Singh M, Soni JS, Jain M, Bhirud DP, Navriya SC, Choudhary GR, Sandhu AS. Lymphocele after renal transplant: Prevention and management. World J Transplant 2026; 16(2): 114224 [DOI: 10.5500/wjt.v16.i2.114224]
Corresponding Author of This Article
Deepak P Bhirud, Department of Urology, All India Institute of Medical Sciences, Basni Industrial Area Phase 2, Jodhpur 342005, Rajasthan, India. deepakprakashbhirud05@gmail.com
Research Domain of This Article
Transplantation
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review-article
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
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Singh M, Soni JS, Jain M, Bhirud DP, Navriya SC, Choudhary GR, Sandhu AS. Lymphocele after renal transplant: Prevention and management. World J Transplant 2026; 16(2): 114224 [DOI: 10.5500/wjt.v16.i2.114224]
World J Transplant. Jun 18, 2026; 16(2): 114224 Published online Jun 18, 2026. doi: 10.5500/wjt.v16.i2.114224
Lymphocele after renal transplant: Prevention and management
Mahendra Singh, Jaideep Singh Soni, Manali Jain, Deepak P Bhirud, Shiv C Navriya, Gautam R Choudhary, Arjun S Sandhu
Mahendra Singh, Jaideep Singh Soni, Manali Jain, Deepak P Bhirud, Shiv C Navriya, Gautam R Choudhary, Arjun S Sandhu, Department of Urology, All India Institute of Medical Sciences, Jodhpur 342005, Rajasthan, India
Co-first authors: Mahendra Singh and Jaideep Singh Soni.
Co-corresponding authors: Manali Jain and Deepak P Bhirud.
Author contributions: Singh M conceptualized the review and supervised the project; Jain M extracted data from relevant studies and contributed to manuscript editing; Soni JS drafting the initial manuscript; Singh M and Soni JS contributed equally to this article, they are the co-first authors of this manuscript; Soni JS and Sandhu AS conducted the literature review; Bhirud DP designed the review framework, supervised the study, and served as corresponding author; Navriya SC reviewed the methodology and provided critical input; Sandhu AS assisting in manuscript preparation and final editing; Choudhary GR provided overall guidance, senior supervision, and critical revision; Jain M and Bhirud DP contributed equally to this article, they are the co-corresponding authors of this manuscript; and all authors critically revised the manuscript, read and approved the final version.
AI contribution statement: Gemini AI and Grammarly were used for language polishing and writing assistance (abstract/draft structure only). No full AI-generated text, data analysis, study design, result interpretation or AI-created images were involved.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Deepak P Bhirud, Department of Urology, All India Institute of Medical Sciences, Basni Industrial Area Phase 2, Jodhpur 342005, Rajasthan, India. deepakprakashbhirud05@gmail.com
Received: September 17, 2025 Revised: November 11, 2025 Accepted: February 5, 2026 Published online: June 18, 2026 Processing time: 257 Days and 14 Hours
Abstract
Lymphocele is a common postoperative complication following renal transplantation, with reported incidence ranging from 0.6% to 38%. Symptomatic lymphoceles, occurring in 5%-10% of recipients, may cause graft dysfunction through ureteric or vascular compression. This minireview provides a comprehensive synthesis of the epidemiology, pathophysiology, risk factors, prevention, diagnosis, and management of post-transplant lymphoceles. Prevention strategies include meticulous surgical ligation of lymphatics, prophylactic peritoneal fenestration, and delaying the use of mammalian target of rapamycin inhibitors in the early post-transplant period. Diagnosis is best achieved using ultrasound, with computed tomography or magnetic resonance imaging reserved for complex cases. Management follows a stepwise approach: Conservative observation for small asymptomatic collections, percutaneous drainage with or without sclerotherapy for symptomatic cases, and laparoscopic marsupialization for refractory or complicated lymphoceles. Novel techniques, including intraoperative lymphangiography and bioengineered sealants, represent promising future strategies for addressing these challenges. This minireview highlights the importance of integrating surgical refinement, tailored immunosuppression, and emerging technologies to optimize outcomes in renal transplant recipients.
Core Tip: Lymphocele, a frequent complication after renal transplantation, results from lymphatic leakage, causing pelvic fluid accumulation. Incidence varies (0.6%-38%), with symptomatic cases (5%-10%) being at risk of graft dysfunction. Prevention emphasizes meticulous surgical ligation, peritoneal fenestration, and avoiding mammalian target of rapamycin inhibitors early post-transplant. Ultrasound aids diagnosis, while management ranges from conservative monitoring for small lymphoceles to sclerotherapy or laparoscopic marsupialization for persistent cases. Emerging techniques, like intraoperative lymphangiography, show promise. Tailored immunosuppression and refined surgical approaches are critical for reducing lymphocele morbidity.
