P116 Incidence and risk factors for incisional hernias following liver transplantation: a retrospective single-centre study

<h3>Background and Aim</h3> Patients who develop incisional hernias after liver transplantation (LT) have a reduced quality of life.¹ Retrospective studies outside the UK demonstrate a wide range of incidences and risk factors for incisional hernias after LT.² The aim of this study was to describe a UK experience of post LT incisional hernias and the risk factors for their development. <h3>Methods</h3> A retrospective analysis of LTs from the Birmingham Liver unit (January 2013 to May 2023) with a minimum follow-up of 6 months was performed. Risk factors present at listing were recorded including: age, sex, BMI, refractory ascites, hypertension, UKELD and diabetes. Data were analysed using the Mann-Whitney U test for continuous variables and the Chi-squared test for binary variables. A multivariable analysis was also conducted. <h3>Results</h3> 1026 patients (63% male) were identified, with 129 (12.6%) developing incisional hernias. The median (interquartile range) age at LT was 55.80 (45.35–63.31) years and the median follow up was 1326 (574.75–1930.30) days. The median dry BMI was 27.47 (23.70–31.00) kg/m2. Univariable analysis identified BMI &gt;25 kg/m2 (p=0.0047), refractory ascites (p&lt;0.0001), and re-transplantation (p=0.038) as significant risk factors, although none were significant in multivariable analysis. Any combination of one, two or three of these risk factors progressively increased the risk of incisional hernia formation, with relative risks of 2.79, 4.13, and 11.15, respectively. <h3>Conclusion</h3> In the first study from the UK, we show an incidence of 12.6% for incisional hernias post LT. Having a BMI &gt;25kg/m2 at listing, refractory ascites pre-LT, along with having a re-graft are risk factors for incisional hernia development on univariable analysis. The relative risk increases progressively per number of risk factors present. This echoes findings from non-UK data. <h3>References</h3> De Goede B, Eker HH, Klitsie PJ, van Kempen BJ, Polak WG, Hop WC, Metselaar HJ, Tilanus HW, Lange JF, Kazemier G. Incisional hernia after liver transplantation: risk factors and health-related quality of life.<i> Clin Transplant</i>. 2014 Jul;<b>28</b>(7):829–36. Garmpis N, Spartalis E, Schizas D, Patsouras D, Damaskos C, Spartalis M, Garmpi A, Nikiteas NI, Dimitroulis D. Incisional hernias post liver transplantation: current evidence of epidemiology, risk factors and laparoscopic versus open repair. A review of the literature. <i>In Vivo</i>. 2019 Jul-Aug;<b>33</b>(4):1059–1066.