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Repair often includes use of synthetic mesh, but certain risk factors for complication after mesh hernia repair have been described. Among these, immunosuppression due to co-existing conditions is hypothesized to increase postoperative complications, but data is scarce and contradicting. Therefore, the aim was to assess outcome after mesh hernia repair in immunosuppressed patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material &amp; methods<\/jats:title>\n                    <jats:p>Patients with and without immunosuppression undergoing elective incisional hernia repair at our clinic between 2010 and 2019 were analyzed in this retrospective study. Pre-existing conditions, details of immunosuppression, postoperative course and outpatient follow-up for hernia recurrence were collected and impact of clinical variables on outcome was analyzed. Propensity score matching was performed for comparison of cohorts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Immunosuppression was associated with increased postoperative complications in the overall cohort of 732 patients undergoing incisional ventral hernia repair in univariate but not multivariate analysis (p\u2009=\u20090.036 and p\u2009=\u20090.25, respectively). Overall postoperative complications did not differ between patients with immunosuppression compared to the matched collective. However, use of &gt;\u20092 immune suppressive agents and immunosuppression history\u2009&gt;\u200948 months showed significant impact on postoperative complications in univariate and multivariate analysis (p\u2009=\u20090.003\/p\u2009=\u20090.023 and p\u2009=\u20090.018\/p\u2009=\u20090.03, respectively). Age (&lt;\u200960 years), duration of surgery (&gt;\u2009120\u00a0min), midline hernia according to EHS classification and number of immunosuppressive agents administered were identified as important risk factors for recurrence in immunocompromised patients (p\u2009=\u20090.045, p\u2009=\u20090.023, p\u2009=\u20090.012 and 0.049, respectively).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this study, overall safety with desirable outcome of mesh implantation in immunosuppressed patients was documented. Furthermore, data suggested significant impact of number of immunosuppressive agents as a predicator of postoperative complications in this collective, possibly enabling risk stratification within this subgroup.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10029-025-03273-3","type":"journal-article","created":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T05:47:46Z","timestamp":1740376066000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Safety and outcome of elective synthetic mesh repair for incisional ventral hernias in immunosuppressed patients \u2013 a retrospective propensity-score-matched analysis"],"prefix":"10.1007","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8294-3560","authenticated-orcid":false,"given":"Ramin Raul Ossami","family":"Saidy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yvonne May","family":"Callister","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Dittrich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dennis","family":"Eurich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Denecke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johann","family":"Pratschke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonas","family":"Raakow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,2,24]]},"reference":[{"key":"3273_CR1","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1002\/bjs.9364","volume":"101","author":"C Fink","year":"2014","unstructured":"Fink C, Baumann P, Wente MN, Knebel P, Bruckner T, Ulrich A, Werner J, B\u00fcchler MW, Diener MK (2014) Incisional hernia rate 3 years after midline laparotomy. 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