Predictors of symptomatic lymphocele after kidney transplantation

被引:23
|
作者
Joosten, Maja [1 ]
d'Ancona, Frank C. [2 ]
van der Meijden, Wilbert A. [3 ]
Poyck, Paul P. [1 ]
机构
[1] Radboudumc, Dept Vasc & Transplant Surg, Postbus 9101, NL-6500 HB Nijmegen, Netherlands
[2] Radboudumc, Dept Urol, Nijmegen, Netherlands
[3] Radboudumc, Dept Nephrol, Nijmegen, Netherlands
关键词
Renal transplantation; Complication; Lymphocele; Risk factors; Predictors; RENAL-TRANSPLANTATION; RISK-FACTORS; MANAGEMENT;
D O I
10.1007/s11255-019-02269-0
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Purpose The development of a symptomatic lymphocele (SL) is a frequent postoperative surgical complication after kidney transplantation. It may lead to pain and discomfort and cause transplant malfunction or even secondary graft loss. A large cohort of renal recipients was investigated to identify the possible risk factors for SL. Methods All renal transplant patients of a single centre were retrospectively analysed for SL between January 2010 and December 2017. The SL group was compared to a control group from the same cohort. Results 45 out of 1003 transplanted patients developed an SL (incidence 4.5%), on average 50 days after kidney transplantation. SLs developed more in older patients, in those with a PD catheter and in ADKDP as primary diagnosis. Surgical predictors for SLs were venous anastomosis on the external iliac vein, concomitant PD catheter removal, perfusion defects, shorter operating time, splint > 7 days, double J stenting, discharge with drain, low initial drain production and ureteral obstruction. Opening of the peritoneum, re-operation for postoperative bleeding and previous nephrectomy seem protective for developing SL. Conclusion We found multiple heterogeneous predictors for SL with a common denominator related to surgical management of the retroperitoneal space, peritoneum and the ureter. Future prospective studies are necessary to evaluate the influence of these variables on the development of SL.
引用
收藏
页码:2161 / 2167
页数:7
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