title: Treatment of Post-transplant Lymphocele in Children.
abstract: OBJECTIVE
  To review our single-center experience in managing posttransplant lymphoceles in pediatric kidney recipients. Lymphoceles are well-known complications after pediatric kidney transplantation (KT). However, there is no standard treatment for lymphoceles, and the literature lacks consensus on which is the most appropriate approach.
  
  
  METHODS
  We reviewed our retrospective institutional database for recipients of pediatric KT performed between January 2000 and December 2015 who developed lymphoceles.
  
  
  RESULTS
  Out of the 176 patients who underwent KT, lymphoceles occurred in 9 (5.1%) patients. The mean age of recipients in this group was 12.8 years (standard deviation [SD] 4.8) (r: 1-17) and the mean body weight was 43.1 kg (SD 18.8) (r: 9.5-69). Mean lymphocele onset was 32.2 days (SD 23.4) (r: 11-85) post transplantation. Six patients presented with increased serum creatinine from the baseline, whereas 3 patients remained asymptomatic. Ultrasound was the primary diagnostic procedure in all patients. Lymphoceles resolved spontaneously in asymptomatic patients (n = 3), and thus these patients were not further treated. All symptomatic patients (n = 6) were treated: 2 underwent percutaneous catheter drainage and 4 underwent transcatheter sclerotherapy (TS). The main sclerosing agent used was povidone-iodine. In 3 patients, TS with povidone-iodine failed, and they underwent additional procedures: 2 underwent TS with polidocanol and 1 underwent open drainage. There was no graft loss in any of the patients, and no recurrence was documented during a follow-up period of mean 30.3 months (SD 15.6) (r: 7-57).
  
  
  CONCLUSIONS
  There is no gold-standard treatment for lymphoceles in children, and reports in the literature on the topic are scarce. Percutaneous catheter drainage with or without TS is safe and effective, although it can lengthen hospitalization and increase morbidity.
authors.affiliation: Pediatric Urology and Renal Transplant Unit, Department of Pediatric Surgery, Hospital Vall d'Hebron, Barcelona, Spain. Electronic address: rgander@vhebron.net.
authors.forename: Romy
authors.initials: R
authors.lastname: Gander
authors.affiliation: Pediatric Urology and Renal Transplant Unit, Department of Pediatric Surgery, Hospital Vall d'Hebron, Barcelona, Spain.
authors.forename: Marino
authors.initials: M
authors.lastname: Asensio
authors.affiliation: Pediatric Urology and Renal Transplant Unit, Department of Pediatric Surgery, Hospital Vall d'Hebron, Barcelona, Spain.
authors.forename: Gloria Fatou
authors.initials: GF
authors.lastname: Royo
authors.affiliation: Pediatric Urology and Renal Transplant Unit, Department of Pediatric Surgery, Hospital Vall d'Hebron, Barcelona, Spain.
authors.forename: Jose Andrés
authors.initials: JA
authors.lastname: Molino
authors.affiliation: Department of Pediatric Nephrology, Hospital Vall d'Hebron, Barcelona, Spain.
authors.forename: Ramón
authors.initials: R
authors.lastname: Vilalta
authors.affiliation: Department of Pediatric Radiology, Hospital Vall d'Hebron, Barcelona, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Coma
authors.affiliation: Department of Interventional Radiology, Hospital Vall d'Hebron, Barcelona, Spain.
authors.forename: Mercedes
authors.initials: M
authors.lastname: Perez
authors.affiliation: Department of Pediatric Nephrology, Hospital Vall d'Hebron, Barcelona, Spain.
authors.forename: Gema
authors.initials: G
authors.lastname: Ariceta
mesh_terms: D000293:Adolescent; D002404:Catheterization / Q000379:methods*; D002648:Child; D003404:Creatinine / Q000097:blood; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000379:methods; D008210:Lymphocele / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy; D011206:Povidone-Iodine / Q000008:administration & dosage*; D012597:Sclerosing Solutions / Q000008:administration & dosage; D015911:Sclerotherapy / Q000379:methods*; D014463:Ultrasonography / Q000379:methods
chemical_list: D012597:Sclerosing Solutions; D011206:Povidone-Iodine; D003404:Creatinine