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Hernia Correction After Liver Transplantation Using Nonvascularized Fascia
Iago Justo1, Oscar Caso1, Alberto Marcacuzco1
1Unit of Hepato-Pancreato-Biliary Surgery and Abdominal Organ Transplantation, Instituto de Investigación (imas12), Department of Surgery, Faculty of Medicine, Complutense University, Madrid, Spain.
Nonvascularized fascial transplantation offers a promising solution for incisional hernias following liver transplantation, a common complication with high recurrence rates. This technique shows potential for successful treatment in transplant patients.
Area of Science:
- Abdominal Surgery
- Transplant Surgery
- Hernia Repair
Background:
- Liver transplantation is associated with high rates of incisional hernias (5-46%).
- Risk factors include incision type, patient sex, diabetes, ascites, age, and steroid use.
- Traditional incisional hernia treatments in liver transplant patients have high complication rates.
Purpose of the Study:
- To evaluate the efficacy of nonvascularized fascial grafts for treating incisional hernias in liver transplant recipients.
- To assess the safety and outcomes of this novel approach in a high-risk patient population.
Main Methods:
- A cohort of 8 patients who underwent liver transplantation and subsequently developed incisional hernias were treated with nonvascularized fascial grafts.
- Patients were followed up using imaging techniques between January 2019 and January 2023.
Main Results:
- Seven patients were liver transplant recipients; one had a combined liver-kidney transplant.
- The median time from transplant to hernia repair was 41 months.
- Two patients experienced complications (bulging requiring reoperation, surgical site seroma); no mortality was reported.
Conclusions:
- Nonvascularized fascial transplantation demonstrates promising results for incisional hernia treatment in liver transplant patients.
- This technique may offer a successful and safer alternative for managing this challenging complication.
