Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan (R.O.C.).
Department of Radiology, Shuang-Ho Hospital, Taiwan, New Taipei City, Taiwan (R.O.C.).
Clin Transplant. 2022 Jul;36(7):e14691. doi: 10.1111/ctr.14691. Epub 2022 May 16.
Persistent lymphatic leakage from the surgical drain is a troubling complication occasionally encountered postoperatively. This study investigated lymphatic leaks after renal or liver transplantation, comparing the treatment efficacy of traditional catheter drainage vs. minimally invasive lymphatic interventions. We also discuss access and treatment targets considering the physiology of lymphatic flow.
Between September 2018 and September 2020, 13 patients with lymphatic leakage were treated with minimally invasive lymphatic interventions; 11 had received a renal transplant, and two received a liver transplant. The control group included 10 patients with postrenal transplant lymphatic leakage treated with catheter drainage. The treatment efficacy of catheter drainage, lymphatic interventions, and different targets of embolization were compared.
The technical success rate for lymphatic intervention was 100%, and the clinical success rate was 92%, with an 82.9% reduction in drain volume on the first day after treatment. The duration to reach clinical success was 5.9 days with lymphatic intervention, and 33.9 days with conservative catheter drainage.
Lymphangiography and embolization are minimally invasive and efficient procedures for treating persistent lymphatic leaks after renal or liver transplantation. We suggest prompt diagnosis and embolization at upstream lymphatics to reduce the duration of drain retention, days of hospitalization, and associated comorbidities.
手术后持续的淋巴液从引流管漏出是一种令人困扰的并发症。本研究比较了传统的引流管引流与微创淋巴介入治疗肾或肝移植后淋巴漏的疗效。我们还根据淋巴液流动的生理学讨论了介入途径和治疗靶点。
2018 年 9 月至 2020 年 9 月，我们对 13 例淋巴漏患者进行了微创淋巴介入治疗，其中 11 例接受了肾移植，2 例接受了肝移植。对照组为 10 例接受了肾移植后淋巴漏治疗的患者。比较了引流管引流、淋巴介入治疗和不同栓塞靶点的治疗效果。
淋巴介入的技术成功率为 100%，临床成功率为 92%，治疗后第一天引流体积减少了 82.9%。淋巴介入治疗达到临床成功的时间为 5.9 天，而保守的引流管引流为 33.9 天。
淋巴造影和栓塞是治疗肾或肝移植后持续性淋巴漏的微创有效方法。我们建议及时诊断和栓塞上游淋巴管，以减少引流管留置时间、住院天数和相关并发症。
