Objective. The purpose of this study is to look at a wide variety of variables to characterize the risk factors for incisional hernia after liver transplantation.
Summary Background Data. Incisional hernia is a frequent complication after liver transplantation with a reported incidence of 4.6-32.4%. Many of the previous studies on the risk factors for incisional hernia after liver transplantation have found varying results.
Methods. Our single-study retrospective study, we analyzed 519 consecutive liver transplantations from June 2003 to December 2011. Detection of incisional hernia was by computed tomography scan report, by record of objective examinations and of incisional hernia repair. Univariate and multivariate analyses were performed on a variety of pre-, intra-, and post-operative factors.
Results. In our population, 74/519 patients (15%) developed incisional hernia after liver transplantation. Multivariate analysis established the following to be independent risk factors for the development of incisional hernia after liver transplantation: higher age (Odds Ratio, OR=1.04), cardiovascular comorbidity (OR=2.62), pre-transplant end stage liver disease with episodes of severe porto-systemic encephalopathy and presences of esophageal varices (OR=3.47), abdominal surgery following transplantation (OR=4.8), steroid use in immunosuppressive therapy (OR=2.0), and length of hospital stay following transplantation (OR=0.98).
|Variables||Confidence Intervals (95%)||Odds Ratio||P-value|
|1. Age at Liver Transplantation||1.011, 10.77||1.044||0.008|
|2. Portal Vein Complications after Liver Transplantation||0.931, 11.411||3.260||0.065|
|Chronic cardiovascular disease||1.104, 6.246||2.626||0.029|
|Severe Porto-Systemic Encephalopathy and Esophageal Varices||1.472, 8.187||3.472||0.004|
|4. Post- Liver Transplantation Abdominal Surgery||2.715, 8.500||4.804||<0.001|
|5. Steroid Use in Immunosuppressive Therapy||1.053, 3.797||2.000||0.034|
|6. Length of Hospital Stay||0.963, 0.996||0.979||0.014|
Conclusion. Usage of steroids, long-term hospitalization following liver transplantation, and abdominal surgery following transplantation are factors that may be modified to decrease the risk of incisional hernia development in patients who have undergone liver transplantation.
To cite this abstract in AMA style:Zhou S, Pagano D, Cintorino D, Petri SLi, Ricotta C, Fratti A, Paci M, Tuzzolino F, Spada M. Incisional Hernia after Liver Transplantation: Incidence and Risk Factors [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/incisional-hernia-after-liver-transplantation-incidence-and-risk-factors/. Accessed August 3, 2021.
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