Skip to main content


Log in

Incisional Hernia Repair in Renal Transplantation Patients

  • Original Article
  • Published:
Hernia Aims and scope Submit manuscript


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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others


  1., National Report of kidney transplantation, 1/1/2001 – 12/31/2001

  2. Humar A, Ramcharan T, Denny R, Gillingham KJ, Payne WD, Matas AJ (2001) Are wound complications after a kidney transplant more common with modern immunosuppression? Transplantation 72:1920–1923

    Article  PubMed  CAS  Google Scholar 

  3. Mazzucchi E, Nahas WC, Antonopoulos I, Ianhez LE, Arap S (2001) Incisional hernia and its repair with polypropylene mesh in renal transplant recipients. J Urol 160:816–819

    Google Scholar 

  4. Birolini C, Mazzucchi E, Utiyama EM, Nahas WC, Rodrigues AJ Jr, Arap S, Birolini D (2001) Prosthetic repair of incisional hernia in kidney transplant patients A technique with onlay polypropylene mesh. Hernia 5:31–35

    Article  PubMed  CAS  Google Scholar 

  5. Vries Reilingh TS, van Goor H, Rosman C, Bemelmans MHA, de Jong D, van Nieuwenhoven EJ, van Engeland MIA, Bleichrodt RP (2003) “Components separation technique” for the repair of large abdominal wall hernias. J Am Coll Surg 196:32–37

    Article  PubMed  Google Scholar 

  6. Feldt-Rasmussen K, Jensen O (1956) Large ventral herniae treated with free fascial grafts: A follow-up study. Acta Chir Scand 111:403–408

    PubMed  CAS  Google Scholar 

  7. McPeak CJ, Miller TF (1960) Abdominal wall replacement. Surgery 47:944

    Google Scholar 

  8. Disa JJ, Goldberg NH, Carlton JM, Robertson BC, Slezak S (1998) Restoring abdominal wall integrity in contaminated tissue-deficient wounds using autologous fascia grafts. Plast Reconstr Surg 101:979–986

    Article  PubMed  CAS  Google Scholar 

  9. Ramirez OM, Ruas E, Dellon AL (1990) “Component separation” method for closure of abdominal-wall defects: an anatomic and clinical study. Plast Reconstr Surg 86:519–526

    Article  PubMed  CAS  Google Scholar 

  10. Matloub HS, Jensen P, Grunert BK, Sanger JR, Yousif NJ (1992) Characteristics of prosthetic mesh and autogenous fascia in abdominal wall reconstruction after prolonged implantation. Ann Plast Surg 29:508–511

    Article  PubMed  CAS  Google Scholar 

  11. Disa JJ, Klein MH, Goldberg NH (1996) Advantages of autologous fascia versus synthetic patch abdominal wall reconstruction in experimental animal defects. Plast Reconstr Surg 97:801–806

    Article  PubMed  CAS  Google Scholar 

  12. Fabian TC, Croce MA, Pritchard FE, Minard G, Hickerson WL, Howell RL, Schurr MJ, Kudsk KA (1994) Planned ventral hernia: Staged managements for acute abdominal wall defects. Ann Surg 219:651–653

    Article  Google Scholar 

  13. Stone HH, Fabian TC, Turkleson ML, Jurkiewicz MJ (1981) Management of acute full-thickness losses of the abdominal wall. Ann Surg 193:612–618

    Article  PubMed  CAS  Google Scholar 

  14. Luijendijk RW, Hop WC, van den Tol MP, de Lange DC, Braaksma MM, Ijzermans JN, Boelhouwer RU, de Vries BC, Salu MK, Wereldsma JC, Bruijninckx CM, Jeekel J (2000) A comparison of suture repair with mesh repair for incisional hernia. N Engl J Med 343:392–398

    Article  PubMed  CAS  Google Scholar 

  15. Larson GM, Harrower HW (1978) Plastic mesh repair of incisional hernia. Am J Surg 135:559–563

    Article  PubMed  CAS  Google Scholar 

  16. Voyles CR, Richardson JD, Bland KI, Tobin GR, Flint LM, Polk HC Jr (1981) Emergency abdominal wall reconstruction with polypropylene mesh: short-term benefits versus long-term complications. Ann Surg 194: 219–223

    Article  PubMed  CAS  Google Scholar 

  17. Fansler RF, Taheri P, Cullinane C, Sabates B, Flint LM (1995) Polypropylene mesh closure of the complicated abdominal wound. Am J Surg 170:15–18

    Article  PubMed  CAS  Google Scholar 

  18. Dayton MT, Buchele BA, Shirazi SS, Hunt LB (1986) Use of an absorbable mesh to repair contaminated abdominal-wall defects. Arch Surg 121:954–960

    PubMed  CAS  Google Scholar 

  19. Bauer JJ, Salky BA, Gelernt IM, Kreel I (1987) Repair of large abdominal wall defects with expanded polytetrafluoroethylene. Ann Surg 206:765–769

    Article  PubMed  CAS  Google Scholar 

  20. Brown GL, Richardson JD, Malangoni MA, Tobin GR, Ackerman D, Polk HC Jr (1985) Comparison of prosthetic materials for abdominal wall reconstruction in the presence of contamination and infection. Ann Surg 201:705–711

    Article  PubMed  CAS  Google Scholar 

  21. Simmermacher RK, Schakenraad JM, Bleichrodt RP (1994) Reherniation after repair of the abdominal wall with expanded polytetrafluoroethylene. J Am Coll Surg 78:613–616

    Google Scholar 

  22. Franklin ME Jr, Gonzalez JJ Jr, Michaelson RP, Glass JL, Chock DA (2002) Preliminary experience with new bioactive prosthetic material for repair of hernias in infected fields. Hernia 6:171–174

    Article  PubMed  Google Scholar 

  23. Ueno T, Pickett LC, de la Fuente SG, Lawson DC, Pappas TN (2004) Clinical application of porcine small intestinal submucosa in the management of infected or potentially contaminated abdominal defects. J Gastrointest Surg 8:109–112

    Article  PubMed  Google Scholar 

  24. Badylak S, Kokini K, Tullius B, Simmons-Byrd A, Morff R (2002) Morphologic study of small intestinal submucosa as a body wall repair device. J Surg Res 103:190–202

    Article  PubMed  Google Scholar 

  25. Badylak S, Park K, Peppas N, McCabe G, Yoder M (2001) Marrow derived cells populate scaffolds composed of xenogeneic extracellular matrix. Exp Hematol 29:1310–1318

    Article  PubMed  CAS  Google Scholar 

  26. DeSagun EZ, Botts JL, Srivastava A, Hanumadass M, Walter RJ (2001) Long-term outcome of xenogenic dermal matrix implantation in immunocompetent rats. J Surg Res 96:96–106

    Article  PubMed  CAS  Google Scholar 

  27. Menon NG, Rodriguez ED, Byrnes CK, Girotto JA, Goldberg NH, Silverman RP (2003) Revascularization of Human Acellular Dermis in Full-Thickness Abdominal Wall Reconstruction in the Rabbit Model. Annals of Plastic Surgery. 50(5):523–527

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Ronald P. Silverman.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Li, E.N., Silverman, R.P. & Goldberg, N.H. Incisional Hernia Repair in Renal Transplantation Patients. Hernia 9, 231–237 (2005).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: