Is liver transplantation without abdominal drainage safe?

Area of Science:

• Hepatology
• Surgical Innovation
• Transplant Surgery

Background:

• Intra-abdominal drains are commonly used after liver transplantation (OLT) to monitor for complications.
• The necessity and impact of routine drain placement in OLT remain subjects of investigation.

Purpose of the Study:

• To evaluate the safety and impact of omitting intra-abdominal drains in OLT.
• To compare postoperative complications, reinterventions, and resource utilization between OLT patients with and without drains.

Main Methods:

• An observational, analytical cohort study comparing 35 OLT patients without drains to 35 OLT patients with drains.
• Assessment of recipient and donor factors, intraoperative variables, and postoperative outcomes including hemoperitoneum, biliary leaks, collections, reinterventions, and length of stay.

Main Results:

• No significant difference in ICU or in-hospital stays between groups.
• The drain group had two reoperations for hemoperitoneum; the no-drain group had none.
• The no-drain group required more paracentesis (23% vs 5.7%), while the drain group showed higher rates of perihepatic hematomas (53% vs 21%) and increased blood product consumption (platelets and plasma).

Conclusions:

• Liver transplantation without intra-abdominal drainage is a safe approach, not associated with increased morbidity.
• Routine abdominal drainage after OLT may contribute to intra-abdominal hematomas and increased blood product usage.