The Natural Course of Peri graft Fluid Collections After Kidney Transplantation: A Serial Imaging Cohort Study.
- 1Cleveland Clinic Florida
Abstract
BackgroundFluid collections are common after kidney transplantation, but their prevalence at scheduled imaging and their management are inconsistent from canter to canter. We describe the cross-sectional prevalence and management of peri-graft collections, including an exploratory deep-drain subgroup.
MethodsIn this retrospective single-canter cohort, 146 consecutive adult kidney transplant recipients (Cleveland Clinic Weston Hospital, July 2024 to June 2025) were imaged on postoperative day 0/1 and at approximately 1 and 3 months. Routine deep drainage was avoided (n=124); 22 clinically selected recipients with perioperative anticoagulation received a deep drain.
The primary outcome was cross-sectional prevalence of a peri-graft collection at each visit; secondary outcomes were management among patients with a collection. Drain-group comparisons were exploratory.
ResultsCollections were present in 29 of 146 recipients at postoperative day 0/1 (19.9%; 95% CI, 14.2-27.1), 71 of 146 at 1 month (48.6%; 95% CI, 40.7-56.7), and 34 of 146 at 3 months (23.3%; 95% CI, 17.2-30.8). Prevalence in the no-drain group was 21.0%, 50.0%, and 23.4%, respectively; corresponding prevalence in the deep-drain group was 13.6%, 40.9%, and 22.7%.
Between-group prevalence comparisons were not statistically significant at any time point.
BMI was higher in the deep-drain group than in the no-drain group (30.04 vs 27.1 kg/m{superscript 2}; P=0.01). Among patients with a 1-month collection, management did not differ significantly between groups (any invasive management, 11.1% vs 16.1%; P=1.00). Among patients with a 3-month collection, invasive management was more common in the deep-drain group than in the no-drain group (80.0% vs 13.8%; P=0.007). This comparison included only five deep-drain recipients and was confounded by clinical selection, perioperative anticoagulation, and BMI imbalance.
ConclusionsPeri-graft collection prevalence was highest at 1 month and lower at 3 months in this predominantly no-drain cohort. Most collections were managed conservatively, and invasive treatment was uncommon in the no-drain group. The deep-drain subgroup provides clinically relevant information about high-risk recipients selected for drainage but cannot support causal conclusions regarding drain benefit or harm. Patient-level linkage is required to distinguish persistence, resolution, and new collection formation.
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BibTeX
@misc{makki2026natural,
title = {{The Natural Course of Peri graft Fluid Collections After Kidney Transplantation: A Serial Imaging Cohort Study.}},
author = {M. M. Makki and H. Davtyan and K. Kumar and J. Kusakabe and E. Fernandes and P. Antonio and K. Refaai},
howpublished = {medRxiv},
year = {2026},
month = oct,
doi = {10.64898/2026.10.15.26364900},
url = {https://www.medrxiv.org/content/10.64898/2026.10.15.26364900v1},
note = {CC BY},
}
RIS
TY - UNPB
TI - The Natural Course of Peri graft Fluid Collections After Kidney Transplantation: A Serial Imaging Cohort Study.
AU - M. M. Makki
AU - H. Davtyan
AU - K. Kumar
AU - J. Kusakabe
AU - E. Fernandes
AU - P. Antonio
AU - K. Refaai
PY - 2026
DA - 2026/10/15
PB - medRxiv
DO - 10.64898/2026.10.15.26364900
UR - https://www.medrxiv.org/content/10.64898/2026.10.15.26364900v1
AB - BackgroundFluid collections are common after kidney transplantation, but their prevalence at scheduled imaging and their management are inconsistent from canter to canter. We describe the cross-sectional prevalence and management of peri-graft collections, including an exploratory deep-drain subgroup. MethodsIn this retrospective single-canter cohort, 146 consecutive adult kidney transplant recipients (Cleveland Clinic Weston Hospital, July 2024 to June 2025) were imaged on postoperative day 0/1 and at approximately 1 and 3 months. Routine deep drainage was avoided (n=124); 22 clinically selected recipients with perioperative anticoagulation received a deep drain. The primary outcome was cross-sectional prevalence of a peri-graft collection at each visit; secondary outcomes were management among patients with a collection. Drain-group comparisons were exploratory. ResultsCollections were present in 29 of 146 recipients at postoperative day 0/1 (19.9%; 95% CI, 14.2-27.1), 71 of 146 at 1 month (48.6%; 95% CI, 40.7-56.7), and 34 of 146 at 3 months (23.3%; 95% CI, 17.2-30.8). Prevalence in the no-drain group was 21.0%, 50.0%, and 23.4%, respectively; corresponding prevalence in the deep-drain group was 13.6%, 40.9%, and 22.7%. Between-group prevalence comparisons were not statistically significant at any time point. BMI was higher in the deep-drain group than in the no-drain group (30.04 vs 27.1 kg/m{superscript 2}; P=0.01). Among patients with a 1-month collection, management did not differ significantly between groups (any invasive management, 11.1% vs 16.1%; P=1.00). Among patients with a 3-month collection, invasive management was more common in the deep-drain group than in the no-drain group (80.0% vs 13.8%; P=0.007). This comparison included only five deep-drain recipients and was confounded by clinical selection, perioperative anticoagulation, and BMI imbalance. ConclusionsPeri-graft collection prevalence was highest at 1 month and lower at 3 months in this predominantly no-drain cohort. Most collections were managed conservatively, and invasive treatment was uncommon in the no-drain group. The deep-drain subgroup provides clinically relevant information about high-risk recipients selected for drainage but cannot support causal conclusions regarding drain benefit or harm. Patient-level linkage is required to distinguish persistence, resolution, and new collection formation.
ER -