Lymphoceles in Kidney Transplant Recipients: Incidence, Risk Factors, Outcomes, and Clinical Management
Toronto General Hospital, Toronto, ON, Canada
Meeting: 2020 American Transplant Congress
Abstract number: A-106
Keywords: Kidney transplantation, Outcome, Surgical complications
Session Information
Session Name: Poster Session A: Surgical Issues (Open, Minimally Invasive):All Organs
Session Type: Poster Session
Date: Saturday, May 30, 2020
Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
Location: Virtual
*Purpose: Post kidney transplantation, lymphocele development can result in morbidity for the patient and graft. Lacking prior studies in a representative cohort, we aimed to determine the incidence, risk factors, outcomes, and clinical management of lymphoceles among renal transplant recipients.
*Methods: We conducted a single-centre, retrospective cohort study on adults transplanted at our centre between January 1, 2005 and December 31, 2017, excluding those with simultaneous multi-organ transplants. Incidence, risk factors, and clinical outcomes were determined by the Kaplan-Meier product-limit method, multivariate logistic regression, and Cox regression models, respectively.
*Results: Cumulative incidence of lymphoceles within 1-year post-transplant was 0.35 per 100 person months (95%CI: 0.28-0.44). Pre-transplant diabetes mellitus (DM) [RR=2.30, 95% CI: (1.20-4.44)], laparoscopic donor nephrectomy [RR=2.21, 95% CI: (1.07-4.56)], and basiliximab induction therapy [RR=0.46, 95% CI: (0.24-0.89)] were significant risk factors for lymphocele development. Recipient ages 55 to 64, polycystic kidney disease, and transplant era 2013 to 2017 were significant only in the univariable logistic model. Lymphoceles increased the likelihood of hospital readmission (P=0.06) but had no significant effect on the likelihood of total graft failure. Of 78 cases, 62% were treated via drainage or laparoscopic marsupialization. 35% of cases receiving a primary intervention required a second intervention due to reaccumulation within 30 days or other complications.
*Conclusions: Patients affected by DM, receiving a living donor transplant after laparoscopic donor nephrectomy, and treated with basiliximab induction therapy were at risk for developing lymphoceles associated with increased hospital readmissions, but no other detrimental outcomes. Future studies should consider the efficacy of different interventions in optimizing patient outcomes.
To cite this abstract in AMA style:
Kim J, Nguyen E, Minkovich M, Famure O, Li Y, Lee J. Lymphoceles in Kidney Transplant Recipients: Incidence, Risk Factors, Outcomes, and Clinical Management [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/lymphoceles-in-kidney-transplant-recipients-incidence-risk-factors-outcomes-and-clinical-management/. Accessed November 22, 2024.« Back to 2020 American Transplant Congress