Management of Primary Symptomatic Lymphocele After Kidney Transplantation: A Systematic Review

Abstract

Laparoscopic fenestration of a symptomatic lymphocele is associated with the lowest risk of lymphocele recurrence. However, the evidence base to support a recommendation for laparoscopic surgery as first line treatment is weak and highlights the need for a multicenter prospective cohort study to examine the benefits of incorporating initial simple aspiration into the management of lymphocele after kidney transplantation.

Treatment of a Large, Symptomatic Refractory Lymphocele After Pelvic Lymphadenectomy by Using the Hypereye Medical System™

“…However, the recurrence rate after aspiration is high. 3,6 Although percutaneous ultrasound-guided catheter drainage is effective therapy for symptomatic lymphoceles, the catheter must sometimes be replaced when it has been in situ for a long time and has resulted in some adverse effects, including infection, hemorrhage, and hypoalbuminemia. The success rate of drainage is >80%.…”

“…According to the previous reports, percutaneous drainage and sclerotherapy are recommended for the treatment of lymphocele. [3][4][5] However, because repeated percutaneous drainage may increase the risk of infection, hemorrhage, and hypoalbuminemia, a refractory lymphocele is usually managed surgically.…”

Extravascular complications following abdominal organ transplantation

“…9,42 The transplant allograft may be affected by PTLD to varying frequencies, as high as 70e75% in renal transplant recipients, with renal and peri-renal involvement, and in 10% of pancreas transplant recipients. 33,46,47 Renal transplant recipients are at increased risk of renal cell carcinoma (RCC) due to the higher incidence in this population for acquired renal cystic disease associated with dialysis. Approximately 50% of chronic dialysis patients develop acquired renal cystic disease, and 9% develop tumours.…”

“…31 Treatment options include sclerotherapy, laparoscopic fenestration, or open surgery. 33 Ureteric strictures are a common cause of urinary obstruction. 30 Abrupt narrowing at the stricture site with upstream hydronephrosis and hydro-ureter is the typical imaging finding (Fig 10).…”

Massive Ascites in a Renal Transplant Patient after Laparoscopic Fenestration of a Lymphocele

“…The incidence rate of lymphocele after renal transplantation is 1%–26% [1]. The lymphocele is usually small, asymptomatic, and incidentally diagnosed during routine ultrasonography.…”