Lymphokele és vesetranszplantáció

Translated title of the contribution: Lymphocele and kidney transplantation

R. Langer, András Tóth, Zsolt Máthé, A. Remport, J. Járay, Barry D. Kahan

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Introduction: Lymphocele is a special complication following kidney transplantation. The authors examined the factors associated with an increased occurrence of clinically significant perinephric fluid collections and/or lymphoceles among sirolimus-treated renal transplant recipients. Aim: From the point of view of the lymphocele a comparison was made for the risks and benefits of the conventional and a newer immunosuppressive combination. Methods: At the University of Texas in Houston in a retrospective study the incidence, predisposing factors, and consequences of these fluid collections among patients treated with sirotimus-cyclosporine-prednisone (n = 354, Group I) versus cyclosporine-prednisone-azathioprine (n = 136, Group II) were compared. Results: More Group I patients (135/354; 38.1%) displayed perinephric fluid collections than Group II patients (24/136; 17.6%; p <0.001). In both subgroups the serum creatinine levels were elevated at the time of diagnosis from a nadir of 179.5 ± 141.7 to 359.9 ± 259.6 mmol/l (Group III, sirolimus treated) and from 222.6 ± 205.9 to 383.7 ± 255.2 mmol/l (Group IV, sirolimus free). A significantly greater number of patients required treatment for lymphoceles among Group I (15.8%; 56/354) versus Group II recipients (4.4%; 6/136; p <0.001). Single or repeated percutaneous drainage procedures successfully treated 35 Group I patients versus all 6 Group IV patients (p = 0.033). No patients in Group II versus 21 patients in Group I underwent surgical procedures (p <0.001). A significantly higher rate and higher histologic grade of acute rejection episodes, particularly proximate to the onset of the lymphocele, occurred among Group IV patients, namely 54.2% (13/24) versus 21.4% (29/135) Group III patients (p <0.001). Additionally we report the case of a 29-year-old patient who underwent a lymphocele fenestration with omentoplasty 8 years after his transplantation. Despite an Influenza A + Chlamydia. pneumonia and acute rejection which was followed by a GI bleeding and stomach resection he fiffly recovered and is doing well with an excellent kidney fimction a year after. Conclusions: Addition of sirolimus to a cyclosporine-prednisone regimen resulted in both a higher incidence and a requirement for more aggressive treatment of pcrincphric fluid collections and/or lymphoceles with a much lower acute rejection frequency.

Original languageHungarian
Pages (from-to)1475-1480
Number of pages6
JournalOrvosi Hetilap
Volume148
Issue number31
DOIs
Publication statusPublished - Aug 5 2007

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Lymphocele
Kidney Transplantation
Sirolimus
Prednisone
Cyclosporine
Kidney
Chlamydia
Incidence
Azathioprine
Immunosuppressive Agents
Causality
Human Influenza
Drainage
Creatinine
Pneumonia
Stomach

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Lymphokele és vesetranszplantáció. / Langer, R.; Tóth, András; Máthé, Zsolt; Remport, A.; Járay, J.; Kahan, Barry D.

In: Orvosi Hetilap, Vol. 148, No. 31, 05.08.2007, p. 1475-1480.

Research output: Contribution to journalArticle

Langer, R, Tóth, A, Máthé, Z, Remport, A, Járay, J & Kahan, BD 2007, 'Lymphokele és vesetranszplantáció', Orvosi Hetilap, vol. 148, no. 31, pp. 1475-1480. https://doi.org/10.1556/OH.2007.28135
Langer, R. ; Tóth, András ; Máthé, Zsolt ; Remport, A. ; Járay, J. ; Kahan, Barry D. / Lymphokele és vesetranszplantáció. In: Orvosi Hetilap. 2007 ; Vol. 148, No. 31. pp. 1475-1480.
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KW - Renal transplantation

KW - Surgical complications

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