The role of povidone-iodine in prevention of lymphorrhea after kidney transplant surgery - A prospective, pilot study

Abstract

Objective: Lymphatic complications (lymphorrhea or lymphocele) are one of the most common and frustrating complications of renal transplantation. It was well documented in literatures that excessive lymphatic leak in the early postoperative period leads to lymphorrhea, which may transform into lymphocele. Povidone-iodine has been used as a sclerosant in lymphocele management for the past 30 years. In this study, our aim is to establish the role of povidone-iodine to prevent lymphorrhea after kidney transplant surgery. Materials and Methods: A total of 106 (live donor transplant patient = 63 and deceased donor transplant patient 43) patients had undergone renal transplantation from May 2019 to May 2020. Those patients were randomized into three groups – Group A (n = 35): where 1% povidone-iodine was used, Group B (n = 35): where 5% povidone-iodine was used, and Group C (n = 36): control group, where povidone-iodine was not used. Fifty milliliters of 1% or 5% povidone-iodine was used to wash the bed and kept for 5 min in contact with the bed and again 1% (Group A) or 5% (Group B) povidone-iodine wash was given after completion of ureteroneocystostomy and was kept for 5 min. Results: On postoperative day 6, there is a statistically significant decrease in drain output in the 5% and 1% povidone-iodine groups in comparison with the control group, but no statistically significant difference exists between 5% versus 1% povidone-iodine group. Conclusion: Intraoperative instillation povidone-iodine is a cheap, safe, and very effective procedure to prevent lymphorrhea following renal transplant surgeries.

Keywords

• lymphocele
• lymphorrhea
• povidone-iodine
• renal transplantation