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Isolation of Human Lymphatic Endothelial Cells by Multi-parameter Fluorescence-activated Cell Sorting
Published on: May 1, 2015
Complicated lymphoceles after kidney transplantation
E Zagdoun1, M Ficheux, T Lobbedez
1Department of Nephrology, Centre Hospitalier Universitaire, Caen, France.
Transplantation Proceedings
|December 21, 2010
Summary
High doses of mycophenolate mofetil (MMF) increase the risk of complicated lymphocele after renal transplantation. This surgical complication requires further investigation into MMF dosage and patient factors.
Area of Science:
- Nephrology
- Transplantation Surgery
- Immunosuppression Therapy
Background:
- Lymphocele is a frequent surgical complication following renal transplantation, with reported incidences varying widely.
- Understanding the specific risk factors for complicated lymphocele is crucial for improving patient outcomes in the context of contemporary immunosuppressive strategies.
Purpose of the Study:
- To investigate the incidence, identify risk factors, and assess the prognosis of complicated lymphocele in renal transplant recipients.
- To determine the association between immunosuppressive drug regimens, particularly mycophenolate mofetil (MMF), and lymphocele development.
Main Methods:
- A retrospective review of 311 renal transplant cases performed between January 2003 and September 2008 was conducted.
- Patients receiving sirolimus or undergoing multiorgan transplantation were excluded, leaving 269 recipients for analysis.
- Complicated lymphocele was defined as requiring surgical intervention for resolution. Statistical analyses, including multivariate analysis, were employed to identify risk factors.
Main Results:
- A complicated lymphocele occurred in 49 (18.9%) of the 269 transplant recipients.
- While cold ischemia time, waiting time on dialysis, gender, donor source, induction therapy, and dialysis modality were similar between groups, higher MMF doses were observed in the lymphocele group.
- Multivariate analysis identified higher MMF doses (OR 2.75), longer warm ischemia time (OR 1.035), and older recipient age (OR 1.04) as independent risk factors for complicated lymphocele.
Conclusions:
- Elevated MMF doses are an independent risk factor for the development of lymphocele after renal transplantation.
- Warm ischemia time and recipient age also contribute to the risk of developing a complicated lymphocele.
- These findings suggest a need to optimize MMF dosing strategies to mitigate the risk of lymphocele formation in renal transplant recipients.
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