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Incidence and risk factors of incisional hernia formation following abdominal organ transplantation.

Publication ,  Journal Article
Smith, CT; Katz, MG; Foley, D; Welch, B; Leverson, GE; Funk, LM; Greenberg, JA
Published in: Surg Endosc
February 2015

BACKGROUND: Hernia formation is common following abdominal operations, and transplant patients are at increased risk due to postoperative immunosuppression. The purpose of this study was to estimate the incidence of incisional hernia formation following primary abdominal solid organ transplantation and identify clinical risk factors for hernia formation. METHODS: We performed a single-institution retrospective review of a prospectively collected database to evaluate all patients who underwent primary liver, kidney, or pancreas transplantation between 2000 and 2011. The primary outcome was hernia formation at the transplant incision. Univariate and multivariate Cox proportional hazards models were used to identify risk factors for incisional hernia formation. RESULTS: A total of 3,460 transplants were performed during the study period: 2,247 kidney only, 718 liver only, and 495 pancreas or simultaneous pancreas and kidney (pancreas group). The overall incisional hernia rate was 7.5 %. The Kaplan-Meier rates of hernia formation at 1, 5, and 10 years were 2.5, 4.9, and 7.0 % for kidney; 4.5, 13.6, and 19.0 % for liver; and 2.5, 12.7, and 21.8 % for the pancreas groups. On univariate analysis, surgical site infection (SSI), body mass index (BMI) >25, delayed graft function, and withholding a calcineurin inhibitor or mycophenolate mofetil (MMF) were associated with hernia formation in the kidney group. SSI and BMI >25 were associated with hernia formation in the liver group. In the pancreas group, SSI, cyclosporine, and withholding MMF were all associated with hernia formation. On multivariate analysis, SSI was strongly associated with hernia formation in all groups. Hazard ratio: kidney = 24.71 (13.00-46.97); liver = 12.0 (6.40-22.52); pancreas = 12.95 (2.78-60.29). CONCLUSION: Incisional hernias are common following abdominal organ transplant with nearly one in five patients developing an incisional hernia 5 years after liver or pancreas transplantation. Strategies focusing on prevention and early treatment of SSI may help to decrease the risk of incisional hernia formation following abdominal organ transplantation.

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Published In

Surg Endosc

DOI

EISSN

1432-2218

Publication Date

February 2015

Volume

29

Issue

2

Start / End Page

398 / 404

Location

Germany

Related Subject Headings

  • Wisconsin
  • Time Factors
  • Surgery
  • Risk Factors
  • Retrospective Studies
  • Proportional Hazards Models
  • Pancreas Transplantation
  • Organ Transplantation
  • Middle Aged
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
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Smith, C. T., Katz, M. G., Foley, D., Welch, B., Leverson, G. E., Funk, L. M., & Greenberg, J. A. (2015). Incidence and risk factors of incisional hernia formation following abdominal organ transplantation. Surg Endosc, 29(2), 398–404. https://doi.org/10.1007/s00464-014-3682-8
Smith, Carter T., Micah G. Katz, David Foley, Bridget Welch, Glen E. Leverson, Luke M. Funk, and Jacob A. Greenberg. “Incidence and risk factors of incisional hernia formation following abdominal organ transplantation.Surg Endosc 29, no. 2 (February 2015): 398–404. https://doi.org/10.1007/s00464-014-3682-8.
Smith CT, Katz MG, Foley D, Welch B, Leverson GE, Funk LM, et al. Incidence and risk factors of incisional hernia formation following abdominal organ transplantation. Surg Endosc. 2015 Feb;29(2):398–404.
Smith, Carter T., et al. “Incidence and risk factors of incisional hernia formation following abdominal organ transplantation.Surg Endosc, vol. 29, no. 2, Feb. 2015, pp. 398–404. Pubmed, doi:10.1007/s00464-014-3682-8.
Smith CT, Katz MG, Foley D, Welch B, Leverson GE, Funk LM, Greenberg JA. Incidence and risk factors of incisional hernia formation following abdominal organ transplantation. Surg Endosc. 2015 Feb;29(2):398–404.
Journal cover image

Published In

Surg Endosc

DOI

EISSN

1432-2218

Publication Date

February 2015

Volume

29

Issue

2

Start / End Page

398 / 404

Location

Germany

Related Subject Headings

  • Wisconsin
  • Time Factors
  • Surgery
  • Risk Factors
  • Retrospective Studies
  • Proportional Hazards Models
  • Pancreas Transplantation
  • Organ Transplantation
  • Middle Aged
  • Male