Symptomatic lymphocele developing soon after acute renal allograft rejection: coincidental or causal connection?

A renal transplant patient developed a lymphocele soon after an episode of acute rejection (AR). The lymphocele rapidly increased in size causing transplant ureteric and venous obstruction, leading to acute graft dysfunction and swelling of the ipsilateral leg. We appraise the complex relationship that exists between AR, lymphangiogenesis and lymphocele formation to determine whether a case for a causal connection between AR and development of lymphocele can be made in our patient.