[Effect of intraoperative fibrin gluing on lymph flow and lymphocele formation after kidney transplantation].
In a randomized prospective study we examined 100 renal transplant patients including 20 children, to test the hypothesis that intraoperative application of clotting factors (in the form of fibrin glue) reduces the postoperative lymph flow and the frequency of lymphocele formation. The study showed that the use of fibrin glue during renal transplantation did not reduce the postoperative production of drainage fluid or lymphocele formation. The postoperative lymph flow was not related to the formation of lymphoceles. In adults the use of higher doses of immunosuppressants seems to increase the risk of lymphocele formation. On the other hand children have a very low rate of lymphocele formation even when high doses of immunosuppressants are used. The postoperative lymph has a constant composition of erythrocytes and leucocytes. The plasma protein extravasation decreased postoperatively and was influenced by the plasma protein content. From these results we conclude that the postoperative frequency of lymphocele formation cannot be reduced by intraoperative use of fibrin glue in the chosen protocol.
Physiologisches Institut der Universität München.
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Kokesch-Häuser
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Beer
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G
Staehler
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation / Q000379:methods*; D008208:Lymphatic System / Q000601:surgery; D008210:Lymphocele / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D011446:Prospective Studies; D013536:Suture Techniques
D015718:Fibrin Tissue Adhesive