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Transplantation

Prophylactic fenestration: prevention is better than cure

Nature Reviews Nephrology volume 7, page 424 (2011)Cite this article

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Lymphocele formation is a common complication after kidney transplantation and usually requires surgical or radiological intervention. Results from a new study show that prophylactic fenestration of the peritoneum at the time of transplantation reduces the incidence of symptomatic lymphoceles. “As lymphocele formation increases morbidity and length of hospital stay for affected patients, and also adds to the work-load and costs for our department, we were eager to find means to preventing this complication,” explains lead investigator Tim Scholz of the Department of Organ Transplantation, Gastroenterology and Nephrology at Oslo University Hospital, Norway.

The investigators enrolled adult recipients of kidney grafts between 2007 and 2009 and randomly assigned them to undergo peritoneal fenestration (n = 69) or the standard surgical procedure (n = 61). All transplantations were performed using the extraperitoneal method with placement of the kidney graft in the left or right iliac region. In the fenestration group, an incision in the peritoneum parallel to the skin incision with a length at least as long as that of the kidney transplant was made after transplantation. The primary end point of the study was incidence of symptomatic lymphocele 1 year after transplantation. The secondary end point was prevalence of perirenal fluid collections in the first, fifth and tenth week after surgery, as measured using ultrasound.

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ORIGINAL RESEARCH PAPER

  1. Syversveen, T. et al. Prophylactic peritoneal fenestration to prevent morbidity after kidney transplantation: a randomized study. Transplantation doi:10.1097/TP.0b013e318220f57b

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Authors
  1. Helene Myrvang
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Myrvang, H. Prophylactic fenestration: prevention is better than cure. Nat Rev Nephrol 7, 424 (2011). https://doi.org/10.1038/nrneph.2011.79

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  • DOI: https://doi.org/10.1038/nrneph.2011.79

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