Impact of donor kidney recovery method on lymphatic complications in kidney transplantation.
BACKGROUND
Prolonged lymphatic drainage and lymphocele are undesirable complications following kidney transplantation. We evaluated the impact of kidney recovery methods (deceased donor vs laparoscopic nephrectomy) on the lymphatic complications of the kidney transplant recipients.


METHODS
The incidence of lymphatic complications was retrospectively analyzed in recipients of deceased donor kidneys (DD, n = 62) versus laparoscopically procured kidneys from living donors (LP, n = 61). A drain was placed in the retroperitoneal space in all recipients. The drain was maintained until the output became less than 30 mL/d with no evidence of fluid collection by ultrasound examination.


RESULTS
There was no statistically significant difference in the patient demographics (age, gender, and original disease and procedure time) between two groups. The incidence of lymphocele that required therapeutic intervention was comparable in both groups (3.2%). However, the duration of drain placement was significantly longer in the LP group than in the DD group, 8.6 +/- 2.5 days versus 5.4 +/- 2.5 day, respectively (P < .05).


CONCLUSIONS
The recipients of laparoscopically removed kidneys had a higher incidence of prolonged lymphatic leakage. More meticulous back table preparation may be required in LP kidneys to prevent prolonged lymphatic drainage after kidney transplantation. These observations may indicate that the major source of persistent lymphatic leakage is lymphatics of the allograft rather than severed recipient lymphatics.
Saidi
R F
RF
Transplant Center, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts 02214, USA.
Wertheim
J A
JA
Ko
D S C
DS
Elias
N
N
Martin
H
H
Delmonico
F L
FL
Cosimi
A B
AB
Kawai
T
T
D002102:Cadaver; D004322:Drainage; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D010535:Laparoscopy / Q000379:methods; D019520:Living Donors; D042601:Lymphatic Vessels / Q000473:pathology*; D008210:Lymphocele / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control / Q000628:therapy; D009392:Nephrectomy / Q000379:methods*; D012189:Retrospective Studies; D014019:Tissue Donors; D020858:Tissue and Organ Harvesting / Q000379:methods*