Renal Lymphangiectasia in the Transplanted Kidney: Case Series and Literature Review.
Journal
Transplantation
ISSN: 1534-6080
Titre abrégé: Transplantation
Pays: United States
ID NLM: 0132144
Informations de publication
Date de publication:
01 2020
01 2020
Historique:
pubmed:
10
4
2019
medline:
2
10
2020
entrez:
10
4
2019
Statut:
ppublish
Résumé
Renal lymphangiectasia is a rare and poorly understood lymphatic disease associated with lymphatic dilation and leakage. To our knowledge, no cases have been described in the context of a transplanted kidney. We describe 2 cases of renal lymphangiectasia in transplanted kidneys, both from pediatric donors. The cases of allograft lymphangiectasia are characterized by severe, symptomatic ascites refractory to attempts at medical and surgical management, and ultimately requiring allograft nephrectomy. While lymphatic complications, particularly lymphoceles, are not uncommon in renal transplantation, lymphangiectasia is a distinct condition which should be considered in renal transplant patients with ascites, after all other sources have been ruled out.
Sections du résumé
BACKGROUND
Renal lymphangiectasia is a rare and poorly understood lymphatic disease associated with lymphatic dilation and leakage. To our knowledge, no cases have been described in the context of a transplanted kidney.
METHODS
We describe 2 cases of renal lymphangiectasia in transplanted kidneys, both from pediatric donors.
RESULTS
The cases of allograft lymphangiectasia are characterized by severe, symptomatic ascites refractory to attempts at medical and surgical management, and ultimately requiring allograft nephrectomy.
CONCLUSIONS
While lymphatic complications, particularly lymphoceles, are not uncommon in renal transplantation, lymphangiectasia is a distinct condition which should be considered in renal transplant patients with ascites, after all other sources have been ruled out.
Identifiants
pubmed: 30964839
doi: 10.1097/TP.0000000000002745
pii: 00007890-202001000-00033
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
172-175Références
Bazari H, Attar EC, Dahl DM, et al. Case records of the massachusetts general hospital. Case 23-2010. A 49-year-old man with erythrocytosis, perinephric fluid collections, and renal failure. N Engl J Med. 2010; 363:463–475
Pandya VK, Shah MK, Gandhi SP, et al. Bilateral renal lymphangiectasia. J Clin Diagn Res. 2016; 10:TD01–TD02
Pollack SF, Geffrey AL, Thiele EA, et al. Primary intestinal lymphangiectasia treated with rapamycin in a child with tuberous sclerosis complex (TSC). Am J Med Genet A. 2015; 167A:2209–2212
Ishikawa Y, Akasaka Y, Kiguchi H, et al. The human renal lymphatics under normal and pathological conditions. Histopathology. 2006; 49:265–273
Wong BW, Zecchin A, García-Caballero M, et al. Emerging concepts in organ-specific lymphatic vessels and metabolic regulation of lymphatic development. Dev Cell. 2018; 45:289–301
Schulte-Merker S, Sabine A, Petrova TV. Lymphatic vascular morphogenesis in development, physiology, and disease. J Cell Biol. 2011; 193:607–618
Mäkinen T, Veikkola T, Mustjoki S, et al. Isolated lymphatic endothelial cells transduce growth, survival and migratory signals via the VEGF-C/D receptor VEGFR-3. EMBO J. 2001; 20:4762–4773
Mobley JE, O’Dell RM. The role of lymphatics in renal transplantation. Renal lymphatic regeneration. J Surg Res. 1967; 7:231–233
Lucewicz A, Wong G, Lam VW, et al. Management of primary symptomatic lymphocele after kidney transplantation: a systematic review. Transplantation. 2011; 92:663–673
Ranghino A, Segoloni GP, Lasaponara F, et al. Lymphatic disorders after renal transplantation: new insights for an old complication. Clin Kidney J. 2015; 8:615–622
Meredith WT, Levine E, Ahlstrom NG, et al. Exacerbation of familial renal lymphangiomatosis during pregnancy. AJR Am J Roentgenol. 1988; 151:965–966
Stuht S, Gwinner W, Franz I, et al. Lymphatic neoangiogenesis in human renal allografts: results from sequential protocol biopsies. Am J Transplant. 2007; 7:377–384
Wani NA, Kosar T, Gojwari T, et al. Perinephric fluid collections due to renal lymphangiectasia. Am J Kidney Dis. 2011; 57:347–351
Flessner MF. Peritoneal transport physiology: insights from basic research. J Am Soc Nephrol. 1991; 2:122–135