírez G
Determination of liquid collection after renal transplant: urinary leak or lymphocele?
Cir Cir 2010; 78 (4)
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Background: Liquid collections around the renal graft that are displayed in 51% of cases implicate a diagnostic challenge and a risk for graft function. We undertook this study to determine the usefulness of creatinine concentration measurement in drainage in patients with renal transplantation. Methods: We selected patients with surgically corrected urinary leak and patients with lymphocele from November 1, 1999 to November 30, 2008 in whom we determined the creatinine concentration in liquid drainage, plasma and urine.
Results: We included five patients with urinary leak and six patients with lymphocele. Two patients had urinary leak before the lymphocele. The t value of the plasma creatinine (Pcreat), drainage (Dcreat) and urine (Ucreat) was 0.89, 0.045 and 0.63, respectively. The diagnostic criteria of urinary leak represented a value between the creatinine of the drainage and plasma (D/Pcreat) , between urine and drainage (U/Dcreat) and between urine and plasma (U/ Pcreat) . When we compared both groups the χ2 values were 0.018, 0.007 and 0.094, respectively.
Conclusions: There is a statistically significant difference among the creatinine drainage liquid values. Our study shows that D/Pcreat ratio after the first week or U/Dcreat ratio at any time during the postoperative period represents a six-times higher possibility of urinary leak.
||Renal transplant, creatinine measurement, urinary leak, lymphocele.
Silver T, Campbell D, Wicks J, Lorber M, Surace P, Turcotte J. Peritransplant fluid collections. Radiology 1981;138:145-151.
Spigos D, Tan W, Pavel D, Mozes M, Jonasson O, Capek V. Diagnosis of urine extravasation after renal transplantation. Am J Roentgenol 1977;129:409-413
Humar A, Matas A. Surgical complications after kidney transplantation. Semin Dial 2005;18:505-510.
Streeter E, Little D, Cranston D, Morris P. The urological complications of renal transplantation: a series of 1535 patients. BJU Int 2002;90:627-634.
Fortenbery E, Blue P, Van Nostrand D, Anderson J. Lymphocele: the spectrum of scintigraphic findings in lymphoceles associated with renal transplant. J Nucl Med 1990;31:1627-1631.
Dirlik A, Erinç R, Özcan Z, Duman S, Özkahya M, Özbek S, et al. Diagnosis of urinary leakage in renal transplant patients: ultrasonographic, clinical and scintigraphic findings. Turk Hij Deney Biyol Derg 2001;10:239-243.
Dinckan A, Tekin A, Serdar T, Kocak H, Gurkan A, Erdogan O, et al. Early and late urological complications corrected surgically following renal transplantation. Transpl Int 2007;20:702-707.
Zomorrodi A, Buhluli A. Instillation of povidone iodine to treat lymphocele and leak of lymph after renal transplantation. Saudi J Kidney Dis Transplant 2007;18:621-624.
Gómez B, Lehnhardt A, Glüer S, Offner G, Nashan B, Ure B. Laparoscopic fenestration of postransplant lymphoceles in children. J Pediatr Surg 2004;39:1230-1232.
Martínez-Mier G, Jiménez-López L, Valencia-Mercado D, George-Micelli E, Salas-Díaz F, González-Medina MF. Complicaciones urológicas postrasplante renal con técnica de Lich-Gregoir. Experiencia de cuatro años. Cir Cir 2009;77:111-114.
Schultze L, Blickman J, Es A, Hew J. Retroperitoneal reabsorption of extravasated urine in renal transplant patients. Radiology 1984;153:625-626.
Spector D, Yang Q, Wade J. High urea and creatinine concentrations and urea transporter B in mammalian urinary tract tissues. Am J Physiol Renal Physiol 2007;292:F467-F474.
Englesbe M, Dubay D, Gillespie B, Moyer A, Pelletier S, Sung R. Risk factors for urinary complications after renal transplantation. Am J Transplant 2007;7:1536-1541.
Stothert J. Renal blood flow and intrarenal distribution of blood flow afterdecapsulation in the postischemic kidney. Ann Surg 1980;191:456- 459.
Hebert L, Stuart K, Stemper J. Effect of renal decapsulation on renal function. Am J Physiol 1975;229:632-639.
Hebert L, Chen W, Hartmann A, Garancis J. Mechanical properties of the dog renal capsule. J Appl Physiol 1976;40:2164-2170.
>Cirugía y Cirujanos
>Year 2010, Issue 4