Romy Gander1, Marino Asensio2, Gloria Fatou Royo2, Jose Andrés Molino2, Ramón Vilalta3, Ana Coma4, Mercedes Perez5, Gema Ariceta3. 1. Pediatric Urology and Renal Transplant Unit, Department of Pediatric Surgery, Hospital Vall d'Hebron, Barcelona, Spain. Electronic address: rgander@vhebron.net. 2. Pediatric Urology and Renal Transplant Unit, Department of Pediatric Surgery, Hospital Vall d'Hebron, Barcelona, Spain. 3. Department of Pediatric Nephrology, Hospital Vall d'Hebron, Barcelona, Spain. 4. Department of Pediatric Radiology, Hospital Vall d'Hebron, Barcelona, Spain. 5. Department of Interventional Radiology, Hospital Vall d'Hebron, Barcelona, Spain.
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. MATERIALS AND 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). CONCLUSION: 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.
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. MATERIALS AND 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). CONCLUSION: 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: C M Sommer; C C Pieper; F Offensperger; F Pan; H J Killguss; J Köninger; M Loos; T Hackert; M Wortmann; T D Do; G Maleux; G M Richter; H U Kauczor; J Kim; S Hur Journal: Langenbecks Arch Surg Date: 2021-04-12 Impact factor: 3.445
Authors: Loes Oomen; Charlotte Bootsma-Robroeks; Elisabeth Cornelissen; Liesbeth de Wall; Wout Feitz Journal: Front Pediatr Date: 2022-04-08 Impact factor: 3.569