Perinephric fluid collections are commonly seen after renal transplantation. The appearance of a perinephric fluid collection is often nonspecific, and generating a differential often relies on when the transplant occurred.
Early post-transplant period
- ultrasound probably has limited sensitivity, and often underestimates haematoma volume when present 3
- decrease in haemoglobin level may be more sensitive 3
urinoma: mean time of onset is 45 days
- occurs from breakdown of the ureterovesicle anastomosis
- can be diagnosed with a MAG-3 nuclear medicine scan
Late post-transplant period
- lymphocoele: 4-8 weeks post surgery, but may occur as far out as 6 months
Although division of fluid collections into early and late can be useful to generate a differential diagnosis, collections that occur in the early post-transplant period may also occur in the late post-transplant period. If clinically necessary, a definitive diagnosis often requires percutaneous aspiration and fluid analysis.
- 1. Brown ED, Chen MY, Wolfman NT et-al. Complications of renal transplantation: evaluation with US and radionuclide imaging. Radiographics. 2000;20 (3): 607-22. doi:10.1148/radiographics.20.3.g00ma14607 - Pubmed citation
- 2. Richard HM. Perirenal transplant fluid collections. Semin Intervent Radiol. 2004;21 (04): 235-7. doi:10.1055/s-2004-861557 - Free text at pubmed - Pubmed citation
- 3. Fananapazir G, Rao R, Corwin MT et-al. Sonographic Evaluation of Clinically Significant Perigraft Hematomas in Kidney Transplant Recipients. AJR Am J Roentgenol. 2015;205 (4): 802-6. doi:10.2214/AJR.15.14426 - Pubmed citation