Utilidad del trasplante de la pared abdominal en el trasplante de órganos. Nuestra experiencia inicial / Abdominal wall transplantation in organ transplantation: Our experience

RESUMEN

El cierre de la pared abdominal después del trasplante de órganos abdominales, especialmente en los casos de trasplante intestinal y multivisceral, sigue siendo un reto en muchos pacientes debido al importante número de intervenciones previas al trasplante, así como al edema de asas que dichos injertos presentan. Ante la imposibilidad de cierre primario y debido a las complicaciones en el uso de mallas, surge la opción del trasplante de la pared abdominal. Existen diversas opciones para dicho procedimiento, desde el empleo únicamente de la fascia no vascularizada hasta el trasplante de espesor completo de la pared abdominal. Revisamos la literatura en cuanto al uso de los injertos referidos y presentamos 2 casos de trasplante de fascia no vascularizada realizados en nuestra unidad de trasplante

ABSTRACT

Abdominal wall transplantation has been consolidated as an alternative to primary abdominal wall closure in intestinal and multiple organ transplant recipients. Given that it is feasible to obtain the visceral graft and the abdominal wall graft from the same donor, abdominal wall transplantation could offer satisfactory outcomes and be easily coordinated. Non-vascularized fascia is one of the alternatives for abdominal wall closure in transplantation. We report two cases of non-vascularized fascia transplantation in intestinal and multivisceral transplants, respectively. Both donors were young (23 and 18 years old). Both recipients had endured multiple previous surgeries, and no surgical alternatives for primary wall repair could be offered. In both cases, a complete abdominal wall flap was retrieved from the donor, however, due to the characteristics of the recipient's abdominal wall defect, only non-vascularized fascia was used after removing skin and subcutaneous cellular tissue from the graft. Abdominal wall transplantation is an option to consider for abdominal wall closure in patients with multiple previous surgeries and no alternatives for primary wall repair