The estimation of post-transplant lymphocele origin using creatine kinase activity.
BACKGROUND
The aim of this research was to create a laboratory instrument for the estimation of post-transplant lymphocele origin. It is based on the enzymatic activity of creatine kinase (CK) in the lymphocele content.


METHODS
A total of 120 lymph samples from different retroperitoneal regions were obtained from non-transplanted patients; equal numbers from the iliac region, renal cysts, and the subdiaphragmatic retroperitoneum. Activities of creatine kinase (CK) and gamma-glutamyl transpeptidase (GGT) were determined in all samples and statistically analyzed against their activity in serum from patients without surgery.


RESULTS
Activities of CK in the pelvis, retroperitoneum, renal cysts, and serum were 5.06, 0.83, 6.48 (P<0.001), 2.50, 0.73, 3.60 (P<0.001), 0.02, 0.01, 0.05 (P<0.001), and 0.66, 0.41, 0.79 microkat/l, respectively. Activities of GGT in the same lymph samples were 0.26, 0.16, 0.36 (P=0.048), 0.41, 0.25, 0.48 (non-significant), 0.11, 0.07, 1.17 (P=0.003) and 0.34, 0.24, 0.55 microkat/l, respectively. A graph was constructed relating CK activity to lymph origin.


CONCLUSIONS
Significantly different CK enzyme activity was observed in different regions of the retroperitoneum. The presented graph is a simple instrument for the estimation of the lymphocele content origin. The method requires percutaneous aspiration of the lymphocele and evaluation of the CK and GGT activity in the sample. From the graph the estimated proportion of renal lymph in the lymphocele can be read directly. This instrument can provide better understanding of post-transplant lymphocele fluid source.
Pacovsky
Jaroslav
J
Department of Urology-Regional Transplant Center, University Hospital and Charles University Medical School, Hradec Kralove, Czech Republic. japacovsky@post.cz
Hyspler
Radomir
R
Navratil
Pavel
P
Ticha
Alena
A
Brodak
Milos
M
D000328:Adult; D000368:Aged; D003402:Creatine Kinase / Q000097:blood / Q000378:metabolism*; D005260:Female; D006801:Humans; D015994:Incidence; D008210:Lymphocele / Q000175:diagnosis / Q000201:enzymology / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D014180:Transplantation / Q000009:adverse effects*
D003402:Creatine Kinase