A comparative outcome analysis of incisional hernia repair in patients who underwent liver transplantation vs. those that underwent hepatopancreaticobiliary surgery using the EHS guidelines as a means of comparison.

AIM: We retrospectively analyzed incisional hernia (IH) outcomes of liver transplant (LT) vs. hepatopancreaticobiliary (HPB) cases sharing the same incision.

METHODS: IH repair patients with a history of LT were compared with those with HPB surgical history sharing the same type of incision and using the European Hernia Society classification and nomenclature for reporting outcome.

RESULTS: Eighty-two patients (27 HPB and 55 LT) between February 2001 and February 2014 were analyzed. Baseline demographics showed that the LT group had more diabetes and steroid use, but were less physical active. Outcomes showed no differences in wound complication, SSI rate, and recurrence rate (recurrence rate of 11.1% and 16.4% for HPB and LT, respectively). Multivariate analysis showed longer operating time to be a risk factor for both wound complication and SSI. M-tor inhibitor use was an additional risk factor for SSI. Interval to recurrence was significant longer in the LT group (35 vs. 61 months). Cox analysis showed steroid use, immunosuppression and not using a synthetic mesh as risk factors for recurrence.

CONCLUSION: Incisional hernia repair with synthetic mesh after liver transplantation does not result in more wound complications, SSI, and recurrences, when compared to patients without immunosuppression.