BAHA implantation seems to provide a high level of short- and long-term perceived benefit and satisfaction in subjects with PUSHL and high rate of long-term device usage. Implant site adverse local skin reactions and repairs of the external sound processor were quite common.

Restoring abdominal wall cover and contour in children undergoing bowel and multivisceral transplantation is often challenging due to discrepancy in size between donor and recipient, poor musculature related to birth defects and loss of abdominal wall integrity from multiple surgeries. A recent innovation is the use of vascularized posterior rectus sheath to enable closure of abdomen. We describe the application of this technique in two pediatric multivisceral transplant recipientsone to buttress a lax abdominal wall in a 22-month-old child with megacystis microcolon intestinal hypoperistalsis syndrome and another to accommodate transplanted viscera in a 10-month child with short bowel secondary to gastoschisis and loss of domain. This is the first successful report of this procedure with longterm survival. The procedure has potential application to facilitate difficult abdominal closure in both adults and pediatric liver and multivisceral transplantation.Key words: Abdominal wall transplantation, composite tissue allotransplantation, multivisceral transplantation, megacystis microcolon intestinal hypoperistalsis syndrome Abbreviations: HFA, hepatic falciform artery; MMIHS, megacystis-microcolon-intestinal hypoperistalsis syndrome; TPN, total parenteral nutrition.

Rehabilitation devices that improve discrimination and localization, and hearing preservation surgery, if indicated, should be considered for these patients.