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. 2018;18(73):126-132.
doi: 10.15557/JoU.2018.0018.

Sonographic assessment of the prevalence and evolution of fluid collections as a complication of kidney transplantation

Maryla Kuczyńska  1 , Ewa Piasek  1 , Łukasz Światłowski  1 , Ewa Kuklik  1 , Jan Sobstyl  1 , Anna Drelich-Zbroja  1 , Tomasz Słomka  2 , Krzysztof Pyra  1 , Olga Furmaga  3 , Małgorzata Szczerbo-Trojanowska  1
Affiliations

Sonographic assessment of the prevalence and evolution of fluid collections as a complication of kidney transplantation

Maryla Kuczyńska et al. J Ultrason. 2018.

Abstract

Aim of the study: The aim of this study is to assess the prevalence and evolution of perirenal fluid collections in a group of 488 patients who have undergone kidney transplantation.

Material and methods: Sonographic documentation of 488 deceased-donor kidney recipients was evaluated for the prevalence of perirenal fluid collections and their evolution in time, depending on selected demographic features of the patients, time of detection, initial dimensions and precise position of the collection relative to the kidney and the location of the transplanted organ in the right or left iliac fossa. The collected data were used for statistical analysis to determine the strength of the potential relationships.

Results: In 146 out of 488 subjects perirenal fluid collections were found. In 1/3 of the patients more than one fluid collection was diagnosed. Over 40% of fluid collections were detected within 10 days from the date of the first scan and 24.11% were detected within 10-20 days from the date of the first scan. The majority of fluid collections were located near the lower pole of the kidney. Perihilar collections were the least common. Collections encapsulating the kidney and subcutaneous collections were the largest in size on average. A statistically significant difference between the size of collections located on the surface and the size of those located near the upper pole of the transplanted kidney was demonstrated. However, no correlation was proven to exist between the persistence of the fluid collection and its position relative to the transplanted kidney and its initial size.

Conclusions: The correct evaluation of a fluid collection's dynamics of development and nature requires periodic follow-up of the recipient, preferably in a single clinical center. Ultrasonography is an inexpensive, non-invasive and repeatable method for the determination of the presence of fluid collections. However, the decision whether treatment is necessary requires the sonographic image to be compared with the laboratory signs of inflammation and biochemical analysis of the contents of fluid collections.

Keywords: diagnostic imaging; kidney diseases; kidney transplantation; ultrasonography.

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Figures

Fig. 1.
Fig. 1.
Perirenal, partly hyperechoic fluid collection with smooth contours. Ultrasound image of a possible haematoma
Fig. 2.
Fig. 2.
Fluid collection with polycyclic contours with internal compartments – an image of possible late evolution of a perirenal haematoma
Fig. 3.
Fig. 3.
Perirenal, regular fluid collection, most probably a lymphocele
Fig. 4.
Fig. 4.
Extensive, irregular fluid collection partially encapsulating the kidney, most probably a lymphocele
Fig. 5.
Fig. 5.
Percentage distribution of the detected fluid collections depending on the time elapsed
Fig. 6.
Fig. 6.
Prevalence of fluid collections depending on their position relative to the transplanted organ
Fig. 7.
Fig. 7.
Fluid collection size distribution depending on their position relative to the transplanted organ
Fig. 8.
Fig. 8.
Analysis of correlation between the persistence of a fluid collection and its position relative to the kidney, following the determination of non-normality of distribution for both these characteristics
See this image and copyright information in PMC

References

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