title: Use of biological prosthesis in a patient with kidney and pancreas transplant and a giant incisional hernia: case report.
abstract: OBJECTIVE
  The use of synthetic mesh in transplant patients is controversial. Recent studies have shown that biological prostheses have a greater ability to integrate into tissues, resist bacterial colonization, and reduce cytotoxic or allergic reactions, and provide similar functional results, compared with synthetic prostheses. Biological prostheses do not require any reduction or discontinuation of immunosuppressive therapy. We present the case of a kidney and pancreas transplant recipient who had a giant incisional hernia that was treated successfully with a biological prosthesis.
  
  
  METHODS
  A 40-year-old male kidney and pancreas transplant recipient was admitted to our hospital with a giant incisional hernia, 2 years after transplant. The defect on the abdominal wall was 40 . 30 cm. We used 2 biological prostheses (40 . 20 cm and 30 . 20 cm) to close the abdominal wall. The patient was discharged on postoperative day 5 without complications. An abdominal magnetic resonance imaging scan showed complete integrity of the biological prostheses at 1 year after surgery.
  
  
  CONCLUSIONS
  Transplant recipients have higher risks with use of synthetic prostheses because of being immunosuppressed, compared with other patients. Recent studies show that biological prostheses provided similar functional results without complications compared with synthetic prostheses. These prostheses are versatile and do not require any changes in immunosuppressive therapy. Therefore, they seem to be a better option than synthetic prostheses. In our opinion, biological prostheses are more safe, effective, and reliable than synthetic prostheses, especially for large incisional hernias in transplant recipients. We believe that further larger studies can support our opinion.
authors.affiliation: From the Department of General Surgery, Baskent University School of Medicine, Istanbul, Turkey.
authors.forename: Umit
authors.initials: U
authors.lastname: Ozcelik
authors.forename: Halime
authors.initials: H
authors.lastname: Cevik
authors.forename: Huseyin Yuce
authors.initials: HY
authors.lastname: Bircan
authors.forename: Alp
authors.initials: A
authors.lastname: Demirag
mesh_terms: D000328:Adult; D001705:Bioprosthesis; D003094:Collagen / Q000627:therapeutic use*; D046449:Hernia, Abdominal / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D059685:Herniorrhaphy / Q000295:instrumentation*; D006801:Humans; D000069290:Incisional Hernia / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D016035:Pancreas Transplantation / Q000009:adverse effects*; D011474:Prosthesis Design; D019919:Prosthesis Implantation / Q000295:instrumentation*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: C422414:Permacol; D003094:Collagen