title: Use of the abdominal rectus fascia as a nonvascularized allograft for abdominal wall closure after liver, intestinal, and multivisceral transplantation.
abstract: BACKGROUND
  Abdominal wall closure management has become an important challenge during recipient candidate selection, at the time of donor to recipient matching and during the planning of the surgical procedure for intestinal or multiorgan transplantation. Different strategies have been proposed to overcome the lack of abdominal domain: to reduce the graft size or to increase the abdominal domain. Based on the recent concept of using an acellular dermis matrix (Alloderm) and the availability of abdominal wall tissues from the same organ donor, we conceived the idea of using the fascia of the rectus muscle (FoRM) as a nonvascularized tissue allograft.
  
  
  METHODS
  This is a retrospective report of a series of 16 recipients of FoRM as part of a liver, intestinal, or multiorgan transplant procedure performed between October 2004 and May 2008 at three different transplant centers.
  
  
  RESULTS
  Of the 16 recipients of FoRM, all but one case was performed during their transplantation (four multivisceral, two modified multivisceral, three isolated intestine, and two livers). Five patients underwent a retransplant surgery (two livers, two multivisceral, and one isolated intestine). Abdominal wall infection was present in 7 of 16 cases. Nine patients are still alive. No deaths were related to wound infection. Long-term survival showed complete wound healing and only one ventral hernia.
  
  
  CONCLUSIONS
  The use of a nonvascularized FoRM is a novel and simple surgical option to resolve complex abdominal wall defects in liver/intestinal/multivisceral transplant recipients when it can be covered with the recipient skin.
authors: Unidad de Nutrición, Rehabilitación y Transplante Intestinal, Fundación Favaloro, Buenos Aires, Argentina. ggondolesi@ffavaloro.org
authors: Gabriel
authors: G
authors: Gondolesi
authors: Gennaro
authors: G
authors: Selvaggi
authors: Andreas
authors: A
authors: Tzakis
authors: Gonzalo
authors: G
authors: Rodríguez-Laiz
authors: Ariel
authors: A
authors: González-Campaña
authors: Martín
authors: M
authors: Fauda
authors: Michael
authors: M
authors: Angelis
authors: David
authors: D
authors: Levi
authors: Seigo
authors: S
authors: Nishida
authors: Kishore
authors: K
authors: Iyer
authors: Bernhard
authors: B
authors: Sauter
authors: Luis
authors: L
authors: Podesta
authors: Tomoaki
authors: T
authors: Kato
mesh_terms: D000009:Abdominal Muscles / Q000033:anatomy & histology / Q000637:transplantation*; D034861:Abdominal Wall / Q000601:surgery*; D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D007422:Intestines / Q000637:transplantation*; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D012189:Retrospective Studies; D014184:Transplantation, Homologous / Q000379:methods*; D014781:Viscera / Q000637:transplantation*