Liver and vascularized posterior rectus sheath fascia composite tissue allotransplantation

S. Agarwal, A. H. Dorafshar, R. C. Harland, J. M. Millis, L. J. Gottlieb

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


Abdominal wall closure in pediatric solid organ recipients may be confounded by donor size discrepancy and structural insults from previous surgery. Here we describe the novel use of vascularized donor abdominal wall posterior rectus sheath fascia, as a composite tissue allotransplant (CTA), to achieve abdominal wall closure in a liver and double kidney pediatric recipient who could not be closed primarily due to donor/recipient size mismatch. The posterior rectus sheath fascia was procured in continuity with the liver and falciform ligament. Blood supply was achieved using the single hepatic artery anastomosis as part of the standard liver transplantation procedure. Specimens of posterior rectus sheath fascia taken on postoperative days 3 and 30 showed no signs of acute rejection. The patient succumbed to an overwhelming fungal infection on day 51, with no signs of intraabdominal involvement. The patient received no additional immunosuppression in conjunction with the posterior rectus sheath fascia allotransplant.

Original languageEnglish (US)
Pages (from-to)2712-2716
Number of pages5
JournalAmerican Journal of Transplantation
Issue number12
StatePublished - Dec 2010
Externally publishedYes


  • Abdominal wall transplantation
  • hernia
  • immunosuppression
  • kidney
  • liver

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)


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