Welcome to the AHS 2020 ePoster Session. Please scroll down to view all of the submitted posters or press Control-F to search. To view the poster and its abstract, click on the poster image. Many posters also have a brief audio introduction which can be played by going to the bottom of the poster screen.
P021: POST-TRANSPLANT OPEN VENTRAL HERNIA REPAIR (OVHR) WITH BIOLOGIC MESH
Meshka Anderson, MD; Sharbel Elhage, MD; B. Todd Heniford, MD; David Levi, MD; Vedra Augenstein, MD; Carolinas Medical Center
Introduction: Ventral hernias occur in up to a third of liver transplant recipients. Repairing these incisional hernias can be challenging due their subcostal location, increased risk of surgical site infection (SSI) and poor wound healing secondary to immunosuppression.
Objective: This study evaluated outcomes following OVHR with biologic mesh in post-transplant patients.
Methods: A prospective single-center database was queried for patients undergoing OVHR using biologic mesh following liver transplantation. Descriptive statistics are reported as percentages and means with standard deviations.
Results: This cohort consists of 15 post-transplant patients. Demographics included: age 58±12.8 years, BMI 30.23±4.86 kg/m2, 86.7% male and 80% Caucasian. Co-morbidities were: 53.3% diabetics and 33.3% former smokers. Average time from transplantation to hernia repair was 3.1 years. Preoperative benchmarks such as weight loss, HgbA1c < 7.2 and negative cotinine levels were met. Preoperative botulinum toxin was used in 13.3%. Perioperative immunosuppression consisted of Tacrolimus(46.7%), Cyclosporine(13.3%) and Tacrolimus+MMF(40.0%). Hernia defects were large (338±123.4 cm2) and 33.3% recurrent. Component separation was performed in 6.7% and panniculectomy in 53.3% of patients. All received preperitoneal biologic mesh (813.3±216.7 cm2). Hospital stay was 6.1±3.0 days. At 100% follow-up ranging from 1.2 – 34.9 months, with an average of 17.5 months, there was zero hernia recurrence. There were also no mesh infections or SSI. Superficial wound breakdown occurred in 20%, seroma and hematoma in 13.3% each.
Conclusion: Despite the complexity of the patients and hernias, OVHR in post-transplant patients can be performed with excellent results by intergrating preoperative optimization, intraoperative techniques and mesh choices.
Click the image below to expand: