JUAN SANTİAGO RUBİO, DANİELA WOJTOWİCZ, MİGUEL ANGEL AMORE, GASTÓN IRİARTE, SİLVİA Dİ PİETRANTONİO
Experimental and Clinical Transplantation - 2021;19(10):1099-1102
Kidney transplant is the best therapeutic option for patients with end-stage kidney disease. However, kidney transplant is not exempt from postoperative complications. One of the most frequent urological complications is lymphocele, which can appear in up to 20% of patients. Lymphocele most often appears during the first month after surgery. However, its appearance after the first year is completely infrequent. Here, we report a case of a giant idiopathic lymphocele 18 years after kidney transplant and its resolution with lymphatic embolization. The patient, a 34-year-old man who received a deceased-donor kidney transplant in 2002, had presented with no complications until the lymphocele was diagnosed. The lymphocele presented as a voluminous organ-compressing mass. A percuta - neous drainage was placed, and 3600 cm3 of lymphatic fluid were drained. After that, 800 cm3 continued to leak every day. An intranodal lymphography and lymphatic embolization with Lipiodol Ultra-Fluide (Guerbet Australia) were performed, owing to the high amount of leakage. At 50 days after embolization, an ultrasonograph showed no fluid collections, so the percutaneous catheter was removed. In most patients, the treatment of the lymphocele after kidney transplant is frequently conservative. However, for patients whose situation cannot be resolved spontaneously, there are few therapeutic choices. As described here, intranodal lymphatic embolization is a mini-invasive option, with a success rate of up to 80%, and should be offered as the first approach.
