Risk Factors and Treatments of Lymphoceles in Living Renal Transplants: A Single-Center Experience.

OBJECTIVES

This study aimed to determine interventions and identify risk factors for lymphocele formation following kidney transplant.

MATERIALS AND

METHODS

We conducted a retrospective review of 296 adult kidney transplants from 2010 to 2022 to investigate postoperative lymphocele formation. We divided patients into lymphocele cases and nonlymphocele cases. Clinical data were collected. We evaluated interventions and risk factors for lymphocele formation and compared 1-year posttransplant graft function between the groups.

RESULTS

Lymphocele formation occurred in 23/296 (7.8%) patients; 13/296 (4.4%) were asymptomatic, and 16/296 (5.4%) received interventions. Of those who received interventions, 25.0% resolved with a single intervention, whereas 37.5% required laparoscopic fenestration. No significant difference in recipient or donor demographic data orintraoperative factors was observed between groups. Total protein and albumin concentrations in the lymphocele group were significantly lower versus the nonlymphocele group at postoperative day 7 (total protein 5.91 ± 0.66 vs 6.32 ± 0.64 mg/dL, P = .008; albumin 3.08 ± 0.42 vs 3.43 ± 0.48 mg/dL, P = .003). The percentage change in weight from pretransplant to postoperative day 7 was significantly higher in the lymphocele group (7.06% ± 8.39%) versus the nonlymphocele group (0.78% ± 6.03%, P < .001). A multivariate analysis showed that the percentage change in body weight from pretransplant to postoperative day 7 was significant(odds ratio 1.14; 95% CI, 1.05-1.25; P = .004), with a cutoff of 5.2% (sensitivity, 0.609; specificity, 0.795; area under the curve, 0.717; P < .001).

CONCLUSIONS

Excessive weight gain after kidney transplant is a significant risk factor for lymphocele formation. To avoid further invasive treatment for a lymphocele, management of fluids during the perioperative period may reduce the risk oflymphocele development.