Staged abdominal closure after small bowel or multivisceral transplantation

J. Sheth, K. Sharif, C. Lloyd, G. Gupte, D. Kelly, J. De Ville De Goyet, A. J. Millar, D. F. Mirza, C. Chardot

Research output: Contribution to journalArticlepeer-review

Abstract

Following paediatric SBMT, size discrepancy between the recipient's abdomen and the graft may lead to ACS, graft dysfunction, and death. We report our experience with SAC in these patients. Between 04/1993 and 03/2009, 57 children underwent 62 SBMTs. When abdominal wall tension seemed excessive for safe PAC, SAC was performed, using a Silastic Â∞ sheet and a vacuum occlusive dressing. Transplantations with SAC (23 combined liver and small bowel [CLB]) were compared with those with PAC [14 ISB and 25 CLB]. Indications for transplantation, preoperative status (after stratification for ISB/CLB transplants), age at transplantation, donor-to-recipient weight ratio, reduction in bowel and/or liver, and incidence of wound complications were not different in both groups. Post-operative intubation, stay in intensive care unit, and hospital stay were prolonged after SAC. Two deaths were related to ACS after PAC, none after SAC. Since 2000, one-yr patient survival is 73% after ISB transplantation and 57% vs. 75% after CLB transplantation with PAC vs. SAC, respectively (NS). SAC safely reduces severe ACS after paediatric SBMT and can be combined with graft reduction for transplantation of small recipients.

Original languageEnglish
Pages (from-to)36-40
Number of pages5
JournalPediatric Transplantation
Volume16
Issue number1
DOIs
Publication statusPublished - Feb 2012

Keywords

  • intestinal transplantation
  • surgery

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Transplantation

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