Urologic Survey (Transplantation)

Re: Fibrin Glue Injections: A Minimally Invasive and Cost-Effective Treatment for Post-Renal Transplant Lymphoceles and Lymph Fistulas

10.4274/jus.2016.01.001

  • Yarkin Kamil Yakupoglu

J Urol Surg 2016;3(1):28-28

EDITORIAL COMMENT In this retrospective study, 46 (2.7%) patients out of 1662 kidney transplant recipients had developed symptomatic lymphocele/lymph fistula requiring intervention over an 11-year period. Open surgical drainage (22), laparoscopic surgical drainage (11) and percutaneous fibrin glue injections into the drained lymphocele cavity (13) were used to treat this complication. Besides being effective both on the early and late developed lymphoceles, significantly lower recurrence rates by fibrin glue injections and lower median treatment costs were observed when compared with the other two surgical modalities. It has also the advantage of an outpatient procedure that can be performed using ?uoroscopic guidance, under local anesthesia. However, due to era effect, most of the open and laparoscopic surgical recipients were treated with sirolimus, a well-known antiproliferative immunosuppressive agent, which can promote development of lymphoceles and surgical failure. However, the majority of fibrin glue-treated cases were with tacrolimus-based regimens, but this study, in its nature, is far from giving the answer for decreased number of recurrences with fibrin glue.