Evaluation of postoperative lymphocele according to amounts and symptoms by using 3-dimensional CT volumetry in kidney transplant recipients

Heungman Jun, Sung Ho Hwang, Sungyoon Lim, Myung-Gyu Kim, Cheol Woong Jung

Research output: Contribution to journalArticle

Abstract

Purpose: To analyze the risk factors for postoperative lymphocele, for predicting and preventing complications. Methods: We evaluated 92 kidney transplant recipients with multidetector CT (MDCT) at 1-month posttransplantation. From admission and 1-month postoperative records, data including diabetes, dialysis type, immunosuppressant use, steroid pulse therapy, and transplantation side were collected. Lymphocele volume was measured with 3-dimensional reconstructed, nonenhanced MDCT at one month postoperatively. The correlations between risk factors and lymphocele volume and between risk factors and symptomatic lymphocele (SyL) were analyzed. The cutoff was calculated by using the receiver operating characteristic (ROC) curve for SyL volume. Results: Among 92 recipients, the mean volume was 44.53 ± 176.43 cm3 and 12 had SyL. Univariable analysis between risk factors and lymphocele volume indicated that donor age, retransplantation, and inferiorly located lymphocele were statistically significant. The ROC curve for SyL showed that 33.20 cm3 was the cutoff, with 83.3% sensitivity and 93.7% specificity. On univariable analysis between risk factors and SyL, steroid pulse, inferiorly located lymphocele, and >33.20 cm3 were statistically significant. Multivariable analysis indicated that steroid pulse, >33.20 cm3 , and serum creatinine level at one month were significant factors. Conclusion: Risk factors including donor age, retransplantation, steroid pulse therapy, and inferiorly located lymphocele are important predictors of large lymphoceles or SyL. In high-risk recipients, careful monitoring of renal function and early im age surveillance such as CT or ultrasound are recommended. If the asymptomatic lymphocele is >33.20 cm3 or located infe riorly, early interventions can be considered while carefully observing the changes in symptoms.

Original languageEnglish
Pages (from-to)133-138
Number of pages6
JournalAnnals of Surgical Treatment and Research
Volume91
Issue number3
DOIs
Publication statusPublished - 2016 Sep 1

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Lymphocele
Kidney
Steroids
Transplant Recipients
ROC Curve
Tissue Donors

Keywords

  • Cone-beam computed tomography
  • Kidney transplantation
  • Lymphocele
  • Three-dimensional imaging

ASJC Scopus subject areas

  • Surgery

Cite this

@article{5328bd8fcaf9400abe28d58983ac21ee,
title = "Evaluation of postoperative lymphocele according to amounts and symptoms by using 3-dimensional CT volumetry in kidney transplant recipients",
abstract = "Purpose: To analyze the risk factors for postoperative lymphocele, for predicting and preventing complications. Methods: We evaluated 92 kidney transplant recipients with multidetector CT (MDCT) at 1-month posttransplantation. From admission and 1-month postoperative records, data including diabetes, dialysis type, immunosuppressant use, steroid pulse therapy, and transplantation side were collected. Lymphocele volume was measured with 3-dimensional reconstructed, nonenhanced MDCT at one month postoperatively. The correlations between risk factors and lymphocele volume and between risk factors and symptomatic lymphocele (SyL) were analyzed. The cutoff was calculated by using the receiver operating characteristic (ROC) curve for SyL volume. Results: Among 92 recipients, the mean volume was 44.53 ± 176.43 cm3 and 12 had SyL. Univariable analysis between risk factors and lymphocele volume indicated that donor age, retransplantation, and inferiorly located lymphocele were statistically significant. The ROC curve for SyL showed that 33.20 cm3 was the cutoff, with 83.3{\%} sensitivity and 93.7{\%} specificity. On univariable analysis between risk factors and SyL, steroid pulse, inferiorly located lymphocele, and >33.20 cm3 were statistically significant. Multivariable analysis indicated that steroid pulse, >33.20 cm3 , and serum creatinine level at one month were significant factors. Conclusion: Risk factors including donor age, retransplantation, steroid pulse therapy, and inferiorly located lymphocele are important predictors of large lymphoceles or SyL. In high-risk recipients, careful monitoring of renal function and early im age surveillance such as CT or ultrasound are recommended. If the asymptomatic lymphocele is >33.20 cm3 or located infe riorly, early interventions can be considered while carefully observing the changes in symptoms.",
keywords = "Cone-beam computed tomography, Kidney transplantation, Lymphocele, Three-dimensional imaging",
author = "Heungman Jun and Hwang, {Sung Ho} and Sungyoon Lim and Myung-Gyu Kim and Jung, {Cheol Woong}",
year = "2016",
month = "9",
day = "1",
doi = "10.4174/astr.2016.91.3.133",
language = "English",
volume = "91",
pages = "133--138",
journal = "Annals of Surgical Treatment and Research",
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TY - JOUR

T1 - Evaluation of postoperative lymphocele according to amounts and symptoms by using 3-dimensional CT volumetry in kidney transplant recipients

AU - Jun, Heungman

AU - Hwang, Sung Ho

AU - Lim, Sungyoon

AU - Kim, Myung-Gyu

AU - Jung, Cheol Woong

PY - 2016/9/1

Y1 - 2016/9/1

N2 - Purpose: To analyze the risk factors for postoperative lymphocele, for predicting and preventing complications. Methods: We evaluated 92 kidney transplant recipients with multidetector CT (MDCT) at 1-month posttransplantation. From admission and 1-month postoperative records, data including diabetes, dialysis type, immunosuppressant use, steroid pulse therapy, and transplantation side were collected. Lymphocele volume was measured with 3-dimensional reconstructed, nonenhanced MDCT at one month postoperatively. The correlations between risk factors and lymphocele volume and between risk factors and symptomatic lymphocele (SyL) were analyzed. The cutoff was calculated by using the receiver operating characteristic (ROC) curve for SyL volume. Results: Among 92 recipients, the mean volume was 44.53 ± 176.43 cm3 and 12 had SyL. Univariable analysis between risk factors and lymphocele volume indicated that donor age, retransplantation, and inferiorly located lymphocele were statistically significant. The ROC curve for SyL showed that 33.20 cm3 was the cutoff, with 83.3% sensitivity and 93.7% specificity. On univariable analysis between risk factors and SyL, steroid pulse, inferiorly located lymphocele, and >33.20 cm3 were statistically significant. Multivariable analysis indicated that steroid pulse, >33.20 cm3 , and serum creatinine level at one month were significant factors. Conclusion: Risk factors including donor age, retransplantation, steroid pulse therapy, and inferiorly located lymphocele are important predictors of large lymphoceles or SyL. In high-risk recipients, careful monitoring of renal function and early im age surveillance such as CT or ultrasound are recommended. If the asymptomatic lymphocele is >33.20 cm3 or located infe riorly, early interventions can be considered while carefully observing the changes in symptoms.

AB - Purpose: To analyze the risk factors for postoperative lymphocele, for predicting and preventing complications. Methods: We evaluated 92 kidney transplant recipients with multidetector CT (MDCT) at 1-month posttransplantation. From admission and 1-month postoperative records, data including diabetes, dialysis type, immunosuppressant use, steroid pulse therapy, and transplantation side were collected. Lymphocele volume was measured with 3-dimensional reconstructed, nonenhanced MDCT at one month postoperatively. The correlations between risk factors and lymphocele volume and between risk factors and symptomatic lymphocele (SyL) were analyzed. The cutoff was calculated by using the receiver operating characteristic (ROC) curve for SyL volume. Results: Among 92 recipients, the mean volume was 44.53 ± 176.43 cm3 and 12 had SyL. Univariable analysis between risk factors and lymphocele volume indicated that donor age, retransplantation, and inferiorly located lymphocele were statistically significant. The ROC curve for SyL showed that 33.20 cm3 was the cutoff, with 83.3% sensitivity and 93.7% specificity. On univariable analysis between risk factors and SyL, steroid pulse, inferiorly located lymphocele, and >33.20 cm3 were statistically significant. Multivariable analysis indicated that steroid pulse, >33.20 cm3 , and serum creatinine level at one month were significant factors. Conclusion: Risk factors including donor age, retransplantation, steroid pulse therapy, and inferiorly located lymphocele are important predictors of large lymphoceles or SyL. In high-risk recipients, careful monitoring of renal function and early im age surveillance such as CT or ultrasound are recommended. If the asymptomatic lymphocele is >33.20 cm3 or located infe riorly, early interventions can be considered while carefully observing the changes in symptoms.

KW - Cone-beam computed tomography

KW - Kidney transplantation

KW - Lymphocele

KW - Three-dimensional imaging

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U2 - 10.4174/astr.2016.91.3.133

DO - 10.4174/astr.2016.91.3.133

M3 - Article

AN - SCOPUS:84988851418

VL - 91

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EP - 138

JO - Annals of Surgical Treatment and Research

JF - Annals of Surgical Treatment and Research

SN - 2288-6575

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