title: Prevention of fluid effusion in kidney transplantation with the use of hemostatic biomaterials.
abstract: BACKGROUND
  Fluid effusion (blood, lymph, or urine) in kidney transplantation may give rise to several complications, directly, such as hematoma, seroma, lymphocele, and/or urinoma, or consequently, such as increased infection risk, longer hospital stay, graft compression--with or without functional impairment--and necessity of further hospitalizations. The aim of this study was to evaluate effectiveness of hemostatic biomaterials in prevention of fluid effusions, especially lymphocele in kidney transplant patients.
  
  
  METHODS
  We selected 40 patients who underwent kidney transplantation from 2009 to 2012 in which we used hemostatic biomaterials, and compared their results with those of other transplant patients from our center in which we did not used these biomaterials. Evaluated parameters were: fluid effusion, graft function, quality and quantity of drainage, blood count, and operative time.
  
  
  RESULTS
  There was no difference in operative time. The incidence of complications on which biomaterials can have a role decreased; particularly, we observed a reduction from 24.21% to 7.5% of fluid effusions (lymphocele). There was no evidence of complications due to biomaterials.
  
  
  CONCLUSIONS
  Hemostasis is important in surgery, and in kidney transplantations lymphostasis also has a significant role. In addition to the traditional hemostatic methods, recently some biomaterials, with the purpose of providing atraumatic hemostasis, were added. In our experience they are easy to use, and their use has proved to be effective for both hemostasis and lymphostasis with consequent reduction of fluid effusions.
authors.affiliation: Interdepartmental Kidney Transplantation Center, University Federico II of Naples, Italy. Electronic address: vincenzo.tammaro@unina.it.
authors.forename: V
authors.initials: V
authors.lastname: Tammaro
authors.affiliation: Department of Surgical Sciences and Nephrology, University Federico II, Naples, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Vernillo
authors.affiliation: Department of Surgical Sciences and Nephrology, University Federico II, Naples, Italy.
authors.forename: Xh
authors.initials: X
authors.lastname: Dumani
authors.affiliation: Department of Surgical Sciences and Nephrology, University Federico II, Naples, Italy.
authors.forename: I
authors.initials: I
authors.lastname: Florio
authors.affiliation: Interdepartmental Kidney Transplantation Center, University Federico II of Naples, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Pelosio
authors.affiliation: Interdepartmental Kidney Transplantation Center, University Federico II of Naples, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Jamshidi
authors.affiliation: Department of Surgical Sciences and Nephrology, University Federico II, Naples, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Romagnuolo
authors.affiliation: Department of Surgical Sciences and Nephrology, University Federico II, Naples, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Calogero
authors.affiliation: Department of Surgical Sciences and Nephrology, University Federico II, Naples, Italy.
authors.forename: N
authors.initials: N
authors.lastname: Carlomagno
authors.affiliation: Interdepartmental Kidney Transplantation Center, University Federico II of Naples, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Santangeloa
authors.affiliation: Interdepartmental Kidney Transplantation Center, University Federico II of Naples, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Renda
mesh_terms: D000328:Adult; D000368:Aged; D003487:Cyanoacrylates / Q000627:therapeutic use; D004322:Drainage; D004338:Drug Combinations; D005260:Female; D005340:Fibrinogen / Q000627:therapeutic use; D006470:Hemorrhage / Q000517:prevention & control; D006490:Hemostatics; D006801:Humans; D016030:Kidney Transplantation; D008210:Lymphocele / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000517:prevention & control*; D013213:Starch / Q000627:therapeutic use; D013917:Thrombin / Q000627:therapeutic use
chemical_list: C527600:Arista; D003487:Cyanoacrylates; D004338:Drug Combinations; D006490:Hemostatics; C518955:TachoSil; C421461:glubran 2; D005340:Fibrinogen; D013213:Starch; D013917:Thrombin