Abdominal Wall Transplantation and Technique

Many patients undergoing intestinal or multivisceral transplantation
have a past history of complete midgut removal with the loss of the
domain of the abdominal compartment or have severely damaged
abdominal walls from repeated laparotomies or enterocutaneous
fistulae.
These patients may encounter severe abdominal wall closure problems
at the end of transplantation, resulting in increased morbidity and
mortality. It is, therefore, of paramount importance to properly cover
transplanted organs in order to reduce postoperative complications.
Abdominal wall transplantation was proposed for closure of patients
undergoing both small bowel and multivisceral transplantation.
We present our experience in abdominal wall transplantation in
which, by taking advantage of microsurgical experience, we were
able to re-vascularize the composite tissue allograft anastomosing the
deep inferior epigastric vessels of the graft to those of the recipient.
This technique allows to preserve donor’s vascular pedicle that can
be used as grafts for vascular procedures.