Perinephric fluid collections post renal transplant are common. The appearance of a perinephric fluid collection after renal transplantation is often non-specific but may be partially differentiated by how long ago the transplant occurred.
Radiographic features
Early post-transplant period (<4 weeks)
-
hematoma
- ultrasound probably has limited sensitivity, and often underestimates hematoma volume when present 3
- decrease in hemoglobin level may be more sensitive 3
- seroma
-
urinoma
- occurs from breakdown of the ureterovesical anastomosis
- can be diagnosed with a MAG-3 nuclear medicine scan
Late post-transplant period (>4 weeks)
- lymphocele: 4-8 weeks post surgery, but may occur as far out as 6 months
- abscess
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.