Incisional Hernia Prevention in Liver & Kidney Transplantation

About the project

Incisional hernia is a significant post-transplant complication that can affect patients’ quality of life, physical function and long-term recovery. It may also lead to further interventions, hospital readmissions and increased healthcare costs.

Despite its clinical impact, approaches to risk assessment, abdominal wall closure and incisional hernia prevention are not yet standardised across European transplant centres.

The Incisional Hernia Prevention in Liver & Kidney Transplantation project brings together available evidence and insights from the European transplant community to improve understanding of this important clinical challenge. By connecting research, clinical experience and education, the initiative aims to support more consistent, evidence-based approaches to prevention following liver and kidney transplantation.

Project aims

The project aims to:

• Better understand the burden and clinical impact of incisional hernia following liver and kidney transplantation.
• Assess current awareness, clinical practices and attitudes among European transplant surgeons.
• Explore approaches to risk assessment, patient selection and the use of prophylactic mesh.
• Identify variations, knowledge gaps and barriers affecting clinical practice.
• Promote education and awareness around incisional hernia prevention and its potential impact on post-transplant quality of life.
• Support the development of future recommendations and educational resources for the transplant community.

Evidence review

A structured review of the available literature will examine:

• The incidence and risk factors associated with incisional hernia following transplantation.
• Patient-, surgical- and transplant-related risk factors.
• Abdominal wall closure techniques and preventive strategies.
• Current evidence relating to prophylactic mesh use in patients considered at higher risk.
• The impact of incisional hernia on quality of life, healthcare utilisation and costs.
• Gaps in existing evidence, clinical practice and guidance.

The findings will provide the scientific foundation for the subsequent stages of the project.

European survey

A European survey will gather insights from liver and kidney transplant surgeons on current clinical practice. It will explore:

• Methods used to assess risk and select patients for preventive interventions.
• Perioperative management and abdominal wall closure techniques.
• Current use of prophylactic mesh and perceived barriers to its adoption.
• Variations in practice between transplant centres.
• Training, education and evidence-generation needs.Aggregated findings will help build a clearer picture of current practice across Europe and identify areas where further guidance or education may be valuable.

Survey deadline 31/08/2026

Education and knowledge exchange

Building on the evidence review and survey findings, the project will explore educational and consensus-building activities that may include:

• Practical workshops on abdominal wall closure and incisional hernia prevention.
• Webinars and digital learning resources.
• Multidisciplinary dialogue involving transplant surgeons, abdominal wall specialists and other healthcare professionals.
• Patient engagement activities to better understand the impact on quality of life.

The potential development of expert recommendations or a best-practice framework.

Steering Committee