Incisional hernias after liver transplantation

Background. One of the late complications of liver transplantation is postoperative hernia of the abdominal wall, which occurs in 5–46% of recipients. An incisional hernia reduces the quality of life, and is accompanied by various complications, such as adhesive disease, intestinal passage disorder, entrapment. In addition to other factors affecting the formation of an abdominal scar, traumatic surgical approaches are reviewed as predictors of herniation. Material and methods. The results of treatment of 77 recipients after liver transplantation in the period 2018-2025 were evaluated. Related living donor transplantation was performed in 5 and cadaveric one in 72 patients. J-shaped approach was provided to 75 (97.4%) and “Mercedes” was used in 2 (2.59%) recipients. Results. An incisional hernia of the abdominal wall complicated the late postoperative period in 38.9% of cases. Hernial defect was diagnosed 0.5–7 years after transplantation, and in 50% of cases, the diagnosis of incisional hernia was made within 6 to 12 months after surgery. The locus minoris resistentiae of the J-shaped access is the white line and angle of the postoperative scar, where hernial defects appear more often. Conclusion. One of the factors of herniation after liver transplantation is the multidirectional, relatively traumatic J-approach, which implies the optimal methods for strengthening "weak" points or the use of other, mainly transverse approaches.