Management of lymphocele after kidney transplantation: twenty years’ experience in a high-complexity clinic

Abstract

Objective: To describe the 20-year experience of a high-complexity clinic in southwestern Colombia regarding the percutaneous and laparoscopic management of post-kidney transplant lymphocele (PKTL).

Methods: We conducted a retrospective, descriptive, and observational study to identify patients diagnosed with lymphocele through the kidney transplant program database. Demographic and clinical data were collected, including comorbidities, risk factors for lymphocele development, and treatment outcomes. Inclusion criteria included patients aged ≥18 years with a diagnosis of lymphocele following kidney transplantation and with complete medical records available. Data were compiled using Excel and analyzed with Stata 14.0®.

Results: We included 31 patients with post-kidney transplant lymphocele between 2000 and 2020. Of these, 19 were male and 12 female; the median age was 46 years, and the median body mass index was 22.7 kg/m². The most common comorbidities were hypertension and type 2 diabetes mellitus. The median time to initial diagnosis was 41 days, and the median lymphocele volume was 240 mL. Recurrence following percutaneous treatment occurred in 77 % of cases, while no recurrence was observed in patients who underwent laparoscopic marsupialization.

Conclusions: PKTL is a common complication occurring within the first 45 days post-transplantation. Although percutaneous management is linked to a high recurrence rate, it may be utilized as a first-line treatment. In cases of treatment failure, the laparoscopic approach should be regarded as the standard of care due to its favorable outcomes.