Perirenal lymphocyst formation in renal transplant recipients: diagnosis and pathogenesis

Perirenal lymphocyst formation occurred in 7 of 46 consecutive renal allografts which had survived at least one month. This complication developed from one to four and one-half months post-transplantation, resulted in a specific spectrum of clinical signs and symptoms, and was best diagnosed by a combination of intravenous pyelography and ultrasonic examination of the transplanted kidney. The lymph fluid is of recipient origin and its collection appears to be related to use of a high-dose immunosuppressive regimen and to a conscious decision to avoid the use of postoperative surgical drains. Surgical intraperitoneal marsupialization of the lymphocyst emerges as the clear treatment of choice for peritransplant lymphocyst formation.