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Isiktas Sayilar E, Ersoy A, Ayar Y, Aydin MF, Sahin AB, Coskun B, Kaygisiz O, Yildiz A, Kordan Y, Vuruskan H. Factors Influencing Lymphocele Development After Kidney Transplant: Single Center Experience. EXP CLIN TRANSPLANT 2022; 21:116-122. [PMID: 31250740 DOI: 10.6002/ect.2018.0293] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES Lymphocele is a well-known postoperative surgical complication after kidney transplant. In this study, our aim was to analyze incidence, risk factors, and outcomes of posttransplant lymphocele in a large cohort. MATERIALS AND METHODS This observational study included 395 consecutive patients (219 males and 176 females) who underwent kidney transplant procedures from 183 living and 212 deceased donors in our center between January 2007 and 2014. A lymphocele was diagnosed with ultrasonography. RESULTS The incidence of lymphoceles in our cohort was 31.9% (n = 126). There were no significant dif-ferences with regard to body mass indexes, age of donors, deceased donor ratios, acute rejection episodes, and history of abdominal surgery between those with and without lymphoceles. The pre-transplant serum albumin levels (3.29 ± 0.67 vs 3.48 ± 0.69 g/dL; P = .009) in the lymphocele group and diabetes mellitus ratios (15.9% vs 4.5%; P < .001) in the nonlymphocele group were lower than levels shown in the other group. The lymphocele ratio in patients who received cyclosporine was higher than that shown in patients who did not received it (37.5% vs. 27.4%; P = .032). There was no difference in lymphocele incidence between patients who were taking and those who were not taking mammalian target of rapamycin inhibitors, mycophenolate mofetil, or mycophenolate sodium. In regression analysis, presence of diabetes mellitus, transplant from deceased donors, older age of donors, and lower albumin levels were independent risk factors for posttransplant lymphocele occurrence. CONCLUSIONS Posttransplant lymphocele was a relatively common surgical complication in our cohort. We concluded that diabetes mellitus, use of kidneys from deceased donors, older donor age, and hypoalbuminemia were independent risk factors for lymphocele development.
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Affiliation(s)
- Emel Isiktas Sayilar
- From the Department of Nephrology, Uludag University Faculty of Medicine, Bursa, Turkey
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Gaied H, Bacha MM, Jaziri F, Ounissi M, Aoudia R, Jerbi M, Hedri H, Goucha R, Benabdallah T. Encapsulating Peritoneal Sclerosis after kidney Transplantation: Success of Medical Treatment. Indian J Nephrol 2021; 31:194-196. [PMID: 34267447 PMCID: PMC8240943 DOI: 10.4103/ijn.ijn_329_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Accepted: 11/27/2019] [Indexed: 11/08/2022] Open
Abstract
Encapsulating peritoneal sclerosis (EPS) is an infrequent but serious complication of long-term peritoneal dialysis (PD). EPS may become clinically apparent when patients are on PD (classical EPS) or after undergoing kidney transplantation (post-transplantation EPS). This presentation of EPS seems to occur shortly after kidney transplantation in former PD patients. In this report, we present our experience in our first case of patient diagnosed with EPS after kidney transplantation.
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Affiliation(s)
- Hanene Gaied
- Department of Nephrology, Mongi Slim Hospital, Tunis, Tunisia.,Faculty of Medicine of Tunis, Tunis, Tunisia.,Laboratory of Histopathology, Charles Nicolle Hospital, Tunis, Tunisia
| | - Mohamed Mongi Bacha
- Faculty of Medicine of Tunis, Tunis, Tunisia.,Department of Internal Medicine « A », Charles Nicolle Hospital, Tunis, Tunisia.,Laboratory of Histopathology, Charles Nicolle Hospital, Tunis, Tunisia
| | - Fatima Jaziri
- Faculty of Medicine of Tunis, Tunis, Tunisia.,Department of Internal Medicine « A », Charles Nicolle Hospital, Tunis, Tunisia.,Laboratory of Histopathology, Charles Nicolle Hospital, Tunis, Tunisia
| | - Mondher Ounissi
- Faculty of Medicine of Tunis, Tunis, Tunisia.,Department of Internal Medicine « A », Charles Nicolle Hospital, Tunis, Tunisia.,Laboratory of Histopathology, Charles Nicolle Hospital, Tunis, Tunisia
| | - Raja Aoudia
- Faculty of Medicine of Tunis, Tunis, Tunisia.,Department of Internal Medicine « A », Charles Nicolle Hospital, Tunis, Tunisia.,Laboratory of Histopathology, Charles Nicolle Hospital, Tunis, Tunisia
| | - Mouna Jerbi
- Department of Nephrology, Mongi Slim Hospital, Tunis, Tunisia.,Department of Internal Medicine « A », Charles Nicolle Hospital, Tunis, Tunisia.,Laboratory of Histopathology, Charles Nicolle Hospital, Tunis, Tunisia
| | - Hafedh Hedri
- Faculty of Medicine of Tunis, Tunis, Tunisia.,Department of Internal Medicine « A », Charles Nicolle Hospital, Tunis, Tunisia.,Laboratory of Histopathology, Charles Nicolle Hospital, Tunis, Tunisia
| | - Rim Goucha
- Department of Nephrology, Mongi Slim Hospital, Tunis, Tunisia.,Faculty of Medicine of Tunis, Tunis, Tunisia.,Laboratory of Histopathology, Charles Nicolle Hospital, Tunis, Tunisia
| | - Taieb Benabdallah
- Faculty of Medicine of Tunis, Tunis, Tunisia.,Department of Internal Medicine « A », Charles Nicolle Hospital, Tunis, Tunisia.,Laboratory of Histopathology, Charles Nicolle Hospital, Tunis, Tunisia
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Managing Hospitalized Peritoneal Dialysis Patients: Ten Practical Points for Non-Nephrologists. Am J Med 2021; 134:833-839. [PMID: 33737056 DOI: 10.1016/j.amjmed.2021.02.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 01/31/2021] [Accepted: 02/06/2021] [Indexed: 01/08/2023]
Abstract
Although nephrologists are responsible for the long-term care of dialysis patients, physicians from all disciplines will potentially be involved in the management of patients with kidney failure, including patients on peritoneal dialysis, the major home-based form of kidney-replacement therapy. This review aims to fill knowledge gaps of non-experts in peritoneal dialysis and to highlight key management aspects of in-hospital care of patients on peritoneal dialysis, with a focus on acute scenarios to facilitate prompt decision-making. The clinical pearls provided should enable non-nephrologists to avoid common pitfalls in the initial assessment of peritoneal dialysis-related complications and guide their decision regarding when to refer their patients to a specialist, resulting in improved multidisciplinary patient care.
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Kutlutürk K, Şahin TT, Çimen S, Dalda Y, Gönültaş F, Doğan SM, Altunışık Toplu S, Ünal B, Pişkin T. Is peritoneal dialysis prior to kidney transplantation a risk factor for ureteral stenosis after adult to adult live kidney transplantation. Turk J Surg 2020; 36:33-38. [PMID: 32637873 DOI: 10.5578/turkjsurg.4605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Accepted: 09/26/2019] [Indexed: 02/05/2023]
Abstract
Objectives Major urinary complications such as urinary leaks, stenosis or urinary tract infections after kidney transplantation can lead to graft or patient loss. The effect of peritoneal dialysis on post-kidney transplantation complications have been discussed but its effect on ureteral stenosis is unknown. In this study, it was aimed to analyze factors effecting major ureteral complications after living donor kidney transplantation and impact of peritoneal dialysis and double J-stents (JJ stents). Material and Methods This study included 116 adult to adult living donor kidney transplant patients. Factors effecting major urologic complications after living donor kidney transplantation were analyzed. The donors were primary relatives of the recipients. Results Major urologic complications after living donor kidney transplantation was 8/116 (6.9%). Urinary leak was present in 2 (1.7%) patients. Ureteral stenosis was encountered in 6 (5.2%) patients. Double J stents were used in 84 (72.4%) of the cases. The effect of JJ ureteral stent was not statistically significant for urinary leak, ureteral stenosis (p= 0.074, p= 0.470, respectively). A total of 29 (25%) patients had peritoneal dialysis before kidney transplantation. Preoperative peritoneal dialyses and bacteriuria after kidney transplantation were independent risk factors for ureteral stenosis in multivariate analysis (p= 0.013, and p= 0.010 respectively). Conclusion In the guidance of the results of the present study, peritoneal dialysis prior to kidney transplantation and bacteriuria are independent risk factors for ureteral stenosis after living donor kidney transplantation. JJ stents have no effect on urologic complications after living donor kidney transplantation.
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Affiliation(s)
- Koray Kutlutürk
- Department of General Surgery, Inonu University School of Medicine, Malatya, Turkey
| | - Tevfik Tolga Şahin
- Department of General Surgery, Inonu University School of Medicine, Malatya, Turkey
| | - Serhan Çimen
- Clinic of Urology, Malatya Education and Research Hospital, Malatya, Turkey
| | - Yasin Dalda
- Department of General Surgery, Inonu University School of Medicine, Malatya, Turkey
| | - Fatih Gönültaş
- Department of General Surgery, Inonu University School of Medicine, Malatya, Turkey
| | - Sait Murat Doğan
- Department of General Surgery, Inonu University School of Medicine, Malatya, Turkey
| | - Sibel Altunışık Toplu
- Department of Infectious Diseases and Clinical Microbiology, Inonu University School of Medicine, Malatya, Turkey
| | - Bülent Ünal
- Department of General Surgery, Eskisehir Osmangazi University School of Medicine, Eskisehir, Turkey
| | - Turgut Pişkin
- Department of General Surgery, Inonu University School of Medicine, Malatya, Turkey
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