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Abstract: SA-PO861

Effectiveness of Lymphatic Lipiodol Embolization for Post Renal Transplant Lymphoceles

Session Information

Category: Transplantation

  • 2002 Transplantation: Clinical

Authors

  • Konishi, Kasumi, St. Luke's International Hospital, Tokyo, Japan
  • Ito, Yugo, St. Luke's International Hospital, Tokyo, Japan
  • Shimoyama, Kotaro, St. Luke's International Hospital, Tokyo, Japan
  • Kadota, Nozomi, St. Luke's International Hospital, Tokyo, Japan
  • Fujimaru, Takuya, St. Luke's International Hospital, Tokyo, Japan
  • Taki, Fumika, St. Luke's International Hospital, Tokyo, Japan
  • Nagahama, Masahiko, St. Luke's International Hospital, Tokyo, Japan
  • Shimbo, Masaki, St. Luke's International Hospital, Tokyo, Japan
  • Nakayama, Masaaki, St. Luke's International Hospital, Tokyo, Japan
Introduction

Lymphocele is a relatively common complications after kidney transplantation. Although the majority of cases are asymptomatic and self-limiting, interventional treatment is required for cases with worsening kidney function, deep vein thrombosis, lower leg edema or urinary tract obstruction. A wide range of treatment strategies are available, but there is no consensus on the optimal management as far as high recurrence and complication rate is concerned.

Case Description

A 75 year-old man with end-stage kidney disease due to diabetic nephropathy underwent ABO-incompatible living kidney transplantation from his wife. His perioperatively course was uneventful. He developed right lower leg edema 1 month after the surgery . Abdominal CT scan revealed the lymphoceles around the transplanted kidney with external iliac vein compression. Percutaneous catheter drainage reduced the size of lymphocele transiently only for 1 day. Since, right intranodal lymphography demonstrated active lymph leakage (Figure), we performed lymphatic embolization with Lipiodol. The lymphocele was diminished and his lower leg edema was improved successfully.

Discussion

Regarding treatment of lymphocele after kidney transplantation, high recurrence rate after aspiration and drainage have been important issue. Furthermore, sclerotherapy can cause allergy for sclerosant and spillage of it induces inflammation around the graft. Recently some case reports have indicated that lymphatic lipiodol embolization is effective for lymphoceles. Our case suggested that it is minimally invasive and safe for treatment as well as diagnosis of lymphoceles after kidney transplantation.