Use of biological prostheses in transplant patients with incisional hernias Preliminary experience

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Published: Jul 1, 2013
Keywords:
Biological prostheses, Incisionel hernia, Transplantation

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Michele L. Santangelo
Department of Surgery, Anesthesia and Emergency Science, School of Medicine, University of Naples “Federico II”, O.U. of General Surgery and Organ Transplantations, Naples, Italy
Nicola Carlomagno
Department of Surgery, Anesthesia and Emergency Science, School of Medicine, University of Naples “Federico II”, O.U. of General and Abdominal Surgery, Naples, Italy
Sergio Spiezia
Department of Surgery, Anesthesia and Emergency Science, School of Medicine, University of Naples “Federico II”, O.U. of General Surgery and Organ Transplantations, Naples, Italy
Danilo Palmieri
Department of Surgery, Anesthesia and Emergency Science, School of Medicine, University of Naples “Federico II”, O.U. of General Surgery and Organ Transplantations, Naples, Italy
Marco Clemente
Department of Surgery, Anesthesia and Emergency Science, School of Medicine, University of Naples “Federico II”, O.U. of General Surgery and Organ Transplantations, Naples, Italy
Maria Pina Piantadosi
Department of Surgery, Anesthesia and Emergency Science, School of Medicine, University of Naples “Federico II”, O.U. of General Surgery and Organ Transplantations, Naples, Italy
Francescopaolo Palumbo
Department of Surgery, Anesthesia and Emergency Science, School of Medicine, University of Naples “Federico II”, O.U. of General Surgery and Organ Transplantations, Naples, Italy
Giovanni Docimo
Department of Surgery, School of Medicine, Second University of Naples “SUN”, 7th O.U. of Surgery
Nicola Normanno
INT, Fondazione Pascale, Cell Biology and Biotherapy, Naples, Italy
Andrea Renda
Department of Surgery, Anesthesia and Emergency Science, School of Medicine, University of Naples “Federico II”, O.U. of General Surgery and Organ Transplantations, Naples, Italy

Abstract

AIM: The use of synthetic mesh in transplant patients is still under debate. In this paper the authors report their preliminary experience on biological prosthesis for surgical treatment of incisional hernias in transplant patients.


MATERIAL OF STUDY: Between 2009-2010, 10 patients with incisional hernia underwent surgery using a biological prosthesis (porcine dermis collagen). All patients were transplanted: 9 kidney transplants and 1 liver transplant.


RESULTS: In all patients postoperative course was uneventful and were not observed complications related to surgery, kind of prosthesis or transplanted organs. At follow up, laparoplasty was associated with good functional outcome.


DISCUSSION: Transplant patients are at risk for use of synthetic prostheses, as immunosuppressed. In our preliminary experience biological prostheses compared to synthetic ones showed a greater ability to integrate into tissues, to resist bacterial colonization and to reduce cytotoxic or allergenic reactions, providing similar functional results. Moreover it must be added that biological prostheses did not require reductions/suspensions of immunosuppressive therapy and resulted to be versatile. All these features are particularly sought in incisional hernias surgery of transplanted patients.


CONCLUSIONS: Surgery of incisional hernias in transplanted patients requires a prosthesis with characteristics as close as possible to the ideal one and, in this sense, biological prostheses would seem to outweigh synthetic ones. In our experience, biological prostheses have shown to be safe, effective and reliable; therefore they seem to be able to open new horizons in the treatment of wall defects in this group of patients.

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How to Cite
Santangelo, Michele L., et al. “Use of Biological Prostheses in Transplant Patients With Incisional Hernias Preliminary Experience”. Annali Italiani Di Chirurgia, vol. 84, no. 4, July 2013, pp. 471-5, https://annaliitalianidichirurgia.it/index.php/aic/article/view/2921.
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Vol. 84 No. 4 (2013)
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Article