Consensus on definition and severity grading of lymphatic complications after kidney transplantation

Background: The incidence of lymphatic complications after kidney transplantation varies considerably in the literature. This is partly because a universally accepted definition has not been established. This study aimed
Background: The incidence of lymphatic complications after kidney transplantation varies considerably in the literature. This is partly because a universally accepted definition has not been established. This study aimed to propose an acceptable definition and severity grading system for lymphatic complications based on their management strategy.
Methods: Relevant literature published in MEDLINE and Web of Science was searched systematically. A consensus for definition and a severity grading was then sought between 20 high-volume transplant centres.
Results: Lymphorrhoea/lymphocele was defined in 32 of 87 included studies. Sixty-three articles explained how lymphatic complications were managed, but none graded their severity. The proposed definition of lymphorrhoea was leakage of more than 50 ml fluid (not urine, blood or pus) per day from the drain, or the drain site after removal of the drain, for more than 1 week after kidney transplantation. The proposed definition of lymphocele was a fluid collection of any size near to the transplanted kidney, after urinoma, haematoma and abscess have been excluded. Grade A lymphatic complications have a minor and/or non-invasive impact on the clinical management of the patient; grade B complications require non-surgical intervention; and grade C complications require invasive surgical intervention.
Conclusion: A clear definition and severity grading for lymphatic complications after kidney transplantation was agreed. The proposed definitions should allow better comparisons between studies.
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Author:Arianeb Mehrabi, Yakup Kulu, Mohammad Sadegh Sabagh, Elias Khajeh, Sara Mohammadi, Omid Ghamarnejad, Mohammad Golriz, Christian Morath, Wolf Otto Bechstein, Gabriela A. Berlakovich, Nicolas Demartines, Mansur Duran, Lutz Fischer, Lorenz Gürke, Jürgen Klempnauer, Alfred Königsrainer, Hauke Lang, Ulf Peter Neumann, Andreas Pasche, Andreas Paul, Przemyslaw Pisarski, Johann Pratschke, Stefan Schneeberger, Utz Settmacher, Richard Viebahn, Manfred Wirt, Bernd Wullich, Martin Zeier, Markus W. Büchler
URN:urn:nbn:de:hebis:30:3-562290
DOI:http://dx.doi.org/10.1002/bjs.11587
ISSN:1365-2168
Pubmed Id:http://www.ncbi.nlm.nih.gov/pubmed?term=32227483
Parent Title (English):British journal of surgery
Publisher:Wiley
Place of publication:Oxford [u.a.]
Document Type:Article
Language:English
Date of Publication (online):2020/11/30
Date of first Publication:2020/11/30
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2020/12/10
Volume:107
Pagenumber:11
First Page:801
Last Page:811
HeBIS PPN:476670829
Institutes:Medizin
Dewey Decimal Classification:610 Medizin und Gesundheit
Sammlungen:Universitätspublikationen
Licence (German):License LogoCreative Commons - Namensnennung 4.0

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