Analysis of Risk Factors and Long-Term Outcomes in Kidney Transplant Patients with Identified Lymphoceles
The collection of lymphatic fluids (lymphoceles) is a frequent adverse event following renal transplantation. A variety of surgical and medical factors has been linked to this entity, but reliable data on risk factors and long-term outcomes are lacking. This retrospective single-center study include...
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doaj-e3ec711c309141f7a630b0750c3746252020-11-25T03:40:50ZengMDPI AGJournal of Clinical Medicine2077-03832020-09-0192841284110.3390/jcm9092841Analysis of Risk Factors and Long-Term Outcomes in Kidney Transplant Patients with Identified LymphocelesLukas J. Lehner0Arnim Hohberger1Lisanne Marschke2Nils Lachmann3Robert Peters4Frank Friedersdorff5Dmytro Khadzhynov6Fabian Halleck7Klemens Budde8Oliver Staeck9Michael Duerr10Department of Nephrology and Intensive Care Medicine, Charité Universitätsmedizin Berlin, 10115 Berlin, GermanyDepartment of Nephrology and Intensive Care Medicine, Charité Universitätsmedizin Berlin, 10115 Berlin, GermanyDepartment of Nephrology and Intensive Care Medicine, Charité Universitätsmedizin Berlin, 10115 Berlin, GermanyCenter for Tumor Medicine, H&I Laboratory, Charité Universitätsmedizin Berlin, 13353 Berlin, GermanyDepartment of Urology, Charité Universitätsmedizin Berlin, 10115 Berlin, GermanyDepartment of Urology, Charité Universitätsmedizin Berlin, 10115 Berlin, GermanyDepartment of Nephrology and Intensive Care Medicine, Charité Universitätsmedizin Berlin, 10115 Berlin, GermanyDepartment of Nephrology and Intensive Care Medicine, Charité Universitätsmedizin Berlin, 10115 Berlin, GermanyDepartment of Nephrology and Intensive Care Medicine, Charité Universitätsmedizin Berlin, 10115 Berlin, GermanyKfH Kuratorium für Dialyse und Nierentransplantation e.V., 10559 Berlin, GermanyDepartment of Nephrology and Intensive Care Medicine, Charité Universitätsmedizin Berlin, 10115 Berlin, GermanyThe collection of lymphatic fluids (lymphoceles) is a frequent adverse event following renal transplantation. A variety of surgical and medical factors has been linked to this entity, but reliable data on risk factors and long-term outcomes are lacking. This retrospective single-center study included 867 adult transplant recipients who received a kidney transplantation from 2006 to 2015. We evaluated for patient and graft survival, rejection episodes, or detectable donor-specific antibodies (dnDSA) in patients with identified lymphoceles in comparison to controls. We identified 305/867 (35.2%) patients with lymphocele formation, of whom 72/867 (8.3%) needed intervention. Multivariate analysis identified rejection episode as an independent risk factor (OR 1.61, CI 95% 1.17–2.21, <i>p</i> = 0.003) for lymphocele formation, while delayed graft function was independently associated with symptomatic lymphoceles (OR 1.9, CI 95% 1.16–3.12, <i>p</i> = 0.011). Interestingly, there was no difference in detectable dnDSA between groups with a similar graft and patient survival in all groups after 10 years. Lymphoceles frequently occur after transplantation and were found to be independently associated with rejection episodes, while symptomatic lymphoceles were associated with delayed graft function in our cohort. As both are inflammatory processes, they might play a causative role in the formation of lymphoceles. However, development or intervention of lymphoceles did not lead to impaired graft survival in the long-term.https://www.mdpi.com/2077-0383/9/9/2841kidney transplantationadverse eventslymphocelesdonor specific antibodiesallograft rejection |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Lukas J. Lehner Arnim Hohberger Lisanne Marschke Nils Lachmann Robert Peters Frank Friedersdorff Dmytro Khadzhynov Fabian Halleck Klemens Budde Oliver Staeck Michael Duerr |
spellingShingle |
Lukas J. Lehner Arnim Hohberger Lisanne Marschke Nils Lachmann Robert Peters Frank Friedersdorff Dmytro Khadzhynov Fabian Halleck Klemens Budde Oliver Staeck Michael Duerr Analysis of Risk Factors and Long-Term Outcomes in Kidney Transplant Patients with Identified Lymphoceles Journal of Clinical Medicine kidney transplantation adverse events lymphoceles donor specific antibodies allograft rejection |
author_facet |
Lukas J. Lehner Arnim Hohberger Lisanne Marschke Nils Lachmann Robert Peters Frank Friedersdorff Dmytro Khadzhynov Fabian Halleck Klemens Budde Oliver Staeck Michael Duerr |
author_sort |
Lukas J. Lehner |
title |
Analysis of Risk Factors and Long-Term Outcomes in Kidney Transplant Patients with Identified Lymphoceles |
title_short |
Analysis of Risk Factors and Long-Term Outcomes in Kidney Transplant Patients with Identified Lymphoceles |
title_full |
Analysis of Risk Factors and Long-Term Outcomes in Kidney Transplant Patients with Identified Lymphoceles |
title_fullStr |
Analysis of Risk Factors and Long-Term Outcomes in Kidney Transplant Patients with Identified Lymphoceles |
title_full_unstemmed |
Analysis of Risk Factors and Long-Term Outcomes in Kidney Transplant Patients with Identified Lymphoceles |
title_sort |
analysis of risk factors and long-term outcomes in kidney transplant patients with identified lymphoceles |
publisher |
MDPI AG |
series |
Journal of Clinical Medicine |
issn |
2077-0383 |
publishDate |
2020-09-01 |
description |
The collection of lymphatic fluids (lymphoceles) is a frequent adverse event following renal transplantation. A variety of surgical and medical factors has been linked to this entity, but reliable data on risk factors and long-term outcomes are lacking. This retrospective single-center study included 867 adult transplant recipients who received a kidney transplantation from 2006 to 2015. We evaluated for patient and graft survival, rejection episodes, or detectable donor-specific antibodies (dnDSA) in patients with identified lymphoceles in comparison to controls. We identified 305/867 (35.2%) patients with lymphocele formation, of whom 72/867 (8.3%) needed intervention. Multivariate analysis identified rejection episode as an independent risk factor (OR 1.61, CI 95% 1.17–2.21, <i>p</i> = 0.003) for lymphocele formation, while delayed graft function was independently associated with symptomatic lymphoceles (OR 1.9, CI 95% 1.16–3.12, <i>p</i> = 0.011). Interestingly, there was no difference in detectable dnDSA between groups with a similar graft and patient survival in all groups after 10 years. Lymphoceles frequently occur after transplantation and were found to be independently associated with rejection episodes, while symptomatic lymphoceles were associated with delayed graft function in our cohort. As both are inflammatory processes, they might play a causative role in the formation of lymphoceles. However, development or intervention of lymphoceles did not lead to impaired graft survival in the long-term. |
topic |
kidney transplantation adverse events lymphoceles donor specific antibodies allograft rejection |
url |
https://www.mdpi.com/2077-0383/9/9/2841 |
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