title: Lymphocele after pediatric kidney transplantation: incidence and risk factors.
abstract: Lymphocele is a well-known postoperative complication after kidney transplantation. The aim of this study was to analyze time trend incidence, risk factors, and outcome of post-transplant lymphocele in a large pediatric cohort. This is a retrospective single institution review of 241 pediatric kidney transplants performed from 2000 to 2013. Etiology of end-stage renal disease, recipient age and gender, transplant year, BMI percentile for age, type of dialysis, living/non-living related donor, acute rejection, and multiple transplantations were analyzed in association with lymphocele formation. Fourteen of 241 (5.81%) children developed a postoperative lymphocele. There has been a reduction in the incidence of lymphocele after 2006 (3.22% vs. 8.55%, p < 0.05). Significant risk factors for lymphocele were older age (≥11 yr), transplant before 2006, male gender, BMI percentile for age ≥95%, and multiple transplantations (p < 0.05). The one-yr graft survival was significantly reduced in the group with lymphocele compared with control (81.2% vs. 92.51%, p < 0.04). This is the first pediatric report showing the following risk factors associated with post-transplant lymphocele: age ≥11 yr, male gender, BMI for age ≥95%, and multiple transplantations. A lymphocele can contribute to graft loss in the first-year post-transplant.
authors.affiliation: Department of Pediatric & Neonatal Surgery, St George's Healthcare NHS Trust and University, London, UK; Division of Pediatric Surgery, Department of 'Salute della Donna e del Bambino', University of Padova, Padova, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Giuliani
authors.forename: Piergiorgio
authors.initials: P
authors.lastname: Gamba
authors.forename: Rim
authors.initials: R
authors.lastname: Kiblawi
authors.forename: Paola
authors.initials: P
authors.lastname: Midrio
authors.forename: Giulia
authors.initials: G
authors.lastname: Ghirardo
authors.forename: Giovanni F
authors.initials: GF
authors.lastname: Zanon
mesh_terms: D000293:Adolescent; D000367:Age Factors; D015992:Body Mass Index; D002648:Child; D005260:Female; D006085:Graft Survival; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008210:Lymphocele / Q000150:complications* / Q000453:epidemiology*; D008297:Male; D015999:Multivariate Analysis; D011183:Postoperative Complications; D011184:Postoperative Period; D012189:Retrospective Studies; D012307:Risk Factors
keywords: kidney; lymphocele; pediatric; transplantation