Long-term Outcome After Nonvascularized Rectus Fascia Transplantation in Solid Organ Transplantation: A Global Multicenter IIRTA Survey

Van De Winkel, N; Muylle, E; Canovai, E; Amin, I; Butler, A; Vianna, R; Selvaggi, G; Farinelli, P; Gondolesi, G; Loinaz, C; Justo, I; Vilca-Melendez, H; Skogsberg Dahlgren, U; Herlenius, G; Shamsaeefar, A; Nikoupour, H; Dubois, A; Miserez, M; D'Hoore, A; Venick, R; Pirenne, J; Ceulemans, LJ

Journal article

Long-term Outcome After Nonvascularized Rectus Fascia Transplantation in Solid Organ Transplantation: A Global Multicenter IIRTA Survey

Abstract:: BackgroundAbdominal wall (AW) closure after solid organ transplantation (SOT) is challenging in case of loss of abdominal domain and/or large-for-size grafts. Primary closure is crucial to avoid open abdomen-associated morbidity and mortality. Several techniques have been developed to address this challenge, including nonvascularized rectus fascia transplantation (NVRF Tx). Long-term outcome is missing.MethodsWe designed a multicenter survey to analyze the worldwide experience after NVRF Tx. International Intestinal Rehabilitation And Transplantation Association members were invited to participate to a questionnaire. The survey included all NVRF Tx performed after SOT. Questions were classified into pre-, intra-, and postoperative data.ResultsOf the 29 responding centers, 8 performed NVRF Tx, comprising 98 patients in total. Thirty-two patients underwent multivisceral Tx (33.3%), 27 isolated intestinal Tx (28.1%), 21 combined liver-intestinal Tx (21.9%), 8 liver Tx (8.3%), 8 other SOT (8.3%), and 2 (2.0%) not reported. Thirty NVRF (30.9%) were from third-party donors. Thirty patients (31.3%) had surgical site infections. Seventy-one (74.0%) patients had reoperations, of them 18 (26.1%) patients had NVRF removal. Median follow-up time was 31 mo (10.0-63.5). Seventeen patients presented with bulging of the AW (18.7%), 5 with herniation (5.9%). No NVRF graft rejection was reported.ConclusionsThis survey reports long-term outcome after NVRF Tx, with herniation in a limited number of patients, no suspicion of clinical rejection and no additional infection and mortality. NVRF Tx has proven to be a useful option, belonging to the standard armamentarium for AW closure after SOT.

Publication status:: Published

Peer review status:: Peer reviewed

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APA Style

Van De Winkel, N., Muylle, E., Canovai, E., Amin, I., Butler, A., Vianna, R., Selvaggi, G., Farinelli, P., Gondolesi, G., Loinaz, C., Justo, I., Vilca-Melendez, H., Skogsberg Dahlgren, U., Herlenius, G., Shamsaeefar, A., Nikoupour, H., Dubois, A., Miserez, M., D'Hoore, A., … Ceulemans, L. J. (2025). Long-term Outcome After Nonvascularized Rectus Fascia Transplantation in Solid Organ Transplantation: A Global Multicenter IIRTA Survey. Transplantation Direct, 11(8), e1839.

MLA Style

Van De Winkel, N., et al. “Long-Term Outcome After Nonvascularized Rectus Fascia Transplantation in Solid Organ Transplantation: A Global Multicenter IIRTA Survey.” Transplantation Direct, vol. 11, no. 8, Lippincott, Williams & Wilkins, 2025, p. e1839.

Chicago Style

Van De Winkel, N, E Muylle, E Canovai, I Amin, A Butler, R Vianna, G Selvaggi, et al. 2025. “Long-Term Outcome After Nonvascularized Rectus Fascia Transplantation in Solid Organ Transplantation: A Global Multicenter IIRTA Survey.” Transplantation Direct 11 (8): e1839.
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