Lehner Lukas J, Hohberger Arnim, Marschke Lisanne, Lachmann Nils, Peters Robert, Friedersdorff Frank, Khadzhynov Dmytro, Halleck Fabian, Budde Klemens, Staeck Oliver, Duerr Michael
Department of Nephrology and Intensive Care Medicine, Charité Universitätsmedizin Berlin, 10115 Berlin, Germany.
Center for Tumor Medicine, H&I Laboratory, Charité Universitätsmedizin Berlin, 13353 Berlin, Germany.
J Clin Med. 2020 Sep 2;9(9):2841. doi: 10.3390/jcm9092841.
The collection of lymphatic fluids (lymphoceles) is a frequent adverse event following renal transplantation. A variety of surgical and medical factors has been linked to this entity, but reliable data on risk factors and long-term outcomes are lacking. This retrospective single-center study included 867 adult transplant recipients who received a kidney transplantation from 2006 to 2015. We evaluated for patient and graft survival, rejection episodes, or detectable donor-specific antibodies (dnDSA) in patients with identified lymphoceles in comparison to controls. We identified 305/867 (35.2%) patients with lymphocele formation, of whom 72/867 (8.3%) needed intervention. Multivariate analysis identified rejection episode as an independent risk factor (OR 1.61, CI 95% 1.17-2.21, = 0.003) for lymphocele formation, while delayed graft function was independently associated with symptomatic lymphoceles (OR 1.9, CI 95% 1.16-3.12, = 0.011). Interestingly, there was no difference in detectable dnDSA between groups with a similar graft and patient survival in all groups after 10 years. Lymphoceles frequently occur after transplantation and were found to be independently associated with rejection episodes, while symptomatic lymphoceles were associated with delayed graft function in our cohort. As both are inflammatory processes, they might play a causative role in the formation of lymphoceles. However, development or intervention of lymphoceles did not lead to impaired graft survival in the long-term.
淋巴液聚集(淋巴囊肿)是肾移植后常见的不良事件。多种手术和医学因素与该病症相关,但缺乏关于危险因素和长期预后的可靠数据。这项回顾性单中心研究纳入了2006年至2015年接受肾移植的867名成年移植受者。我们评估了有确诊淋巴囊肿的患者与对照组在患者和移植物存活、排斥反应发作或可检测到的供体特异性抗体(dnDSA)方面的情况。我们确定了305/867(35.2%)例形成淋巴囊肿的患者,其中72/867(8.3%)例需要干预。多变量分析确定排斥反应发作是淋巴囊肿形成的独立危险因素(比值比1.61,95%置信区间1.17 - 2.21,P = 0.003),而移植肾功能延迟独立与有症状的淋巴囊肿相关(比值比1.9,95%置信区间1.16 - 3.12,P = 0.011)。有趣的是,10年后所有组中移植物和患者存活率相似的组之间,可检测到的dnDSA没有差异。淋巴囊肿在移植后经常发生,并且在我们的队列中发现其与排斥反应发作独立相关,而有症状的淋巴囊肿与移植肾功能延迟相关。由于两者都是炎症过程,它们可能在淋巴囊肿的形成中起因果作用。然而,淋巴囊肿的发生或干预在长期内并未导致移植物存活受损。