Isiktas Sayilar Emel, Ersoy Alparslan, Ayar Yavuz, Aydin Mehmet Fethullah, Sahin Ahmet Bilgehan, Coskun Burhan, Kaygisiz Onur, Yildiz Abdulmecit, Kordan Yakup, Vuruskan Hakan
From the Department of Nephrology, Uludag University Faculty of Medicine, Bursa, Turkey.
Exp Clin Transplant. 2022 Feb;21(2):116-122. doi: 10.6002/ect.2018.0293. Epub 2019 Jun 25.
Lymphocele is a well-known postoperative surgical complication after kidney transplant. In this study, our aim was to analyze incidence, risk factors, and outcomes of posttransplant lymphocele in a large cohort.
This observational study included 395 consecutive patients (219 males and 176 females) who underwent kidney transplant procedures from 183 living and 212 deceased donors in our center between January 2007 and 2014. A lymphocele was diagnosed with ultrasonography.
The incidence of lymphoceles in our cohort was 31.9% (n = 126). There were no significant dif-ferences with regard to body mass indexes, age of donors, deceased donor ratios, acute rejection episodes, and history of abdominal surgery between those with and without lymphoceles. The pre-transplant serum albumin levels (3.29 ± 0.67 vs 3.48 ± 0.69 g/dL; P = .009) in the lymphocele group and diabetes mellitus ratios (15.9% vs 4.5%; P < .001) in the nonlymphocele group were lower than levels shown in the other group. The lymphocele ratio in patients who received cyclosporine was higher than that shown in patients who did not received it (37.5% vs. 27.4%; P = .032). There was no difference in lymphocele incidence between patients who were taking and those who were not taking mammalian target of rapamycin inhibitors, mycophenolate mofetil, or mycophenolate sodium. In regression analysis, presence of diabetes mellitus, transplant from deceased donors, older age of donors, and lower albumin levels were independent risk factors for posttransplant lymphocele occurrence.
Posttransplant lymphocele was a relatively common surgical complication in our cohort. We concluded that diabetes mellitus, use of kidneys from deceased donors, older donor age, and hypoalbuminemia were independent risk factors for lymphocele development.
淋巴囊肿是肾移植术后一种众所周知的手术并发症。在本研究中,我们的目的是分析一大群患者移植后淋巴囊肿的发生率、危险因素及预后情况。
这项观察性研究纳入了2007年1月至2014年期间在我们中心接受肾移植手术的395例连续患者(男性219例,女性176例),这些患者的供肾来自183例活体供者和212例已故供者。通过超声检查诊断淋巴囊肿。
我们队列中淋巴囊肿的发生率为31.9%(n = 126)。有淋巴囊肿和无淋巴囊肿的患者在体重指数、供者年龄、已故供者比例、急性排斥反应发作次数以及腹部手术史方面无显著差异。淋巴囊肿组移植前血清白蛋白水平(3.29±0.67 vs 3.48±0.69 g/dL;P = .009)以及非淋巴囊肿组糖尿病比例(15.9% vs 4.5%;P < .001)低于另一组。接受环孢素治疗的患者淋巴囊肿比例高于未接受环孢素治疗的患者(37.5% vs. 27.4%;P = .032)。服用和未服用雷帕霉素靶蛋白抑制剂、霉酚酸酯或麦考酚钠的患者之间淋巴囊肿发生率无差异。回归分析显示,糖尿病、接受已故供者的肾脏移植、供者年龄较大以及白蛋白水平较低是移植后淋巴囊肿发生的独立危险因素。
移植后淋巴囊肿是我们队列中一种相对常见的手术并发症。我们得出结论,糖尿病、使用已故供者的肾脏、供者年龄较大以及低白蛋白血症是淋巴囊肿形成的独立危险因素。