Transplantation of the abdominal wall.
BACKGROUND
Closure of the abdomen in patients undergoing intestinal transplantation can be extremely difficult, if not impossible. We describe our initial experience with abdominal wall allotransplantation to facilitate abdominal closure.


METHODS
We undertook nine cadaveric abdominal wall composite allograft transplants in eight patients. The graft's blood supply was based on the inferior epigastric vessels left in continuity with the donor femoral and iliac vessels. Skin biopsies were undertaken randomly and when rejection was suspected. Vessel patency was monitored by doppler ultrasound.


RESULTS
Six patients have survived, five of whom have intact, viable abdominal wall grafts. Two patients have had a clinically mild episode of acute rejection of the skin of the abdominal wall that resolved with corticosteroid therapy. No clinically apparent graft-versus-host disease has been noted.


CONCLUSIONS
Transplantation of an abdominal wall composite allograft can facilitate reconstruction and closure of the abdominal compartment in intestinal transplant recipients with complex abdominal wall defects.
Levi
David M
DM
Division of Transplantation, Department of Surgery, University of Miami/Jackson Memorial Medical Center, Miami, Florida 33101, USA. dlevi@med.miami.edu
Tzakis
Andreas G
AG
Kato
Tomoaki
T
Madariaga
Juan
J
Mittal
Naveen K
NK
Nery
Jose
J
Nishida
Seigo
S
Ruiz
Phillip
P
D034861:Abdominal Wall / Q000098:blood supply / Q000601:surgery*; D000273:Adipose Tissue / Q000637:transplantation; D000293:Adolescent; D000328:Adult; D000074323:Alemtuzumab; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D000912:Antibodies, Neoplasm / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D013505:Digestive System Surgical Procedures / Q000379:methods*; D005205:Fascia / Q000637:transplantation; D006084:Graft Rejection / Q000517:prevention & control; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007223:Infant; D007422:Intestines / Q000637:transplantation*; D016031:Liver Transplantation / Q000379:methods; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation / Q000379:methods; D017568:Rectus Abdominis / Q000637:transplantation*; D016038:Skin Transplantation; D013270:Stomach / Q000637:transplantation; D013524:Surgical Flaps / Q000098:blood supply; D016559:Tacrolimus / Q000627:therapeutic use; D014184:Transplantation, Homologous; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000912:Antibodies, Neoplasm; D007166:Immunosuppressive Agents; D000074323:Alemtuzumab; D016559:Tacrolimus