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Kidney Week

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Abstract: FR-PO741

Renal Allograft Lymphangiectasia After Kidney Transplantation

Session Information

Category: Transplantation

  • 2102 Transplantation: Clinical

Authors

  • Ko, Eun jeong, The Catholic University of Korea, Seoul, Korea (the Republic of)
  • Chung, Byung ha, The Catholic University of Korea, Seoul, Korea (the Republic of)
  • Yang, Chul Woo, The Catholic University of Korea, Seoul, Korea (the Republic of)
Introduction

Renal lymphangiectasia is a rarein the setting of transplant kidney. We report a case of renal lymphangiectasia after kidney transplantation

Case Description

A 43-year-old man received living donor kidney transplantation due to IgA nephropathy. 14 years after transplantation, he presented with abdominal distension, and dyspnea. Serum creatinine level was elevated to 1.6mg/dL from 1.1mg/dL. Computed tomography (CT) showed multi-septated cystic lesions around the graft kidney with a large amount of ascites. Ascites profile showed transudative, non-chylous, suggesting lymphatic fluid. There was no evidence for infectious or malignant disease. At first, tacrolimus was switched to sirolimus for anti-lymphangiogenic effect, consequently the amount of ascites was significantly reduced. However, 3 weeks after, large amount of ascites were recurred. Surgical approach with explore laparotomy, argon coagulation and helixor injection through Hemo-vac drain were performed. Also, lymphatics embolization was performed using lipiodol. Nevertheless, massive ascites recurred just after 1 week from procedures, therefore, allograft nephrectomy was inevitable

Discussion

Post-transplant renal lymphangiectasia is a rare but critical complication of allografts, still poorly understood. However, once it happens, active treatment is required.

Abominal computed Tomography

Gross pathology of transplant nephrectomy