Perinephric fluid collection post renal transplant

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Perinephric fluid collections are commonly seen after renal transplantation. The appearance of a perinephric fluid collection is often nonspecific but may be partially differentiated by when the transplant occurred.

Radiographic features

Early post-transplant period (<4 weeks)

hematoma
- ultrasound probably has limited sensitivity, and often underestimates hematoma volume when present
- decrease in hemoglobin level may be more sensitive
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.