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Introduction: Lymphocele formation following renal transplantation is a well-known complication. Mostly these are small and inconsequential, but large lymphocele may cause symptoms like pain, infection , renal dysfunction, surgical drainage of lymphatics Surgical damage of the lymphatics of the graft during the procurement and of the lymphatics around the iliac vessels of the recipients has been responsible with development of lymphocele. Several factors such as diabetes, obesity, blood coagulation abnormalities, anticoagulation prophylaxis, high dose of diuretics, delay in graft function and immunosuppressive drugs are known to be related to these complications. We report three cases of symptomatic lymphoceles managed at our centre during the past one year. Patients and Methods: We retrospectively reviewed patients undergoing renal transplant at our centre. Out of 18 transplant recipients 3 cases developed large symptomatic lymphoceles. These were evaluated by Computed Tomography (CT) scan/ Ultrasound (USG) and serum creatinine levels. These patients were managed by ultrasound guided aspiration and instillation of doxycyline. Results: All three patients underwent USG guided aspiration and doxycyline instillation had significant reduction in serum creatinine levels with no recurrence of lymphoceles on follow-up. Conclusions: lymphocele remains important surgical complications following renal transplantation. Prompt diagnosis and early intervention is crucial to prevent permanent renal damage..

Comprehensive preoperative evaluation of potential donors is crucial for selecting the right donor, with adequately functioning kidneys, and the best surgical approach for harvesting the organs to prevent donor-related complications and to assure good recipient graft function. Multidetector computed tomography is the choice of imaging in the preoperative evaluation of living renal donors with an accuracy of 95%–100%. The donor must retain one normal kidney. The left kidney is preferred for living donor nephrectomy because it has a longer renal vein and it is technically easier to remove. It is always preferable to choose kidneys with a single artery because both donor and recipient surgeries are less complicated and there is less risk for arterial thrombosis. We report in a case of successful transplantation wherein the donor had an early division of the main renal artery bilaterally as well as bilateral accessory renal arteries. [ABSTRACT FROM AUTHOR]

Introduction: Complex renal cystic lesions have long posed a clinical dilemma to clinicians as they represent a heterogeneous group of both benign and malignant conditions sharing similar clinical and radiological features. The Bosniak classification system based on computed tomography (CT) imaging remains the gold standard to predict the risk of malignancy in cystic renal masses. We retrospectively reviewed our series of patients who underwent surgery for renal cysts, their histopathological diagnosis, the outcome of surgery, and follow-up. Materials and Methods: We retrospectively reviewed the inpatient charts of the hospital for patients with renal cysts undergoing surgery for the same during the period January 2000-December 2017. CT images of these patients were re-reviewed. Clinical, surgical, radiological, pathological, and postoperative outcomes were analyzed. Based on the final pathology findings, the patients were stratified into a renal cell carcinoma (RCC) or a benign tumor subgroup. Results: During the 18-year study period, 31 patients with Bosniak I simple renal cysts, 23 with Bosniak 2 cysts, 1 patient with Bosniak IIF cyst, 8 with III cyst, and 11 with IV cyst underwent surgery. None of the patients with Bosniak I, II, and IIF had malignancy on histopathological examination (HPR) of the resected cyst wall. Five of the eight patients with Bosniak III and all 11 patients with Bosniak IV cysts had malignant lesions. Histopathological variety of RCC was clear cell type with Fuhrman Grade 1–2 in all the 16 patients. None of the patients have had either local or systematic recurrence of the malignancy. Five patients died during the follow-up period due to causes other than malignancy. Conclusions: Patients with unifocal cystic RCC evaluated and managed using standard imaging carry an excellent prognosis. Bosniak classification system is very effective in predicting malignancy in categories II, IIF, and IV, but low in category III, and that 37.5% of Bosniak III cysts were benign on HPR. [ABSTRACT FROM AUTHOR]