P056 RETROSPECTIVE ANALYSIS OF LONG-TERM INCIDENCE, RISK FACTORS AND SURGICAL REPAIR OF VENTRAL INCISIONAL HERNIAS AFTER LIVER TRANSPLANTATION

Aim “Assess risk factors and incidence of ventral incisional hernia (VIH) following liver transplantation (LT).” Material and Methods “Retrospective analysis of clinical or radiological signs of VIH during a systematic ten year follow up after liver transplantation. Descriptive statistics and a binary logistic regression analysis were performed to identify possible risk factors.” Results “Between 01/2007-12/2017, 708 LT were performed in 660 patients at our institution. Following LT, 122 patients (18.5%) had a VIH as identified per clinical examination. Further to this, 85 patients (12.9%) had CT findings consistent with VIH adding to a total of 207 (31.4%) patients with VIH after LT. Male gender (p < 0.001), BMI (p < 0.001), age at LT (p < 0.001), alcohol induced cirrhosis (p = 0.032) and reoperation after 180 days following LT (p = 0.007) were identified as risk factors in a multivariate analysis. An incisional hernia repair was performed in 76 patients (11.5%) at 22.9 months (median, 5.7-101.5). Laparoscopic IPOM repair was performed in 46 (60.5%) patients and 30 patients had an open hernia repair including 26 (34.2%) with mesh augmentation and 4 (5.3%) with primary closure. Five patients (6.6%) needed a reoperation for postoperative complications related to hernia repair. Recurrent VIH occurred in 12 (15.8%) patients. In 131 patients, no hernia repair was performed because of only mild clinical symptoms, patient preference and/or poor general condition.” Conclusions “The incidence and burden of incisional hernia following LT is significant. Many cases of VIH are clinically mild but radiomorphologically manifest.”