Chylous ascites after laparoscopic donor nephrectomy.
BACKGROUND
The aim of this study was to determine the incidence, presentation, management, and outcomes of chylous ascites following laparoscopic donor nephrectomy.


METHODS
An Internet-based, multi-institutional survey was performed using http://www.surveymonkey.com. An email invitation to the voluntary survey was sent to 30 transplant centers and posted on CenterSpan, an email forum for transplant surgeons. The number of living donor transplantations and the number of cases of chylous ascites with clinical information, treatment and outcomes were sought from the questionnaire.


RESULTS
A total of 12 centers responded and reported 7683 cases of live donor nephrectomy. The reported incidence of postoperative chylous ascites was 0.013% (n = 12). Six centers reported 10 cases of chylous ascites following laparoscopic donor nephrectomy and 2 cases after open donor nephrectomy. Among the eight patients who developed chylous ascites following laparoscopic donor nephrectomy, presentation was typically 2 weeks after the date of initial surgery. Conservative therapy was successful in 50% of cases. Refractory ascites managed secondarily with surgical intervention had a success rate of 100%.


CONCLUSIONS
Chylous ascites is a rare complication following laparoscopic donor nephrectomy. Initial treatment should be conservative, with surgical therapy reserved for refractory cases.
The Transplant Center, Glickman Kidney and Urological Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Ho Yee
HY
Tiong
Raj K
RK
Goel
Wesley M
WM
White
David A
DA
Goldfarb
Jihad H
JH
Kaouk
D000328:Adult; D002915:Chylous Ascites / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005544:Forecasting; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D009392:Nephrectomy / Q000009:adverse effects* / Q000379:methods; D011183:Postoperative Complications; D011795:Surveys and Questionnaires; D020858:Tissue and Organ Harvesting / Q000009:adverse effects* / Q000379:methods; D014481:United States / Q000453:epidemiology
Complications; donor nephrectomy; laparoscopy