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Piros, L; Máthé, Z; Földes, K; Langer, RM.
Incisional hernia after simultaneous pancreas kidney tranplantation: a single-center experience from Budapest.
Transplant Proc. 2011; 43(4):1303-1305 Doi: 10.1016/j.transproceed.2011.03.090
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Co-authors Med Uni Graz: Mathe Zoltan
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Abstract:: The occurrence of postoperative incisional hernia is more frequent after simultaneous pancreas-kidney transplantation compared with other transplanted parenchymal organs. These complications are especially dangerous in this patient population, because they can compromise the survival of the transplanted organ. We performed a retrospective review of a series of adult patients with incisional herniae after 23 consecutive simultaneous pancreas-kidney transplantations between January 2004 and June 2010 seeking to identify risk factors. All 23 patients had a body mass index (BMI) of <25. All surgeons used a similar technique, including a median incision with an intraperitoneal approach, and systemic venous and enteric drainage methods and a layered fascial closure. All combined pancreas-kidney transplant recipients received induction with thymoglobulin and maintenance therapy with sirolimus, reduced-dose cyclosporine and corticosteroids. An incisional hernia repair was performed in 8/23 patients (34.8%). Four reoperations were required in this group (50%), due to hemoperitoneum (n=2), intra-abdominal abscess (n=1), and venous thrombosis (n=1). The mean elapsed time between transplantation and hernioplasty was 24.5 months (range, 8-51). There was no significant difference in age, gender, BMI, dialysis modality, or operative time among affected compared with the other members of the group. Despite lack of obesity we observed a relatively higher rate of postoperative herniase, possibly owing to the side effects of a thymoglobulin-sirolimus combination. Copyright © 2011 Elsevier Inc. All rights reserved.
Find related publications in this database (using NLM MeSH Indexing): Adrenal Cortex Hormones - adverse effects; Adult -; Antilymphocyte Serum - adverse effects; Cyclosporine - adverse effects; Drug Therapy, Combination -; Female -; Hernia, Abdominal - etiology; Hernia, Abdominal - surgery; Humans -; Hungary -; Immunosuppressive Agents - adverse effects; Kidney Transplantation - adverse effects; Male -; Middle Aged -; Pancreas Transplantation - adverse effects; Reoperation -; Retrospective Studies -; Risk Assessment -; Risk Factors -; Sirolimus - adverse effects; Time Factors -; Treatment Outcome -