Surgeons insert a drain (a tube emerging from the tummy to the exterior) with an intention of detecting, monitoring, or prevention of any blood or body fluids collection in the abdominal cavity after the operation. This is called abdominal drain. While this is standard practice in patients undergoing liver transplantation, some recent studies have suggested that routine use of an abdominal drainage may not be useful and even can be harmful. We searched the medical literature to find an answer to the question as to whether it is beneficial or harmful to use abdominal drains routinely in patients undergoing liver transplantation.

We were unable to identify randomised trials, which are studies that have the highest potential to give an accurate answer. We were unable to locate any such trial. We identified three non-randomised studies. All these studies were at high risk of giving inaccurate answers to the question. The results in these studies were conflicting. This highlights the need for well-designed randomised trials. Such trials should be very well designed so as to give the correct answer to the question. Such trials should also include sufficient patients to decrease the play of chance in finding the correct answer. The results from non-randomised studies show that the question of routine abdominal drainage in liver transplantation is an important clinical research question. Currently, there is no evidence to conclude whether routine abdominal drainage is useful or harmful in patients undergoing orthotopic liver transplantation.