Incisional Hernia After Liver Transplant

Area of Science:

• Hepatology
• Transplant Surgery
• Abdominal Surgery

Background:

• Incisional hernias significantly impact quality of life post-liver transplant, with reported incidences ranging from 4% to 20%.
• Understanding risk factors and management strategies is crucial for improving patient outcomes.

Purpose of the Study:

• To evaluate incisional hernias in adult liver transplant recipients.
• To assess the outcomes of intentionally created incisional hernias in infant liver transplant procedures.

Main Methods:

• A retrospective review of 536 liver transplant procedures (1988-2016) in 515 patients.
• Analysis of demographic features, surgical outcomes, and predisposing factors for incisional hernia.
• Evaluation of repair methods and recurrence rates for both adult and pediatric cases.

Main Results:

• Incisional hernias occurred in 6.4% of liver transplant patients (22 adults, 7 pediatric).
• Risk factors in adults included wound infection (31%), obesity (30%), and repeated surgery (18%).
• Repairs with mesh grafts showed no complications or recurrence during follow-up; pediatric cases also had favorable outcomes.

Conclusions:

• Postoperative wound infection, obesity, and repeated surgery are significant risk factors for incisional hernia after adult liver transplant.
• Intentionally created incisional hernias with staged abdominal closure are suggested as a safe and effective approach for infant liver transplants.
• Further research may explore optimal management strategies for incisional hernias in this patient population.