Use of OviTex 1S, reinforced tissue matrix, for the repair of post renal transplant incisional hernias: Four case reports.

Abstract

Background: Incisional hernia is one of the known complications of renal transplant surgery, with a reported incidence between 1.1% to 3.8%. Depending on the site and extent of incisional hernia, it may require surgery particularly if it contains the transplanted kidney either partially or completely. The current common clinical practice is to repair incisional hernias using polypropylene meshes, which have their own risks and benefits. Biological meshes, which are made from human or animal-derived connective tissue, are also in use and have a less inflammatory response. Recently, hybrid meshes have been developed. These are composed of both biological and synthetic products. One such example is OviTex 1S permanent, which is a sterile reinforced tissue matrix composed of ovine (sheep) derived extracellular matrix and monofilament polypropylene. In this case report, we are sharing our experience with the use of OviTex 1S in the repair of post-renal transplant incisional hernias.

Case summary: We report four cases of post-renal transplant incisional hernia with a median time of 27 months post-surgery. The median size of the defect was 15 cm long. There was no post-operative complication. One patient required renal transplant biopsy after mesh repair, which was easily performed compared with polypropylene meshes repaired hernias in the past.

Conclusion: The OviTex 1S mesh provides benefits in hernial repairs pKTx, but cost is an issue, and their long-term viability is unclear. Continued use and reporting will help build a more informed picture.