TY - JOUR
T1 - The use of bi-planar tissue expanders to augment abdominal domain in a pediatric intestinal transplant recipient
AU - Weiner, Joshua
AU - Wu, June
AU - Martinez, Mercedes
AU - Lobritto, Steven
AU - Ovchinsky, Nadia
AU - Rohde, Christine
AU - Griesemer, Adam
AU - Kato, Tomoaki
PY - 2014/8
Y1 - 2014/8
N2 - Intestinal transplantation is a well-accepted treatment for SBS. However, patients with SBS often have decreased abdominal capacity, which makes size-matching of donor organs more difficult, thus decreasing organ availability. Reported approaches for addressing this problem include surgically reducing the graft size, leaving an open abdomen for a prolonged period, and cotransplanting rectus fascia as a non-vascularized allograft. Each approach has significant disadvantages. There has been one previous report of tissue expanders used intra-abdominally and two reports of subcutaneous use to increase intra-abdominal capacity prior to transplantation. We report the first use of bi-planar expander placement for this purpose. In our case, a two-yr-old male child with SBS due to malrotation was treated with tissue expanders 10 months prior to intestinal transplantation, thus allowing transplantation of a larger graft with the ability to close the abdomen safely. There were no complications, and the patient is now doing well and tolerating diet off PN. The use of tissue expanders prior to intestinal transplantation is a promising approach for such patients and avoids the morbidity associated with other approaches. This approach requires a multidisciplinary effort by gastroenterology, transplant surgery, and plastic surgery teams.
AB - Intestinal transplantation is a well-accepted treatment for SBS. However, patients with SBS often have decreased abdominal capacity, which makes size-matching of donor organs more difficult, thus decreasing organ availability. Reported approaches for addressing this problem include surgically reducing the graft size, leaving an open abdomen for a prolonged period, and cotransplanting rectus fascia as a non-vascularized allograft. Each approach has significant disadvantages. There has been one previous report of tissue expanders used intra-abdominally and two reports of subcutaneous use to increase intra-abdominal capacity prior to transplantation. We report the first use of bi-planar expander placement for this purpose. In our case, a two-yr-old male child with SBS due to malrotation was treated with tissue expanders 10 months prior to intestinal transplantation, thus allowing transplantation of a larger graft with the ability to close the abdomen safely. There were no complications, and the patient is now doing well and tolerating diet off PN. The use of tissue expanders prior to intestinal transplantation is a promising approach for such patients and avoids the morbidity associated with other approaches. This approach requires a multidisciplinary effort by gastroenterology, transplant surgery, and plastic surgery teams.
KW - abdominal compartment syndrome
KW - intestinal transplantation
KW - pediatric transplantation
KW - tissue expander
UR - http://www.scopus.com/inward/record.url?scp=84903992805&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84903992805&partnerID=8YFLogxK
U2 - 10.1111/petr.12282
DO - 10.1111/petr.12282
M3 - Article
C2 - 25041331
AN - SCOPUS:84903992805
SN - 1397-3142
VL - 18
SP - E174-E179
JO - Pediatric Transplantation
JF - Pediatric Transplantation
IS - 5
ER -