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Incidence and Risk Factors for Incisional Hernia Development in Liver Transplant Recipients: A Systematic Review and
Vitor Neves1, Denise Padilha Abs de Almeida2, Júlia Apocalypse Rodrigues Cardoso Dos Santos3
1Hospital Universitário dos Servidores do Estado - HUSE-UNIRIO, Rio de Janeiro, Brazil.
Summary
Incisional hernias after liver transplants occur in 14% of patients. Male sex, older age, high BMI, and wound complications increase the risk of developing these hernias.
Area of Science:
- Hepatology and Transplant Surgery
- Surgical Complications
- Gastroenterology
Background:
- Incisional hernias (IHs) are a common and significant postoperative complication following liver transplantation (LT).
- Understanding the incidence and risk factors for IH is crucial for improving patient outcomes after LT.
Purpose of the Study:
- To systematically review and meta-analyze the pooled incidence of incisional hernias (IHs) after liver transplantation (LT).
- To identify and evaluate risk factors associated with the development of IH following LT.
Main Methods:
- A comprehensive systematic search of PubMed, Cochrane, Embase, and Web of Science databases was performed.
- Included studies reported IH incidence in adult patients undergoing LT.
- Data on patient demographics, comorbidities, and wound complications were extracted and analyzed using proportional meta-analysis.
Main Results:
- The pooled incidence of IH following LT was estimated at 14.5% across 28 studies involving 12,354 patients.
- Significant risk factors for IH development included male sex (RR: 1.16), wound complications (RR: 2.6), older age (RR: 2.00), and high body mass index (BMI) (RR: 0.86).
- Model for End-Stage Liver Disease (MELD) scores, ascites, and diabetes were not significantly associated with increased IH risk.
Conclusions:
- Liver transplantation is associated with a pooled incisional hernia incidence of 14%.
- Key risk factors for IH post-LT include male sex, older age, elevated BMI, and the occurrence of wound complications.