MP32-07 WARM PERFUSION OF CARBON MONOXIDE RELEASING MOLECULE 401 REDUCES INFLAMMATION AND DAMAGE IN PRECLINICAL DONATION AFTER CARDIAC DEATH KIDNEY TRANSPLANTATION MODEL

Abstract

INTRODUCTION AND OBJECTIVES: Definitive treatment of symptomatic post transplant lymphocele includes percutaneous aspiration with or without sclerotherapy, or open/laparoscopic transperitoneal lymphocele drainage. Some authors have demonstrated that lymphocele formation can virtually be prevented by placing an intraoperative drain.We herein prospectively investigated the effect of placing a retroperitoneal drain during renal transplantation surgery on the incidence of lymphocele formation in recipients compared to those who received no drain. METHODS: a totalof315adult patientswhounderwent living renal transplantations in our institution were prospectively enrolled. The patient were randomlyassigned to oneof two groupson thebasis ofwhether or not they received a Jackson Pratt drain in the retroperitoneal space during surgery; group 1 had a drain placed (n1⁄4203) and group 2 did not (n1⁄4112). Patient demographic and clinical data known to affect transplant outcomes were compared between group 1 (drain) and group 2 ( no drain), including recipient age, gender, bodymass index (BMI) at transplantation, cause of end-stage renal disease, dialysis before transplantation, donor age, anastomotic time, delayed graft function and acute rejection episodes. This was correlated with lymphocele incidence rate and the need for lymphocele intervention (operative or percutaneous radiological). RESULTS: Individual risk factors were analyzed for their association with lymphocele formation in a univariate model. Themost important factors associated with an increased risk of lymphocele formation were no drain (P1⁄40.002), high BMI (p1⁄40.003) and diabetic nephropathy as an underlying cause of end stage renal failure (0.0426). The presence of diabetic nephropathy and anastomotic timewasassociatedwith increased risk but was not significant (P 1⁄40.264 and 0.690, respectively). CONCLUSIONS: In conclusion, placing of a retroperitoneal drain during renal transplant surgery significantly decreases the incidence of lymphocele formation. Furthermore, it significantly reduces the need for surgical intervention as a treatment modality for clinically significant lymphoceles. We recommend routine placement of a retroperitoneal drain during kidney transplant surgery in all patients.