Synthetic Mesh is not Associated with Worse Outcomes following Repair of Large Ventral Hernias in Transplant Patients: An Analysis of the ACHQC Database

G.E. Volk BA, P.J. Nguyen-Lee MD, C. Hennessy MS, V. Heh, T.N. Tanner MD, V.M. Kothari MD, I.N. Haskins MD

 

Introduction:

- Transplant patients are a unique ventral hernia repair patient population

- Current debate surrounding ideal mesh type for ventral hernia repair in transplant patients

- Limited data investigating the association of mesh type and ventral hernia repair outcomes in transplant patients

Objective:

The objective of our study was to determine if there is a difference in 30-day morbidity and long-term durability between transplant patients undergoing incisional hernia repair with biologic, slowly resorbable, and permanent synthetic mesh.

Methods:

- Abdominal Core Health Quality Collaborative Database 2012-2023

- Adult patients with a history of liver or kidney transplant undergoing elective open incisional hernia repair with mesh

- At least 30-day follow-up data

- 3 mesh categories:

• Permanent synthetic mesh

• Resorbable synthetic mesh

• Biologic mesh

Results and Conclusion:

- Mesh type did not differ significantly between groups (p = 0.06)

- Mesh was placed in a sublay fashion for the majority of both groups, onlay more common in transplant group (p = 0.007)

- Transplant patients were less likely to experience SSI/SSO or require an intervention for SSI/SSO

- No difference in clinical or patient-reported recurrence over the long-term

- Large ventral hernia repair with permaanent synthetic mesh in transplant patients appears to be safe