Use of the abdominal rectus fascia as a nonvascularized allograft for abdominal wall closure after liver, intestinal, and multivisceral transplantation

Gabriel Gondolesi, Gennaro Selvaggi, Andreas Tzakis, Gonzalo Rodríguez-Laiz, Ariel González-Campaña, Martín Fauda, Michael Angelis, David Levi, Seigo Nishida, Kishore Iyer, Bernhard Sauter, Luis Podesta, Tomoaki Kato

Research output: Contribution to journalArticle

51 Citations (Scopus)

Abstract

INTRODUCTION.: 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. MATERIALS AND 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. DISCUSSION.: 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.

Original languageEnglish
Pages (from-to)1884-1888
Number of pages5
JournalTransplantation
Volume87
Issue number12
DOIs
StatePublished - Jun 27 2009

Fingerprint

Fascia
Abdominal Wall
Allografts
Transplantation
Muscles
Liver
Transplants
Intestines
Acellular Dermis
Tissue Donors
Ventral Hernia
Wound Infection
Wound Healing
Skin
Survival
Infection

Keywords

  • Abdominal wall
  • Allograft
  • Intestine
  • Transplantation

ASJC Scopus subject areas

  • Transplantation

Cite this

Use of the abdominal rectus fascia as a nonvascularized allograft for abdominal wall closure after liver, intestinal, and multivisceral transplantation. / Gondolesi, Gabriel; Selvaggi, Gennaro; Tzakis, Andreas; Rodríguez-Laiz, Gonzalo; González-Campaña, Ariel; Fauda, Martín; Angelis, Michael; Levi, David; Nishida, Seigo; Iyer, Kishore; Sauter, Bernhard; Podesta, Luis; Kato, Tomoaki.

In: Transplantation, Vol. 87, No. 12, 27.06.2009, p. 1884-1888.

Research output: Contribution to journalArticle

Gondolesi, G, Selvaggi, G, Tzakis, A, Rodríguez-Laiz, G, González-Campaña, A, Fauda, M, Angelis, M, Levi, D, Nishida, S, Iyer, K, Sauter, B, Podesta, L & Kato, T 2009, 'Use of the abdominal rectus fascia as a nonvascularized allograft for abdominal wall closure after liver, intestinal, and multivisceral transplantation', Transplantation, vol. 87, no. 12, pp. 1884-1888. https://doi.org/10.1097/TP.0b013e3181a7697a
Gondolesi, Gabriel ; Selvaggi, Gennaro ; Tzakis, Andreas ; Rodríguez-Laiz, Gonzalo ; González-Campaña, Ariel ; Fauda, Martín ; Angelis, Michael ; Levi, David ; Nishida, Seigo ; Iyer, Kishore ; Sauter, Bernhard ; Podesta, Luis ; Kato, Tomoaki. / Use of the abdominal rectus fascia as a nonvascularized allograft for abdominal wall closure after liver, intestinal, and multivisceral transplantation. In: Transplantation. 2009 ; Vol. 87, No. 12. pp. 1884-1888.
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AU - Selvaggi, Gennaro

AU - Tzakis, Andreas

AU - Rodríguez-Laiz, Gonzalo

AU - González-Campaña, Ariel

AU - Fauda, Martín

AU - Angelis, Michael

AU - Levi, David

AU - Nishida, Seigo

AU - Iyer, Kishore

AU - Sauter, Bernhard

AU - Podesta, Luis

AU - Kato, Tomoaki

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N2 - INTRODUCTION.: 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. MATERIALS AND 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. DISCUSSION.: 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.

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