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[First combined intestinal and abdominal wall transplantation in the Netherlands]
Jan W Haveman1, T M Tallechien Tempelman, H S Sijbrand Hofker
1Universitair Medisch Centrum Groningen, Rijksuniversiteit Groningen, Groningen.
Background:
When total parenteral nutrition (TPN) is not an option, intestinal transplantation is the sole treatment for patients with end-stage intestinal failure to increase the chance of long-term survival. However, in 20-33% of patients, abdominal wall-related complications occur after isolated intestinal transplantation.
Case Description:
The patient is a 24-year-old woman with ultra-short bowel syndrome, caused by a severely complicated history of Crohn's disease. After 5 years of TPN, the patient was referred for intestinal transplantation. In addition, an abdominal wall transplant was required due to an abdominal wall defect, extensive scarring of the abdominal wall and lack of free space within the abdomen. Therefore, a combined intestinal and abdominal wall transplantation was performed. Six months after transplantation the patient has a sufficient abdominal wall, a normal body mass index and no longer requires any feeding lines.
Conclusion:
This case report describes the first combined intestinal and abdominal wall transplantation in the Netherlands and in the Eurotransplant region in a patient with end-stage intestinal failure and loss of abdominal domain.
