Incidencia y factores de riesgo de hernia incisional post trasplante renal en el Hospital Universitario Puerta del Mar de Cádiz

Incisional hernias in kidney transplant patients (HIPT) are complex hernias due to the patient's comorbidities and immunosuppression and the characteristics of the hernia itself. Kidney transplantation is predominantly performed by placing the graft in a retroperitoneal position in the right iliac fossa, accessed through a Gibson incision. The incidence of HIPT is 3.2%. Associated risk factors are body mass index, age, sex, smoking, immunosuppression, concurrent abdominal hernia, deceased donor graft, procedure duration, and local complications. The repair of HIPT must be contemplated in two stages, optimizing the patient preoperatively at a metabolic and immunological level, and carrying out the necessary studies to catalog the hernia in order to propose the best treatment. Despite the heterogeneity in the repair, surgeons are inclined to use the separation of components with release of the transverse and the suitability of the preperitoneal plane. At the HUPM, 4 cases of HIPT have been reviewed, all of them transplants from a deceased donor in the right iliac fossa through a Gibson incision. All over 50 years of age, immunocompromised, two women, two diabetics, two bronchopaths and smokers, with concurrent abdominal hernia. The majority present local complications of the surgical wound. The 4 patients underwent HIPT repair, using mesh, in the same center by the General Surgery Service between 2018 and 2021 to repair the hernia.