{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T23:44:03Z","timestamp":1782863043916,"version":"3.54.5"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T00:00:00Z","timestamp":1772582400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T00:00:00Z","timestamp":1772582400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100012681","name":"Universit\u00e4tsklinikum K\u00f6ln","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100012681","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Surg Endosc"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Lymphocele formation is a frequent complication after kidney transplantation, occurring in up to 26% of recipients. It results mainly from lymphatic injury during dissection of the iliac vessels and can impair graft function by compressing the renal graft, vascular structures, or ureter. Improved intraoperative visualization of lymphatic vessels may reduce this risk. Indocyanine green (ICG) fluorescence technology enables real-time lymphatic mapping. This study evaluated the feasibility and clinical utility of ICG fluorescence-guided lymphography during kidney transplantation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In a prospective single-center study, ICG lymphography was performed in 21 consecutive living-donor kidney transplantations. Under ultrasound guidance, ICG was injected into the subcutaneous tissue of the ipsilateral femoral triangle one hour before surgery. Lymphatic structures were visualized intraoperatively using a handheld fluorescence imaging system (Spy-Phi, Stryker) at four procedural time points. Identified lymphatic vessels were preserved, and any visualized lymphatic leakage was clipped. Postoperative surveillance included weekly ultrasonography in the early postoperative phase and MRI at 6 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>ICG injection enabled clear visualization of retroperitoneal lymphatic vessels in all 21 cases. Lymphatic structures were successfully preserved during dissection. In two cases, intraoperative lymphatic leakage was detected and controlled. Postoperative ultrasound showed no perirenal fluid collections in any patient. MRI performed in 15\/21 patients at 6 months confirmed absence of lymphocele formation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>ICG-guided lymphography is a safe, feasible technique for intraoperative visualization of lymphatic vessels during kidney transplantation and may help prevent lymphocele formation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00464-026-12656-1","type":"journal-article","created":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T16:32:14Z","timestamp":1772641934000},"page":"4085-4090","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Fluorescence lymphography in kidney transplantation (FLIKT-study)\u2014real time intraoperative lymphography to avoid lymphocele formation"],"prefix":"10.1007","volume":"40","author":[{"given":"M.","family":"Hummels","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Wagner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Buchner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. R.","family":"Stier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Datta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Ischebeck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. F.","family":"Fuchs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Kann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F. C.","family":"Koehler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Kurschat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Gietzen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Becker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. J.","family":"Bruns","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. L.","family":"Stippel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4121-3091","authenticated-orcid":false,"given":"M. N.","family":"Thomas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,4]]},"reference":[{"key":"12656_CR1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trre.2024.100877","author":"M Sabagh","year":"2024","unstructured":"Sabagh M, Sabetkish N, Fakour S, Ramouz A, Weber S, Mieth M, Lurje G, Golriz M, Zeier M, Mehrabi A, Khajeh E (2024) Methods to prevent lymphocele after kidney transplantation: seeking the optimal technique for avoiding a preventable complication. Transplant Rev. https:\/\/doi.org\/10.1016\/j.trre.2024.100877","journal-title":"Transplant Rev"},{"key":"12656_CR2","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1016\/j.trre.2016.11.001","volume":"31","author":"M Golriz","year":"2017","unstructured":"Golriz M, Klauss M, Zeier M, Mehrabi A (2017) Prevention and management of lymphocele formation following kidney transplantation. Transplant Rev 31:100\u2013105","journal-title":"Transplant Rev"},{"key":"12656_CR3","doi-asserted-by":"publisher","DOI":"10.12659\/aot.942656","author":"N Ay","year":"2024","unstructured":"Ay N, Alp V, Duymu\u015f R, \u00c7etin S (2024) Lymphocele outcomes after renal transplantations performed by an experienced surgeon: is meticulously performed surgery and\u00a0experience adequate to prevent lymphocele? Ann Transplant. https:\/\/doi.org\/10.12659\/aot.942656","journal-title":"Ann Transplant"},{"key":"12656_CR4","doi-asserted-by":"publisher","first-page":"801","DOI":"10.1002\/bjs.11587","volume":"107","author":"A Mehrabi","year":"2020","unstructured":"Mehrabi A, Kulu Y, Sabagh M, Khajeh E, Mohammadi S, Ghamarnejad O, Golriz M, Morath C, Bechstein WO, Berlakovich GA, Demartines N, Duran M, Fischer L, G\u00fcrke L, Klempnauer J, K\u00f6nigsrainer A, Lang H, Neumann UP, Pascher A, Paul A, Pisarski P, Pratschke J, Schneeberger S, Settmacher U, Viebahn R, Wirth M, Wullich B, Zeier M, B\u00fcchler MW (2020) Consensus on definition and severity grading of lymphatic complications after kidney transplantation. Br J Surg 107:801\u2013811","journal-title":"Br J Surg"},{"key":"12656_CR5","doi-asserted-by":"publisher","first-page":"615","DOI":"10.1093\/ckj\/sfv064","volume":"8","author":"A Ranghino","year":"2015","unstructured":"Ranghino A, Segoloni GP, Lasaponara F, Biancone L (2015) Lymphatic disorders after renal transplantation: new insights for an old complication. Clin Kidney J 8:615\u2013622","journal-title":"Clin Kidney J"},{"issue":"3","key":"12656_CR6","first-page":"144","volume":"5","author":"MR Ebadzadeh","year":"2008","unstructured":"Ebadzadeh MR, Tavakkoli M (2008) Special feature lymphocele after kidney transplantation where are we standing now? Urol J 2008 Summer 5(3):144\u20138","journal-title":"Urol J 2008 Summer"},{"key":"12656_CR7","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-025-03989-5","author":"C Kuhn","year":"2025","unstructured":"Kuhn C, J\u00e4nigen B, Matuschik L, Rieger MJ, Sidler D, Zschiedrich S (2025) The effects of lymphocele formation after living donor kidney transplantation on mid-term allograft function. BMC Nephrol. https:\/\/doi.org\/10.1186\/s12882-025-03989-5","journal-title":"BMC Nephrol"},{"key":"12656_CR8","doi-asserted-by":"publisher","first-page":"iii659","DOI":"10.1093\/ndt\/gfv202.82","volume":"30","author":"E Isiktas Sayilar","year":"2015","unstructured":"Isiktas Sayilar E, Ersoy A, Ayar Y, Aydin MF, Sahin AB, Coskun B, Kaygisiz O, Yildiz A, Kordan Y, Vuruskan H (2015) SP856FACTORS influencing lymphocel development after kidney transplantation: single center experience. Nephrol Dial Transplant 30:iii659\u2013iii659. https:\/\/doi.org\/10.1093\/ndt\/gfv202.82","journal-title":"Nephrol Dial Transplant"},{"key":"12656_CR9","doi-asserted-by":"publisher","first-page":"1040","DOI":"10.1016\/J.TRANSPROCEED.2021.01.028","volume":"53","author":"M Sevmis","year":"2021","unstructured":"Sevmis M, Aktas S, Alkara U, Kilercik H, Uyar M, Sevmis S (2021) Risk factors, diagnosis, and treatment of lymphocele after renal transplantation: a retrospective study. Transplant Proc 53:1040\u20131047. https:\/\/doi.org\/10.1016\/J.TRANSPROCEED.2021.01.028","journal-title":"Transplant Proc"},{"key":"12656_CR10","doi-asserted-by":"publisher","first-page":"1955","DOI":"10.1097\/TP.0000000000002268","volume":"102","author":"IO Yildirim","year":"2018","unstructured":"Yildirim IO, Pi\u015fkin T, Duman E, Firat A, Dogan M, Taskapan H, Sahin I, Sarac K (2018) A novel technique in the treatment of lymphoceles after renal transplantation: C-arm cone beam CT-guided percutaneous embolization of lymphatic leakage after lymphangiography. Transplantation 102:1955\u20131960. https:\/\/doi.org\/10.1097\/TP.0000000000002268","journal-title":"Transplantation"},{"key":"12656_CR11","doi-asserted-by":"publisher","first-page":"685","DOI":"10.1007\/S11255-020-02709-2\/TABLES\/4","volume":"53","author":"M Baboudjian","year":"2021","unstructured":"Baboudjian M, Tadrist A, Gondran-Tellier B, McManus R, Akiki A, Gaillet S, Delaporte V, Carballeira A, Andre M, Karsenty G, Lechevallier E, Boissier R (2021) Povidone-iodine sclerotherapy of primary symptomatic lymphocele after kidney transplantation. Int Urol Nephrol 53:685\u2013690. https:\/\/doi.org\/10.1007\/S11255-020-02709-2\/TABLES\/4","journal-title":"Int Urol Nephrol"},{"key":"12656_CR12","doi-asserted-by":"publisher","first-page":"663","DOI":"10.1097\/TP.0b013e31822a40ef","volume":"92","author":"A Lucewicz","year":"2011","unstructured":"Lucewicz A, Wong G, Lam VWT, Hawthorne WJ, Allen R, Craig JC, Pleass HCC (2011) Management of primary symptomatic lymphocele after kidney transplantation: a systematic review. Transplantation 92:663\u2013673","journal-title":"Transplantation"},{"key":"12656_CR13","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.6548","volume":"7","author":"FB Achterberg","year":"2024","unstructured":"Achterberg FB, Bijlstra OD, Slooter MD, Sibinga Mulder BG, Boonstra MC, Bouwense SA, Bosscha K, Coolsen MME, Derksen WJM, Gerhards MF, Gobardhan PD, Hagendoorn J, Lips D, Marsman HA, Zonderhuis BM, Wullaert L, Putter H, Burggraaf J, Mieog JSD, Vahrmeijer AL, Swijnenburg RJ (2024) ICG-fluorescence imaging for margin assessment during minimally invasive colorectal liver metastasis resection. JAMA Netw Open 7:E246548. https:\/\/doi.org\/10.1001\/jamanetworkopen.2024.6548","journal-title":"JAMA Netw Open"},{"key":"12656_CR14","doi-asserted-by":"publisher","first-page":"1841","DOI":"10.4240\/wjgs.v15.i9.1841","volume":"15","author":"ZY Lim","year":"2023","unstructured":"Lim ZY, Mohan S, Balasubramaniam S, Ahmed S, Siew CCH, Shelat VG (2023) Indocyanine green dye and its application in gastrointestinal surgery: the future is bright green. World J Gastrointest Surg 15:1841\u20131857. https:\/\/doi.org\/10.4240\/wjgs.v15.i9.1841","journal-title":"World J Gastrointest Surg"},{"key":"12656_CR15","doi-asserted-by":"publisher","DOI":"10.3390\/cancers15082247","author":"DT M\u00fcller","year":"2023","unstructured":"M\u00fcller DT, Schiffmann LM, Reisewitz A, Chon SH, Eckhoff JA, Babic B, Schmidt T, Schr\u00f6der W, Bruns CJ, Fuchs HF (2023) Mapping the lymphatic drainage pattern of esophageal cancer with near-infrared fluorescent imaging during robotic assisted minimally invasive Ivor Lewis esophagectomy (RAMIE)\u2014first results of the prospective ESOMAP feasibility trial. Cancers (Basel). https:\/\/doi.org\/10.3390\/cancers15082247","journal-title":"Cancers (Basel)"},{"key":"12656_CR16","doi-asserted-by":"publisher","first-page":"3073","DOI":"10.1016\/j.transproceed.2016.08.017","volume":"48","author":"G Ietto","year":"2016","unstructured":"Ietto G, Amico F, Soldini G, Chiappa C, Franchin M, Iovino D, Romanzi A, Saredi G, Cassinotti E, Boni L, Tozzi M, Carcano G (2016) Real-time intraoperative fluorescent lymphography: a new technique for lymphatic sparing surgery. Transplant Proc 48:3073\u20133078. https:\/\/doi.org\/10.1016\/j.transproceed.2016.08.017","journal-title":"Transplant Proc"},{"key":"12656_CR17","doi-asserted-by":"publisher","first-page":"786","DOI":"10.1016\/j.transproceed.2020.08.026","volume":"53","author":"R Wahba","year":"2021","unstructured":"Wahba R, Vitinius F, Walczuch B, Dieplinger G, Buchner D, Datta R, L\u00fcrssen N, Schl\u00f6\u00dfer HA, Thomas M, M\u00fcller R, Kann M, Hellmich M, Kurschat C, Stippel DL (2021) Hand-assisted retroperitoneoscopic donor nephrectomy compared to anterior approach open donor nephrectomy: improved long-term physical component score in health-related quality of life in living kidney donors. Transplant Proc 53:786\u2013792. https:\/\/doi.org\/10.1016\/j.transproceed.2020.08.026","journal-title":"Transplant Proc"},{"key":"12656_CR18","doi-asserted-by":"publisher","first-page":"1839","DOI":"10.1097\/00007890-200206150-00024","volume":"73","author":"J Wadstrom","year":"2002","unstructured":"Wadstrom J, Lindstrom P (2002) Hand-assisted retroperitoneoscopic living-donor nephrectomy: initial 10 cases. Transplantation 73:1839\u20131840","journal-title":"Transplantation"},{"key":"12656_CR19","doi-asserted-by":"publisher","first-page":"592","DOI":"10.1001\/jamasurg.2024.4110","volume":"160","author":"L Boni","year":"2025","unstructured":"Boni L, Cassinotti E, Baldari L (2025) Technique for laparoscopic fluorescence-guided retroperitoneal lymph node dissection. JAMA Surg 160:592\u2013593","journal-title":"JAMA Surg"},{"key":"12656_CR20","doi-asserted-by":"publisher","first-page":"2197","DOI":"10.1016\/j.transproceed.2022.07.011","volume":"54","author":"M Serirodom","year":"2022","unstructured":"Serirodom M, Taweemonkongsap T, Chotikawanich E, Jitpraphai S, Woranisarakul V, Shrestha S, Hansomwong T (2022) Lymphocele in kidney transplantation: a comparison of ligation and non-ligation technique of iliac lymphatic dissection. Transplant Proc 54:2197\u20132204. https:\/\/doi.org\/10.1016\/j.transproceed.2022.07.011","journal-title":"Transplant Proc"}],"container-title":["Surgical Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00464-026-12656-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00464-026-12656-1","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00464-026-12656-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T22:44:34Z","timestamp":1782859474000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00464-026-12656-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,4]]},"references-count":20,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["12656"],"URL":"https:\/\/doi.org\/10.1007\/s00464-026-12656-1","relation":{},"ISSN":["0930-2794","1432-2218"],"issn-type":[{"value":"0930-2794","type":"print"},{"value":"1432-2218","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,4]]},"assertion":[{"value":"18 November 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 February 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 March 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"M.H., T.W., D.B, A.S., R.D., L.I., H.F., M.K., F.K., C.K., C.G., J.B., C.B., D.S., M.T. have no conflicts of interest or financial ties to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosure"}}]}}