Retrospective Cohort Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Transplant. Feb 24, 2017; 7(1): 43-48
Published online Feb 24, 2017. doi: 10.5500/wjt.v7.i1.43
Effectiveness and versatility of biological prosthesis in transplanted patients
Giovanni Vennarecci, Gianluca Mascianà, Edoardo De Werra, Giovanni Battista Levi Sandri, Daniele Ferraro, Mirco Burocchi, Giovanni Tortorelli, Nicola Guglielmo, Giuseppe Maria Ettorre
Giovanni Vennarecci, Gianluca Mascianà, Edoardo De Werra, Giovanni Battista Levi Sandri, Daniele Ferraro, Mirco Burocchi, Giovanni Tortorelli, Nicola Guglielmo, Giuseppe Maria Ettorre, Division of Surgical Oncology and Liver Transplantation, San Camillo Hospital, POIT San Camillo-INMI Lazzaro Spallanzani, 00149 Rome, Italy
Author contributions: All the authors have contributed to this paper.
Institutional review board statement: The study was reviewed and approved for publication by our Institutional Reviewer.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: All the authors declare they have no conflict of interest related to the manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Giovanni Vennarecci, MD, Division of Surgical Oncology and Liver Transplantation, San Camillo Hospital, POIT San Camillo-INMI Lazzaro Spallanzani, Cir.ne Gianicolense N° 187, 00149 Rome, Italy. gvennarecci@scamilloforlanini.rm.it
Telephone: +39-6-58704816 Fax: +39-6-58704719
Received: July 9, 2016
Peer-review started: July 12, 2016
First decision: September 9, 2016
Revised: October 9, 2016
Accepted: November 27, 2016
Article in press: November 29, 2016
Published online: February 24, 2017
Processing time: 231 Days and 2.1 Hours
Abstract
AIM

To emphasize the effectiveness and versatility of prosthesis, and good tolerance by patients with incisional hernia (IH).

METHODS

From December 2001 to February 2016, 270 liver transplantations were performed at San Camillo Hospital. IH occurred in 78 patients (28.8%). IH usually appeared early within the first year post-orthotopic liver transplantation. In the first era, fascial defect was repaired by primary closure for defects smaller than 2.5 cm or with synthetic mesh for greater defects. Recently, we started using biological mesh (Permacol™, Covidien). We present a series of five transplanted patients submitted to surgery for abdominal wall defect correction repaired with biological mesh (Permacol™, Covidien).

RESULTS

In our cases, the use of biological prosthesis (Permacol™, Covidien) have proven to be effective and versatile in repairing hernia defects of different kinds; patients did not suffer infections of the prosthesis and no recurrence was observed. Furthermore, the prosthesis remains intact even in the years after surgery.

CONCLUSION

The cases that we presented show that the use of biological mesh (Permacol™, Covidien) in transplanted patients may be safe and effective, being careful in the management of perioperative immunosuppression and renal and graft function, although the cost of the product itself has been the main limiting factor and there is need for prospective studies for further evaluations.

Keywords: Incisional hernia; Liver transplantation; Heart transplantation; Biological mesh; Surgery; Morbidity; Risk factors; Immunosuppression; Infection; Recurrence

Core tip: Incisional hernia (IH) following abdominal organ transplantation have a high rate, and even more in immunosuppressed patients. Several factors have been described to be associated with IH in transplant patients. Herein, we present our preliminary experience with porcine dermal collagen mesh.