Incisional Hernia Repair in Renal Transplantation Patients

Introduction: Abdominal wall dehiscence in renal transplantation patients risks the survival of the transplanted organ. No clear treatment algorithm exists in the literature for this group of patients. Methods: Between 1992 and 2001, the Division of Plastic Surgery at the University of Maryland treated 41 of 2499 renal transplant patients. Based on a retrospective review of these patients, an algorithm was developed to guide the management of midline and lower quadrant abdominal wall defects. Results: Most lower quadrant defects were repaired with tensor fascia lata grafts. Most midline defects were repaired with the component separation technique. Use of a single- or multi-staged repair was based on the extent of infection. Hernia recurrence was 22% over 21 months. 80% of the transplant kidneys were functioning following repair. Conclusion: An algorithm for the repair of abdominal wall defects after kidney transplantation is presented taking into account the location and the extent of infection.