Surgical Drains Do Not Decrease Complication Rates But Are Associated with a Reduced Need for Imaging After Kidney Transplant Surgery
Sertac Cimen, Sanem Guler, Karthik Tennankore, Abdurrahim Imamoglu, Ian Alwayn
Department of Surgery, Dalhousie University, Halifax, NS, Canada
Ann Transplant 2016; 21:216-221
Available online: 2016-04-14
Perigraft collections and wound complications are common after kidney transplantation. The aim of this study was to determine whether intraoperative drain placement had an effect on the risk of these complications.
MATERIAL AND METHODS: Adult patients who underwent kidney transplantation in our center between January 2006 and December 2014 were included. Information regarding absence/presence of drain, imaging studies, and complications (perigraft collection and wound complications) were collected. The effect of drains on outcomes was analyzed using logistic regression after adjustment for baseline characteristics.
RESULTS: Baseline characteristics were similar for ‘drain’ (n=374) and ‘no drain’ (n=283) groups. Forty-eight percent (n=317) of the patients were imaged. Fewer patients with a drain (40%) were imaged to diagnose a perigraft collection compared to those without a drain (60%, p<0.001). Perigraft collections and wound complications were detected in 28% (n=186) and 14% (n=90) of the cohort, respectively. Presence of a drain was associated with a significantly lower rate of perigraft collections (odds ratio 0.62, 95% CI [0.43–0.88], p=0.011). However, risk of wound complications was similar for those with a drain versus without a drain (odds ratio 0.67, 95% CI 0.42–1.07, p=0.096). Among the 225 patients with a complication, the subsequent intervention rate was the same for those with or without a drain (adjusted odds ratio 1.23, 95% CI 0.61–2.46. p=0.562).
CONCLUSIONS: Drain placement is not associated with a significant reduction in wound complications following kidney transplant and does not reduce the risk of clinically significant perigraft collections. Since it is associated with reduced need for imaging to diagnose collections, it has the potential to reduce transplant costs.
Keywords: Diagnostic Imaging, Drainage, Kidney Transplantation