Is Liver Transplantation Without Abdominal Drainage Safe?

Abdominal drainage after liver transplantation from deceased donors

“…Prophylactic abdominal drainage after liver transplantation has been used for a long time to monitor postoperative intraabdominal complications such as hemorrhage, bile leaks, and others [1,9]. Nevertheless, potential deleterious adverse events followed by abdominal drainage, such as ascending infection or major protein loss due to ascite drainage [3][4][5], need to be set in contrast to potential but never proven benefits of this practice.…”

“…Data on this subject are limited. A systematic review of the Cochrane database in 2011 [10] showed that no prospective randomized controlled trial has been performed yet to evaluate the suitability of abdominal drains in LT. One pair-matched analysis [9] and three retrospective studies have been published [1,9,11,12]. None of these was focused on the risk of infection and bile duct complications associated with the placement of a drain.…”

“…Prophylactic abdominal drainage (AD) has been used for a long time after liver transplantation (LT), with the aim of monitoring postoperative bleeding and bile leaks, drain ascites, and preventing fluid collection that may cause infection [1]. Although abdominal drains are still used in the majority of liver transplant programs throughout the world [2], the question as to whether it is really necessary remains disputed in the transplant community.…”

Impact of abdominal drainage systems on postoperative complication rates following liver transplantation

“…Interestingly however, no comparative studies have evaluated the value of insertion of drains after liver transplantation. Sporadically, the use of no drains at all after liver transplantation has been reported [ 7 – 11 , 13 ]. Nevertheless, this seems only anecdotal in highly selected patients, as most transplant centers use intra-abdominal drains after such an operation.…”

“…Little has been published about the need for, usefulness, safety or complication rate of drain insertion following liver transplantation. To date, only less recent and very rare publications have dealt with this topic [ 7 – 11 ]. Despite the lack of information and evidence, most transplant centers use intraabdominal drains after this high-end surgical intervention and remove or close the drains within 5 days after surgery.…”