Liver Transplantation Without Abdominal Drainage

Fernández-Aguilar, José Luis; Suárez-Muñoz, Miguel Ángel; Sánchez-Pérez, Belinda; Cordoba, E. Gamez; Roa, Y. Pulido; Narváez, JM Aranda; Daga, J.A. Pérez; Casado, Custodia Montiel; Sánchez, Antonio González; Santoyo-Santoyo, Julio

doi:10.1016/j.transproceed.2012.09.039

Cited by 10 publications

(12 citation statements)

References 2 publications

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“…By contrast, prophylactic intra‐abdominal drains after LT may present a risk for intra‐abdominal infections by providing a route for ascending infection . In the present study, the patients with intra‐abdominal infections had not significantly longer period of the prophylactic drain placement in comparison with patients without infections (13 ± seven days vs. 12 ± seven days, p = 0.278).…”

Section: Discussioncontrasting

confidence: 63%

“…In addition, the prophylactic drains in the patients (27.3%) who remained to place the prophylactic drains at the onset of intra-abdominal infections were used as the therapeutic drains of intra-abdominal infections. By contrast, prophylactic intra-abdominal drains after LT may present a risk for intraabdominal infections by providing a route for ascending infection (18)(19)(20). In the present study, the patients with intra-abdominal infections had not significantly longer period of the prophylactic drain placement in comparison with patients without infections (13 AE seven days vs. 12 AE seven days, p = 0.278).…”

Section: Discussioncontrasting

confidence: 60%

“…The prophylactic value of intra‐abdominal drains after LT remains controversial. Recent reports have suggested that prophylactic intra‐abdominal drains in cadaveric LTs using whole‐liver grafts are unnecessary because of the lack of benefit from drainage . LT using split‐liver grafts or reduced‐liver grafts presents a possibility of bleeding and bile leakage from the transection site of graft liver in comparison with whole‐liver grafts, and therefore may pose a high risk for post‐transplant intra‐abdominal infections.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, drains after hepatic resection are associated with a significantly longer hospitalization and higher post‐operative morbidity in patients with chronic liver diseases . Similar results demonstrating a lack of benefit from prophylactic intra‐abdominal drains have been reported in patients undergoing cadaveric LT using whole‐liver grafts . However, no studies have investigated on the necessity of prophylactic drains after living donor liver transplantation (LDLT) using split‐liver grafts and reduced‐liver grafts.…”

mentioning

confidence: 82%

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Examinations of ascites from prophylactic drains can predict intra‐abdominal infections after living donor liver transplantation

Sanada

Kawano

Urahashi

et al. 2015

Pediatric Transplantation

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Studies suggest that prophylactic intra-abdominal drains are unnecessary for cadaveric liver transplantation using whole liver grafts because there is no benefit from drainage. However, no studies have investigated on the necessity of prophylactic drains after LDLT using split-liver grafts or reduced-liver grafts, which may present a high risk of post-transplant intra-abdominal infections. This retrospective study investigated whether the ascitic data on POD 5 after LDLT can predict intra-abdominal infections and on the post-transplant management of prophylactic drains. Between March 2008 and March 2013, 90 LDLTs were performed. We assessed the number of ascitic cells, biochemical examinations, and cultivation tests at POD1 and POD5. The incidence rates of post-transplant intra-abdominal infections were 24.4%. The multivariate analysis showed that left lobe and S2 monosegment grafts were a significant risk factor for intra-abdominal infections (p = 0.006). The patients with intra-abdominal infections had significantly higher acsitic LDH levels and the positive rate of ascitic culture at POD5 in comparison with patients without infections (p < 0.001 and p = 0.014, respectively). LDLT using left lobe and S2 monosegment grafts yields a high risk for post-transplant intra-abdominal infections, and ascitic LDH and cultivation tests at POD5 via prophylactic drains can predict intra-abdominal infections.

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Section: Discussioncontrasting

confidence: 63%

Section: Discussioncontrasting

confidence: 60%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 82%

See 2 more Smart Citations

Examinations of ascites from prophylactic drains can predict intra‐abdominal infections after living donor liver transplantation

Sanada

Kawano

Urahashi

et al. 2015

Pediatric Transplantation

View full text Add to dashboard Cite

show abstract

“…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.…”

Section: Discussionmentioning

confidence: 99%