lymphoceles following renal transplantation

Last reviewed 01/2018

Lymphoceles (lymphocysts) are abnormal collections of lymphatic fluid that can occur following surgery:

  • lymphoceles can be visualized by ultrasound as a low echogenicity collection which may have thickened septa and internal debris
  • lymphoceles following renal transplantation
    • incidence of lymphoceles varies from 0.6 to 16% of the time after kidney transplantation
      • majority of lymphoceles remain unrecognized when of small dimensions
      • lymphatic collections of larger dimension or located close to the ureter may become clinically manifest, usually between 18 and 180 days after transplantation
    • possible clinical manifestations of lymphoceles include
      • ipsilateral edema, deep venous thrombosis, bladder displacement, or obstruction of the ureter resulting in transplant malfunction, requiring drainage
    • management of symptomatic lymphoceles is unclear (1)
      • simple needle aspiration or percutaneous external drainage with or without injection of sclerosing solutions are a less invasive alternative to the surgical approach - however these techniques have high recurrence and complication rates (1,2)
      • open or laparoscopic intraperitoneal marsupialization of the lymphatic collection are other treatment options
        • however these require a hospital stay, general anesthesia, and sometimes extensive surgical dissection
      • a newer technique for the treatment of symptomatic lymphocele is via percutaneous intraperitoneal catheter placement has been reported with good results (1,2)
        • the use of "..outpatient surgical approach using ultrasound-guided intraperitoneal drainage with a Tenckhoff catheter appears to be a simple, effective, and safe method for treating unilobular recurrent symptomatic lymphocele after renal transplantation.." (1)

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