Incisional Hernia After Liver Transplantation: Long Term Outcomes and Evaluation of Quality of Life After Hernia Repair

Background Incisional hernia development after liver transplantation is observed in approximately 40% of patients. Patient-related factors such as smoking, obesity, comorbidities, immunosuppressive therapy and patient-independent factors such as mesh and suture material used are effective in the development of hernia. In our study, we aimed to investigate the risk factors, long-term outcomes and quality of life after hernia repair in patients operated for incisional hernia after liver transplantation. Method Among 220 patients who underwent liver transplantation in our center between October 2018 and October 2023, 15 patients who underwent surgery for post-transplant incisional hernia were included in the study and retrospectively reviewed. Mercedes incision was present in all patients, and the same mesh and suture were used in hernia repair. EuroQol-5D scale was used as a quality of life test. Results Of the patients included in the study, 10 (66.7%) were male and 5 (33.3%) were female. The mean age at hernia repair was 60.26 years. The mean BMI was 56.73. 10 patients (66.7%) were smokers. 9 patients (32.1%) were on tacrolimus, 7 patients (43.8%) on everolimus, 14 patients (93.3%) on mycophelonate mofetil, 7 patients (43.8%) on prednol. When the time between transplantation and hernia operation was evaluated, a statistically significant difference was found between everolimus users and non-users (p = 0.001). The mean hernia development time was 29.0 months in the everolimus group and 42.0 months in the non everolimus group. Conclusion In our study, similar to the literature, we found that mTOR inhibitor drugs shortened the duration of hernia development and recurrence could be prevented with drug regimen modification. In addition, it was observed that patients defined their health status better and their quality of life improved after hernia repair in transplant patients.