EP 178 Abdominal Wall Reinforcement with Absorbable Vicryl Mesh in Repeat Kidney Transplantation: A Case Series
Kwan Lau, Alex Adamec, Nick Fardon, Will Mckane, Muhammad Qureshi, Ravi Pararajasingam, Muhammad Saim AzamAbstract
Introduction
Patients undergoing multiple kidney transplants often have complex abdominal wall anatomy and a heightened risk of incisional hernia. Superficial reinforcement with absorbable polyglactin (Vicryl®) mesh is widely used, but the safety and feasibility of performing percutaneous allograft biopsy through a superficially Vicryl-reinforced abdominal wall remain poorly defined. We report an early experience in recipients with challenging abdominal walls; all three patients were undergoing a third kidney transplant.
Methods
We retrospectively reviewed three recipients who received superficial Vicryl mesh reinforcement at closure. Because of delayed graft function requring dialysis, five ultrasound-guided biopsies were performed by five different operators between postoperative days 7–28. Each procedure used an 18-gauge core needle with a minimum of two passes under real-time imaging. Outcomes included procedural complications, incisional hernia at 1-year follow-up, histologic adequacy, and clinical utility.
Results
All five biopsies were completed without complication; no bleeding, haematoma, wound problems, mesh disruption, or infection. No patient developed an incisional hernia at 1-year follow-up. Histology was adequate in all cases, with glomerular counts 5–23 across the five procedures. Biopsy findings were diagnostic in every case and aided management planning in all patients.
Discussion
In this preliminary series, percutaneous renal allograft biopsy through a superficial Vicryl-reinforced abdominal wall was feasible, safe, and diagnostically effective across multiple operators. Despite the small sample size and retrospective design, the consistent diagnostic adequacy and absence of complications support superficial Vicryl mesh reinforcement in patients with complex abdominal walls and indicate that percutaneous biopsy can be safely performed through the mesh.