Abdominal Wall Transplantation

Abdominal wall vascularized composite allotransplantation (AW-VCA) is a relatively young field within transplantation with 21 reported cases to date in the last decade. All AW-VCAs have been performed on patients undergoing either simultaneous multivisceral transplantation (MVT) or intestinal transplantation (IT). The two approaches to AW-VCA described are macrovascular and microvascular approaches. While at the time that this review is written, only three institutions have performed this procedure; their outcomes have shown low allograft loss. In addition, acute rejection of the abdominal wall graft was uncommon and successfully treated with standard measures. A comparison of each institution’s operative technique, maintenance immunosuppression regimen, and rejection management provide insight regarding the feasibility of AW-VCAs. AW-VCA has proven to serve as a viable option for patients undergoing multivisceral or intestinal transplantation with a donor and recipient size mismatch. Further experience with AW-VCA will aid in better defining its indications and help standardize technique and management.

Duke Scholars

Author Detlev Erdmann Surgery, Plastic, Maxillofacial, and Oral Surgery

Author Kadiyala Venkata Ravindra Surgery, Abdominal Transplant Surgery