Post-Abdominal Transplant Hernia: Can We Predict Size and Onset?

Transplant Proc. 2021 Mar;53(2):730-736. doi: 10.1016/j.transproceed.2020.10.028. Epub 2021 Feb 1.

Abstract

Introduction: Abdominal organ transplant is a life-saving treatment. However, the resultant weakening of abdominal muscles leaves patients susceptible to incisional hernia. Obesity, smoking, and diabetes mellitus are common risk factors for post-transplant hernia. However, the literature is void on the impact these risk factors have on timing and size of hernia.

Methods: We performed a retrospective review of all post-abdominal transplant patients who underwent hernia repair in 2010-2017 at a single institution. Primary outcomes were hernia size and time from transplant to hernia repair.

Results: We identified 31 patients. The majority of patients were female (15 male, 16 female), and the average patient was 56 ± 8.7 years old and obese (body mass index 30.6). Smoking (26.7%, n = 8) and diabetes mellitus (51.6%, n = 16) were prevalent. Transplant types represented were renal (n = 24), simultaneous pancreas-kidney (n = 5), liver (n = 1), and liver with subsequent kidney (n = 1). The median size of hernia was 100.0 cm2 (interquartile range [IQR]: 78.5-234.0), and median time to hernia repair was 53.0 months (IQR: 12.5-110.0). Risk factors (obesity, smoking, and diabetes) did not influence hernia size, nor alter time to hernia repair.

Conclusion: Obesity, smoking, and diabetes mellitus are not prognostic of size or onset of post-transplant incisional hernia. Large cohort studies are needed to determine predictive factors of size and onset of hernia.

MeSH terms

  • Body Mass Index
  • Cohort Studies
  • Diabetes Mellitus / epidemiology
  • Female
  • Hernia, Abdominal / epidemiology*
  • Hernia, Abdominal / etiology*
  • Humans
  • Incisional Hernia / epidemiology*
  • Incisional Hernia / etiology*
  • Male
  • Middle Aged
  • Obesity / epidemiology
  • Organ Transplantation / adverse effects*
  • Prevalence
  • Retrospective Studies
  • Risk Factors
  • Smoking / adverse effects