Incisional hernia following liver tx: incidence & predisposing factors

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Clin Transplant. 2007 May-Jun;21(3):423-6.

Incisional hernia following liver

transplantation: incidence and predisposing factors.

Kahn J, Muller H, Iberer F, Kniepeiss D, Duller D, Rehak P, Tscheliessnigg K.

Department of Transplant Surgery, Medical

University Graz,

University Clinic of Surgery, Graz, Austria.

Background: Patients after orthotopic

liver transplantation (OLT) have a high risk of developing incisional

hernia (IH). In the literature incidences between 5%

and 17% are reported. Patients and methods: In 90

patients, who underwent OLT between October 1998 and December 2005, a

retrospective analysis on the occurrence of IH was performed.

Surgical access for OLT was a transversal upper laparotomy. Age, gender, primary disease, ICU stay, immunosuppressive

regimen and two different closure techniques (running suture or single sutures

in layers) were evaluated. Results: In 73 patients

(76.7%, group 2) healing of the incision was without problems, in 17 patients

(23.3%, group 1), IH occurred. Total survival was

similar between the groups (86.3% vs. 94.1%, n.s.). No significant differences between the groups concerning

age, gender, body mass index, platelet count and duration of ICU stay were

found. Also, the technique of abdominal closure had no

impact on the development of IH. No IH was found in

patients with hepatocellular carcinoma (n = 15),

whereas end-stage liver cirrhosis (n = 75) was associated with development of

IH (p = 0.064). Multivariate analysis revealed

end-stage liver cirrhosis, Sirolimus, and MMF to be

independent significant risk factors for IH after OLT. Conclusion:

IH following OLT has to be regarded a frequent complication. While

technique of abdominal closure seems to have no impact, primary diagnosis and

kind of immunosuppressive regimen exerted a significant influence on the

formation of IH.

PMID: 17488396 [PubMed - in process]

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