title: Donor kidney recovery methods and the incidence of lymphatic complications in kidney transplant recipients.
abstract: BACKGROUND
  Lymphatic leak and lymphocele are well-known complications after kidney transplantation.
  
  
  OBJECTIVE
  To determine the incidence of lymphatic complications in recipients of living donor kidneys.
  
  
  METHODS
  Among 642 kidney transplants performed between 1999 and 2007, the incidence of lymphatic complications was retrospectively analyzed in recipients of living donor kidneys procured by laparoscopic nephrectomy (LP, n=218) or by open nephrectomy (OP, n=127) and deceased donor kidneys (DD, n=297). A Jackson-Pratt drain was placed in the retroperitoneal space in all recipients and was maintained until the output became less than 30 mL/day.
  
  
  RESULTS
  Although the incidence of symptomatic lymphocele, which required therapeutic intervention, was comparable in all groups, the duration of mean±SD drain placement was significantly longer in the LP group-8.6±2.7 days compared to 5.6±1.2 days in the OP group and 5.4±0.7 days in the DD group (p<0.001). Higher output of lymphatic drainage in recipients of LP kidneys could lead to a higher incidence of lymphocele if wound drainage is not provided.
  
  
  CONCLUSIONS
  More meticulous back table preparation may be required in LP kidneys to decrease lymphatic complications after kidney transplantation. These observations also support the suggestion that the major source of persistent lymphatic drainage following renal transplantation is severed lymphatics of the allograft rather than those of the recipient's iliac space.
authors.affiliation: Department of Surgery, Transplantation Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: R F
authors.initials: RF
authors.lastname: Saidi
authors.affiliation: Department of Surgery, Transplantation Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: J A
authors.initials: JA
authors.lastname: Wertheim
authors.affiliation: Department of Surgery, Transplantation Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: P
authors.initials: P
authors.lastname: Kennealey
authors.affiliation: Department of Surgery, Transplantation Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: D S C
authors.initials: DS
authors.lastname: Ko
authors.affiliation: Department of Surgery, Transplantation Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: N
authors.initials: N
authors.lastname: Elias
authors.affiliation: Department of Surgery, Transplantation Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: H
authors.initials: H
authors.lastname: Yeh
authors.affiliation: Department of Surgery, Transplantation Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: M
authors.initials: M
authors.lastname: Hertl
authors.affiliation: Department of Surgery, Transplantation Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: T
authors.initials: T
authors.lastname: Kawai
keywords: complications; kidney transplantation; lymphatic leak; surgery