Incisional Hernia Repairs after Abdominal Organ Transplantation

Abstract

Incisional hernias occur after abdominal organ transplantation with rates of 1.6 per cent to 18 per cent in kidney transplants (KTs) and 1.7 to 32.4 per cent in liver transplants (LTs). We hypothesized a difference in KTand LToutcomes in patients with and without repair of incisional hernias. We conducted a retrospective cohort study of abdominal transplants from 2012 through 2016. The difference across compared groups for continuous variables was assessed using the independent sample t test, and for binary variables, using the chi-squared test. A total of 1518 transplants were performed, including 1138 KTs and 380 LTs. There were 83 KT incisional hernias (67 repaired) and 59 LT incisional hernias (48 repaired). There was no difference between groups with regard to smoking, diabetes, age, BMI, days on dialysis (KTs), pretransplant Model for End-Stage Liver Disease (MELD) (LTs), cold ischemic time, graft survival, or recurrence rate by repair method. In the LT population, there was a statistically significant difference in days on the waitlist ( P = 0.02), drain placement ( P = 0.04), and cytomegalovirus (CMV) mismatch ( P = 0.02). Patient survival was also statistically significant for KTs ( P = 0.04) and LTs ( P = 0.01). KT and LT patients who have their incisional hernias repaired have better overall survival, regardless of the repair technique.