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Updated: Apr 30, 2026
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Procurement for a Vascularized and Reinnervated Abdominal Wall Allotransplantation
Published on: July 18, 2025
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Remote revascularization of abdominal wall transplants using the forearm
1Department of Plastic and Reconstructive Surgery, Oxford University Hospitals and University of Oxford, Oxford, United Kingdom.
Summary
This study introduces a novel technique for abdominal wall transplantation during intestinal transplant surgery. Remotely revascularizing the abdominal wall minimizes ischemia time, enabling primary closure in all patients.
Area of Science:
- Abdominal surgery
- Transplantation immunology
- Vascular surgery
Background:
- Primary abdominal wall closure after small bowel transplantation is challenging due to abdominal domain contraction.
- Abdominal wall transplantation, though reported, is not widely adopted due to complexity and ischemia-reperfusion injury concerns.
Purpose of the Study:
- To present a novel technique for combined small bowel and abdominal wall transplantation.
- To minimize ischemic time for abdominal wall allografts by remote revascularization.
Main Methods:
- Six cases of combined small bowel and abdominal wall transplantation were performed.
- Abdominal wall allografts were remotely revascularized on forearm vessels synchronously with the intestinal transplant procedure.
- Allografts were then transferred to the abdomen for closure.
Main Results:
- Primary abdominal wall closure was achieved in all six patients.
- Mean cold ischemia time was significantly reduced.
- Three patients experienced abdominal wall rejection, successfully treated.
Conclusions:
- Immediate revascularization of the abdominal wall allograft reduces cold ischemia without compromising intestinal transplant.
- This technique offers a viable solution for abdominal closure in small bowel transplantation.
- Reduced storage time may decrease graft immunogenicity related to ischemia-reperfusion injury.
