Abstract
The perirenal and pelvic accumulation of loculated lymphatic fluid following kidney transplantation surgery is a recognized but infrequent complication. We have observed such lymphoceles in association with 5 of 108 renal allografts in children. 2/5 lymphoceles occurred with cadeveric allografts and 3/5 with live related kidneys. Fever, renal insufficiency, and oligo-anuria were present in all 5 patients. Lower abdominal pain (4/5) and leg swelling (3/5) were findings not typical of rejection. Occurrence ranged between 1 and 9 weeks post-transplantation.
The combination of renal scintigraphy and ultrasonography was successful in differentiating the lymphoceles from extravasated urine, hemorrhage and inflammatory collections. Lymphatic collections were seen as persistent photon deficient areas on scintigraphic flow and static images. Contact B-scan ultrasonograms showed them as anechoic collections with strong through transmission. Both modalities detected kidney obstruction secondary to the lymphocele.
All patients required surgical drainage because the lymphocele obstructed the transplanted kidney or pelvic lymphatics. All patients have retained their allografts which are functioning satisfactorily.
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Harcke, H., Baluarte, H., Williams, J. et al. LYMPHOCELES IN PEDIATRIC RENAL TRANSPLANTATION: DIAGNOSIS AND MANAGEMENT. Pediatr Res 14, 992 (1980). https://doi.org/10.1203/00006450-198008000-00111
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DOI: https://doi.org/10.1203/00006450-198008000-00111
