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Use of vascularized posterior rectus sheath allograft in pediatric multivisceral transplantation--report of two cases.
[megacystis-microcolon-intestinal hypoperistalsis syndrome]
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
recipients--
one
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
long
-term
survival
.
The
procedure
has
potential
application
to
facilitate
difficult
abdominal
closure
in
both
adults
and
pediatric
liver
and
multivisceral
transplantation
.