Conservative therapy, which approach is the best in the nutritional management of Chylous effusion following open donor nephrectomy: Case report

Postoperative chyle leak after open donor nephrectomy is rare, but morbid complication that can compromise the safety of the donors. Treatment options can be challenging in the absence of clear guidelines due to relatively small number of studies .We are reporting here the first case in the literature of chylous effusion after an open donor nephrectomy when all reported cases were typically presented as chylous ascites.Our patient presented chyle effusion on the third day post nephrectomy.Diagnosis was confirmed by paracentesis. The patient was placed in a fasting state and received total parenteral nutrition with octreotide for three days. However, two episodes of hypoglycemia were noted. Consequently, we decided to initiate enteral feeding with a low-fat diet supplemented with medium-chain triglycerides which resulted in favorable progress over 10 days.Since there are no official guidelines, our case proposes a specific algorithm for the nutritional management of chyle effusion following open donor nephrectomy.