title: Transplantation of the abdominal wall.
abstract: 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.
authors.affiliation: Division of Transplantation, Department of Surgery, University of Miami/Jackson Memorial Medical Center, Miami, Florida 33101, USA. dlevi@med.miami.edu
authors.forename: David M
authors.initials: DM
authors.lastname: Levi
authors.forename: Andreas G
authors.initials: AG
authors.lastname: Tzakis
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Kato
authors.forename: Juan
authors.initials: J
authors.lastname: Madariaga
authors.forename: Naveen K
authors.initials: NK
authors.lastname: Mittal
authors.forename: Jose
authors.initials: J
authors.lastname: Nery
authors.forename: Seigo
authors.initials: S
authors.lastname: Nishida
authors.forename: Phillip
authors.initials: P
authors.lastname: Ruiz
mesh_terms: 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
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000912:Antibodies, Neoplasm; D007166:Immunosuppressive Agents; D000074323:Alemtuzumab; D016559:Tacrolimus