The role of osmotic self-inflatable tissue expanders in intestinal transplant candidates

Ceulemans, Laurens J.; Deferm, Nathalie P.; Miserez, Marc; Maione, Francesca; Monbaliu, Diethard; Pirenne, Jacques

doi:10.1016/j.trre.2016.07.002

Cited by 9 publications

(10 citation statements)

References 24 publications

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“…As in other abdominal closure techniques, tissue expanders have several potential disadvantages, such as the impossibility of predicting the date for performing the intestinal transplantation, additional exposure to anesthesia, difficulty in the healing process of malnourished patients, and complications related to gradual injection in the inflatable tissue expander [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Techniques for Closing the Abdominal Wall in Intestinal and Multivisceral Transplantation: A Systematic Review

et al. 2022

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Short bowel syndrome is the most common etiology of intestinal failure, resulting from either resections of different intestinal segments or a congenital condition. Due to the absence or considerable reduction of intestinal loops in the abdominal cavity, patients with short bowel syndrome present with atrophy and muscle retraction of the abdominal wall, which leads to loss of abdominal domain and elasticity. This complication is an aggravating factor of intestinal transplantation since it can prevent the primary closure of the abdominal wall. A vast array of surgical techniques to overcome the challenges of the complexity of the abdominal wall have been described in the literature. The aim of our study was to review the modalities of abdominal wall closure in intestinal/multivisceral transplantation. Our study consisted of a systematic review following the methodological instructions described in the PRISMA guidelines. Duplicate studies and studies that did not meet the criteria for the systematic review were excluded, especially those without relevance and an explicit relationship with the investigated theme. After this step, 63 articles were included in our study. The results obtained with these techniques have been encouraging, but a high incidence of wound complications in some reports has raised concerns. There is no consensus among transplantation centers regarding which technique would be ideal and with higher success rates and lower rates of complications.

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Section: Discussionmentioning

confidence: 99%

Techniques for Closing the Abdominal Wall in Intestinal and Multivisceral Transplantation: A Systematic Review

et al. 2022

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“…Firstly, size matching is important in ITx, as most of the recipients have a compromised abdominal domain due to short bowel syndrome and previous surgical procedures [9]. As such, weight is an important factor in donor selection and it has been advocated that the donor should be 25-50% smaller in size than the recipient [10][11][12][13][14]. Graft-reductionboth in isolated ITx and combined liver-ITx -have been shown possible in individual cases [15].…”

Section: Extended Donor Criteriamentioning

confidence: 99%

Potential options to expand the intestinal donor pool: a comprehensive review

Clarysse

Dubois

Vanuytsel

et al. 2022

Current Opinion in Organ Transplantation

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Purpose of reviewIntestinal donation is currently restricted to ‘perfect’ donors, as the intestine is extremely vulnerable to ischemia. With generally deteriorating donor quality and increasing indications for intestinal transplantation (ITx), the potential to safely increase the donor pool should be evaluated.Recent findingsIncreasing awareness on intestinal donation (often forgotten) and cautiously broadening the strict donor criteria (increasing age, resuscitation time and ICU stay) could expand the potential donor pool. Donors after circulatory death (DCD) have so far not been considered for ITx, due to the particularly detrimental effect of warm ischemia on the intestine. However, normothermic regional perfusion might be a well tolerated strategy to render the use of DCD intestinal grafts feasible. Furthermore, machine perfusion is under continuous development and might improve preservation of the intestine and potentially offer a platform to modulate the intestinal graft. Lastly, living donation currently represents only a minority of all ITxs performed worldwide. Various studies and registry analysis show that it can be performed safely for the donor and successfully in the recipient.SummarySeveral potential strategies are available to expand the current intestinal donor pool. Most of them require further investigation or technical developments before they can be implemented in the clinical routine.

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“…Multiple techniques have been developed to facilitate abdominal wall closure in transplant patients such as the reduction of donor-organ size and/or enlargement of the recipient's abdominal domain. The latter can be achieved with the use of tissue expanders, reconstruction with mesh materials, component separation techniques, autologous tissue transfer or full thickness abdominal wall transplantation [1,3,4,7,[13][14][15]. Since these surgical techniques are often complex, cause high morbidity, do not always create enough additional space and/or have variable results, transplant surgeons have sought for other options [10].…”

Section: Introductionmentioning

confidence: 99%

Allotransplantation of donor rectus fascia for abdominal wall closure in transplant patients: A systematic review

Janssen

Winkel

Pirenne

et al. 2021

Transplantation Reviews

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The role of osmotic self-inflatable tissue expanders in intestinal transplant candidates

Cited by 9 publications

References 24 publications

Techniques for Closing the Abdominal Wall in Intestinal and Multivisceral Transplantation: A Systematic Review

Techniques for Closing the Abdominal Wall in Intestinal and Multivisceral Transplantation: A Systematic Review

Potential options to expand the intestinal donor pool: a comprehensive review

Allotransplantation of donor rectus fascia for abdominal wall closure in transplant patients: A systematic review

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