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Liver Transplant and Incisional Hernia: What Do We Know and What Can We Improve
Mireia Dominguez Bastante1, Maria Carmen Montes Osuna1, Alfonso Mansilla Rosello1
1General Surgery and Liver Transplantation Unit, University Hospital Virgen de las Nieves, Grenade, Spain.
Transplantation Proceedings
|November 4, 2024
Summary
Incisional hernias affect 25.3% of transplant recipients, often undiagnosed. Obesity, smoking, and specific immunosuppressants are key risk factors, highlighting the need for lifestyle changes and close patient monitoring.
Area of Science:
- Transplant Surgery
- Abdominal Wall Reconstruction
- Gastroenterology
Background:
- Incisional hernias significantly impact transplant recipient quality of life.
- Understanding incidence and risk factors is crucial for improving patient outcomes.
- A substantial proportion of incisional hernias remain undiagnosed.
Purpose of the Study:
- To analyze the incidence of incisional hernia in transplant recipients.
- To identify demographic and clinical risk factors associated with incisional hernia development.
- To inform strategies for prevention and improved management.
Main Methods:
- Retrospective analysis of transplant recipients from 2002-2021.
- Clinical and/or radiological diagnosis of incisional hernia.
- Multivariate analysis to determine predictors of incisional hernia.
Main Results:
- 101 out of 400 (25.3%) patients developed incisional hernias.
- Obesity (HR 2.36), smoking history (HR 1.71), and specific immunosuppressants (everolimus, sirolimus) were significant risk factors.
- Over 72% of hernias were not clinically diagnosed, indicating underdiagnosis.
Conclusions:
- Incisional hernia is frequent and underdiagnosed in transplant recipients.
- Modifiable risk factors include obesity and smoking; promoting healthy lifestyles is essential.
- Close patient monitoring and potentially improved surgical techniques are recommended for high-risk individuals.
