A transplant patient with a swollen leg.

Abstract

Some degree of peripheral oedema is not uncommon following renal transplantation. Bilateral peripheral oedema is seen in the context of congestive heart failure, delayed graft function with extracellular volume expansion or nephrotic syndrome due to glomerular disease. Mild unilateral peripheral oedema is also often seen, typically early after surgery and on the transplanted side. In these cases, it is usually assumed that some form of damage to the lymphatic ducts has occurred during transplant surgery. The swelling is usually mild and often settles over time. However, severe peripheral oedema on the contralateral side is uncommon, especially if deep venous thrombosis has already been excluded. We report such a case, which led to an unusual diagnosis. We also provide a brief review of the relevant literature and discuss recent insight into possible mechanisms and pathways.