Retroperitoneal viscum album extract injection in high drain output patient after renal transplantation
Youngjun Park1, Sangseob Yoon1, Suncheol Park1.
1Department of Vascular and Transplant Surgery, Seoul St. Mary’s Hospital, Seoul, Korea
Background: After renal transplantation, high drain output of lymph fluid is one of the causes of delaying postoperative recovery with longer hospital stay. Viscum Album extract (sold under the brand name Helixor M) is one of the agents used in pleurodesis procedure when treating malignant pleural effusion, and we evaluated efficacy of this agent in reducing drain output after renal transplantation.
Methods: We retrospectively reviewed medical records of patients with high drain output (>100ml at postoperative day 7) after renal transplantation who undergone Viscum Album extract injection via drain (N=23) or conservative care (N=23). The primary end point was reduction in drain output at postoperative day 14 from postoperative day 7. The secondary end point was postoperative recovery as reflected by the duration of hospitalization after operation.
Results: Reduction in drain output at postoperative day 14 from postoperative day 7 was larger in the Viscum Album extract injection group than in the conservative care group (226.5ml vs. 83.3ml, P=0.010). Duration of hospitalization after operation was shorter in the Viscum Album extract injection group than in the conservative care group (16.0 days vs. 19.5 days, P=0.012). Ratio of patients who discharge with drain kept was also less in the Viscum Album extract injection group than in the conservative care group (17.4% vs. 52.2%, P=0.029). Readmission to perform surgical drainage procedure was needed in 1 patient in the conservative care group and none in the Viscum Album extract injection group.
Conclusions: In this study, reduction in drain output at postoperative day 14 from postoperative day 7 was larger and duration of hospitalization was shorter after renal transplantation when Viscum Album extract was injected via drain, suggesting that Viscum Album extract injection could be considered for faster postoperative recovery in high drain output patients after renal transplantation.
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