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Lymphocele after renal transplantation
The Australian and New Zealand Journal of Surgery
|December 1, 1979
Summary
Post-renal transplant lymphoceles, fluid collections near the kidney, occurred in 25% of patients. A new surgical technique to ligate lymphatics significantly reduced their incidence, preventing future cases.
Area of Science:
- Nephrology
- Transplant Surgery
- Urology
Background:
- Lymphoceles are a known complication following renal transplantation.
- A high incidence of lymphoceles was observed at the Oxford Unit.
- Symptomatic lymphoceles can cause obstruction or pressure, requiring intervention.
Purpose of the Study:
- To investigate the incidence and causes of lymphoceles after renal transplantation.
- To evaluate the effectiveness of a new surgical technique in preventing lymphocele formation.
Main Methods:
- Retrospective analysis of 115 renal transplant patients.
- Identification of symptomatic and asymptomatic lymphoceles.
- Evaluation of potential etiological factors including diathermy and lymphatic division.
- Implementation and assessment of a lymphatic ligation/clipping technique.
Main Results:
- 25 out of 115 patients developed lymphoceles.
- 15% of patients experienced symptomatic lymphoceles requiring treatment (aspiration or fenestration).
- Diathermy and division of iliac lymphatics were identified as likely causes.
- Adoption of lymphatic ligation/clipping resulted in zero lymphoceles in the subsequent 70 transplants.
Conclusions:
- Lymphocele formation after renal transplantation is associated with specific surgical practices.
- Ligating or clipping iliac lymphatics is an effective preventive strategy.
- Minimizing lymphatic disruption during renal transplantation can significantly reduce lymphocele incidence.