Risk factors of severe incisional hernia after renal transplantation: a retrospective multicentric case-control study on 225 patients.

PURPOSE: The aim of this study was to analyze the incidence of severe incisional hernias and find their specific risk factors in renal transplant patients.

METHODS: This retrospective multicentric case-control study focused on 225 kidney transplant patients among 4348 patients transplanted during this period within two French university hospitals (Saint-Louis/Lariboisière in Paris and Tours, Loire Valley) from 2000 to 2014 and from 1995 to 2014, respectively. Forty-five patients developed a severe incisional hernia after renal transplantation. The primary outcome measure was the development of a severe incisional hernia after surgery. Statistical analysis included an univariate analysis and a multivariate analysis using a logistic regression according to the Cox model.

RESULTS: Forty-five patients (1.03%) had a severe incisional hernia surgery after renal transplantation. The median follow-up was 55.5 months. In univariate analysis, smoking, the occurrence of a lymphocele and parietal closure in a single musculo-fascial layer was significantly associated with the occurrence of incisional hernia after renal transplantation. Former or active smoking (OR 2.32, p = 0.0370), lymphocele (OR 4.3903, p = 0.0018) and parietal musculo-fascial closure in one single layer (OR 3.37, p = 0.0088) significantly increased the risk of incisional hernia after kidney transplant in multivariate analysis.

CONCLUSIONS: We report in this study one of the largest series of patients who had incisional hernia after renal transplantation. Former or active smoking, lymphocele and parietal closure in one single musculo-fascial layer were independent risk factors for incisional hernia following kidney transplant.