Login to Access Video or Poster Abstract: MP74-02
Sources of Funding: None

Introduction

Lymphatic collections commonly develop after renal transplantation although most of them are asymptomatic and resolve spontaneously. Persistent drain output is one of the earliest signs of lymphatic leak. An encysted collection or lymphocoele if symptomatic, can lead to complications as grave as the graft dysfunction itself. This study aimed at prospectively evaluating the role of early povidone iodine instillation in the management of post renal transplant lymphorrhoea.

Methods

A prospective evaluation of live related renal transplant recipients was done from Jan 2002 to Dec 2015. Significant lymphorrhoea was defined as >50 mL lymph from drain beyond POD 5. Such patients were randomized into 2 groups: Group A (received 0.5% povidone iodine instillation) and Group B (no instillation). Povidone iodine instillation was done for upto three weeks. The drain was removed if the output decreased to <50ml/day or at three weeks drainage persisted. Absolute risk reduction and NNT were calculated to estimate effect of povidone iodine instillation for the treatment of lymphorrhoea. Fisher exact test or chi square test for categorical data descriptive statistics and t test was used for continuous data SPSS version 20.0. Armonk, NY: IBM Corp.

Results

1766 patients underwent renal transplant during this period. 117 patients with lymphorrhoea through the drain underwent randomization into group A (n=61) and group B (n=56). In group A, 58(95%) patients had successful resolution within two weeks while in group B, 34(60%) patients had successful resolution within two weeks. Symptomatic lymphocoele was present in 1 patient in group A and 7 patients in group B on follow up. Absolute risk reduction was 10.8% and for every symptomatic lymphocoele prevented, 10 patients needed povidone iodine instillation.

Conclusions

Povidone iodine instillation helps in early resolution of post renal transplantation lymphorrhoea as well as reduces the incidence of lymphocoele formation.

Funding

None