Post–Kidney Transplantation Lymphocele due to a Lymphatic Filariasis

Derouiche, A.; Atat, Rabii El; Mechri, M.; Garbouj, N.; Ezzeddine, A.; Khaled, Annette R.; Chébil, Mohamed

doi:10.1016/j.transproceed.2010.04.042

Cited by 8 publications

(2 citation statements)

References 19 publications

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“…Finally, the use of diuretics could increase the rate of lymphocele probably through their ability to increase the lymphatic flow [ 34 ]. Finally, a case of post-kidney transplantation lymphocele due to lymphatic filariasis has been described [ 35 ].…”

Section: Introductionmentioning

confidence: 99%

Lymphatic disorders after renal transplantation: new insights for an old complication

Ranghino¹,

Segoloni²,

Lasaponara

et al. 2015

Clin Kidney J

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In renal transplanted patients, lymphoceles and lymphorrhea are well-known lymphatic complications. Surgical damage of the lymphatics of the graft during the procurement and of the lymphatic around the iliac vessels of the recipients has been associated with development of lymphatic complications. However, lymphatic complications may be related to medical factors such as diabetes, obesity, blood coagulation abnormalities, anticoagulation prophylaxis, high dose of diuretics, delay in graft function and immunosuppressive drugs. Consistently, immunosuppression regimens based on the use of mTOR inhibitors, especially in association with steroids and immediately after transplantation, has been associated with a high risk to develop lymphocele or lymphorrhea. In addition, several studies have demonstrated the association between rejection episodes and lymphatic complications. However, before the discovery of reliable markers of lymphatic vessels, the pathogenic mechanisms underlining the development of lymphatic complications during rejection and the influence of mTOR inhibitors remained not fully understood. The recent findings on the lymphatic systems of either native or transplanted kidneys together with the advances achieved on lymphangiogenesis shared some lights on the pathogenesis of lymphatic complications after renal transplantation. In this review, we describe the surgical and medical causes of lymphatic complications focusing on the rejection and immunosuppressive drugs as causes of lymphatic complications.

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Section: Introductionmentioning

confidence: 99%

Lymphatic disorders after renal transplantation: new insights for an old complication

Ranghino¹,

Segoloni²,

Lasaponara

et al. 2015

Clin Kidney J

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“…The renal biopsy in our patient showed benign nephrosclerosis, which did not explain such a massive amount of proteinuria. Many reports have previously documented the incidence of glomerulonephritis associated with acute filarial infection, which is called ‘filarial nephropathy’ [ 2 – 4 ]. Using light microscopic examination, these reports have described various types of renal injuries such as membranous, mesangiocapillary and chronic sclerosing glomerulonephritis [ 4 – 7 ].…”

Section: Discussionmentioning

confidence: 99%

Successful treatment of massive proteinuria and severe chyluria by inhibition of cholesterol absorption with ezetimibe in a patient with filariasis

Tanaka

Tsuruya

Tsuchimoto

et al. 2012

Clinical Kidney Journal

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We describe a case of filariasis presenting with severe chyluria and nephrotic-range proteinuria. There were no obvious findings of glomerulonephritis in the renal biopsy. Technetium-99m-human serum albumin (Tc-99m-HSA) lymphoscintigraphy revealed the presence of communications between lymphatic channels and the urinary tract. Ezetimibe (10 mg/day) was administered during hospitalization. Chyluria was decreased within a few days following the administration of ezetimibe. Moreover, a remission was obtained from nephrotic-range proteinuria. Tc-99m-HSA lymphoscintigraphy showed a reduction of lymph flow to the urinary tract three months later. In our patient, therapeutic intervention by ezetimibe may have resulted in a reduction of chylous lymph absorption from the intestine and the prevention of mucosal rupture into the renal pelvis and calyx via reduced intralymphatic pressure. Ezetimibe may be an effective and safe treatment for this indication, and should be considered when filarial patients present with chyluria and massive proteinuria before employing invasive surgical procedures.

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Prevention and management of lymphocele formation following kidney transplantation

Golriz

Klauß

Zeier

et al. 2017

Transplantation Reviews

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Post–Kidney Transplantation Lymphocele due to a Lymphatic Filariasis

Cited by 8 publications

References 19 publications

Lymphatic disorders after renal transplantation: new insights for an old complication

Lymphatic disorders after renal transplantation: new insights for an old complication

Successful treatment of massive proteinuria and severe chyluria by inhibition of cholesterol absorption with ezetimibe in a patient with filariasis

Prevention and management of lymphocele formation following kidney transplantation

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