Introduction: Peri-graft collections and wound complications are common after kidney transplantation. Currently, it is unclear whether intraoperative drain placement can reduce the risk of peri-graft collections and wound complications. The aim of this study was to determine whether drain placement had any effect on the risk of these complications following kidney transplantation. Methods: Adult patients who underwent kidney transplant surgery in our centre between January 2006 and December 2014 were included. Information regarding absence/presence of a drain and outcomes of peri-graft collection and wound complication during the first postoperative month were collected. The effect of drain versus no-drain on outcomes was analyzed using logistic regression after adjustment for baseline patient characteristics including age, cause of end-stage renal disease, diabetes status, pre-transplant dialysis status, dialysis modality, body mass index, albumin level and donor type for each patient. Results: There was no significant difference between 'drain' (n=374) and 'no drain' (n=283) groups for all baseline patient characteristics except for cause of end-stage renal disease. Peri-graft collections and wound complications were detected in 28% (n=185) and 13% (n=88) of the entire cohort respectively. The risk of peri-graft collection was significantly reduced by the presence of a drain after multivariable adjustment (odds ratio 0.63, 95% CI [0.44-0.90], p=0.011). The risk of wound complications was similar for those with a drain versus without a drain (odds ratio 0.68, 95% CI 0.42-1.09, p=0.112). Among the 223 patients with any complication (peri-graft collection and/or wound complication) the rate of subsequent intervention (percutaneous drainage tube insertion, vacuum assisted closure therapy or surgery) to treat that particular complication was the same for those with or without a drain (odds ratio 1.01, 95% CI 0.54-1.88. p=0.982). Conclusion: Placing a drain does not seem to have a statistically significant effect on wound complications in kidney transplant patients. Although it reduces the risk of peri-graft collections, it does not appear to reduce the rate of clinically significant peri-graft collections.

CITATION INFORMATION: Cimen S, Cimen S, Tennankore K, Imamoglu A, Alwayn I. Does Drain Placement Reduce the Risk of Peri-Graft Collections and Wound Complications After Kidney Transplant? Am J Transplant. 2016;16 (suppl 3).

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