Abdominal drainage after donor hepatectomy is a routine practice in most of the LDLT centres. But the routine abdominal drainage after donor hepatectomy is questioned as the drain increases the postoperative discomfort and also it hampers early ambulation of donor in postoperative period. At our centre we have done 142 liver transplant out of which 19 were DDLT whereas 123 were LDLT. We have done one dual lobe liver transplant. Retrospective study was performed in 124 donors. Drains were placed selectively with the surgeon deciding based on donor age, remnant volume, and personal preference. We have placed abdominal drain in 95 liver donors whereas abdominal drain was not placed in 29 donors. Average blood loss was significantly more in donors in which drain was placed (559ml Vs 403ml, p <0.05). Blood transfusion was required in 9.5% donors in which drain was placed whereas blood transfusion was required in only 3.4% donors in whom drain was not placed. Average day of discharge was 9.2 postoperative day among donors with drain whereas average day of discharge was 8.86 postoperative day among donors without drain. Ascites at the time of discharge was present in 16.8% donors in which drain was placed. Among donors in which drain was placed only two donors were having ascitic fluid leak from main wound one of which required PCD insertion whereas other was managed with bag application. Both of them improved. Among donors with drain, only one donor required re exploration because of bleeding from caudate lobe. Bleeding was diagnosed because of clinical suspicion and drop in haemoglobin level. Drain fluid didn't show the sign of bleeding. Donors without drain did not require re exploration. Postoperative bile leak was present in two donors in which drain was placed. One of them was having controlled fistula, hence donor was discharged with drain. Gradually drain output decreased and patient improved. Other donor was having bile leak after the drain was removed. This donor presented with clinical signs and required PCD insertion along with ERCP and stenting of biliary tree. Gradually drain output decreased and PCD was removed on same admission. Biliary stent was removed later on. Among patients without drain no one developed bile leak.

Conclusion: Abdominal drain placement in donor hepatectomy should be individualised. Routine abdominal drain placement is not very helpful for early detection of complications.

CITATION INFORMATION: Sharma S, Kumar S, Yadav K, Sable S, Chauhan A, Kapoor S, Varma V, Kumaran V. Are Drains Required After Donor Hepatectomy? Am J Transplant. 2017;17 (suppl 3).

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