Utility of a modified components separation for abdominal wall reconstruction in the liver and kidney transplant population

Cara K. Black, Elizabeth G. Zolper, Elliot T. Walters, Jessica Wang, Jesus Martinez, Andrew Tran, Iram Naz, Vikas Kotha, Paul J. Kim, Sarah R. Sher, Karen K. Evans

Research output: Contribution to journalArticlepeer-review

Abstract

Background Incisional hernia is a common complication following visceral organ transplantation. Transplant patients are at increased risk of primary and recurrent hernias due to chronic immune suppression and large incisions. We conducted a retrospective review of patients with a history of liver or kidney transplantation who underwent hernia repair to analyze outcomes and hernia recurrence. Methods This is a single center, retrospective review of 19 patients who received kidney and/or liver transplantation prior to presenting with an incisional hernia from 2011 to 2017. All hernias were repaired with open component separation technique (CST) with biologic mesh underlay. Results The mean age of patients was 61.0±8.3 years old, with a mean body mass index of 28.4±4.8 kg/m2, 15 males (78.9%), and four females (21.1%). There were seven kidney, 11 liver, and one combined liver and kidney transplant patients. The most common comorbidities were hypertension (16 patients, 84.2%), diabetes (9 patients, 47.4%), and tobacco use (8 patients, 42.1%). Complications occurred in six patients (31.6%) including hematoma (1/19), abscess (1/19), seroma (2/19), and hernia recurrence (3/19) at mean follow-up of 28.7±22.8 months. With the exception of two patients with incomplete follow-up, all patients healed at a median time of 27 days. Conclusions This small, retrospective series of complex open CST in transplant patients shows acceptable rates of long-term hernia recurrence and healing. By using a multidisciplinary approach for abdominal wall reconstruction, we believe that modified open CST with biologic mesh is a safe and effective technique in the transplant population with complex abdominal hernias.

Original languageEnglish (US)
Pages (from-to)462-469
Number of pages8
JournalArchives of Plastic Surgery
Volume46
Issue number5
DOIs
StatePublished - 2019
Externally publishedYes

Keywords

  • Abdominal wall
  • Immunosuppression
  • Incisional hernia
  • Surgical mesh
  • Transplants

ASJC Scopus subject areas

  • Surgery

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