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Lymphocele: a possible relationship with acute cellular rejection in kidney transplantation
M A Lipay1, I de L Noronha, A Vidonho Júnior
1Urology and Nephrology Clinic, Beneficência Portuguesa Hospital, São Paulo, Brazil. mlipay@mobinet.com.br
Context:
The incidence of lymphocele after renal transplantation varies between 0.6 and 18% of cases, and many factors have been associated to its etiology. Cellular rejection of the kidney allograft has been described as a possible causal factor of lymphocele.
Objective:
To analyze the possible relationship between lymphocele and acute cellular rejection.
Design:
A retrospective study.
Setting:
A referral hospital center.
Sample:
170 patients submitted to kidney transplantation from March 1992 to January 1997. A standard technique for renal transplantation was used.
Results:
Of the 19 patients that developed lymphocele, 16 presented at least one episode of acute cell rejection (84%), and were treated with methylprednisolone. The relation between lymphocele and rejection was statistically significant (p = 0.04). Treatment of lymphocele consisted of peritoneal marsupialization in 3 patients (15.3%), percutaneous drainage in 7 (36.8%), laparoscopic marsupialization in 2 (10.5%), and conservative treatment in 7 patients (36.8%). Evolution was favorable in 15 patients (78.9%), 1 patient (5.3%) died due to a cause unrelated to lymphocele, and 3 (15.8%) lost the graft due to immunological factors. The average follow-up period was 24.5 months.
Conclusion:
The high incidence of acute cell rejection in patients with lymphocele suggests a possible causal relationship between both conditions.