Complex Abdominal Wound Healing After Multivisceral Retransplant: A Case Report on the Importance of Nutrition.

Abstract

BACKGROUND:

Intestinal transplantation (ITx) is performed as an isolated ITx or as a part of multivisceral transplantation for intestinal failure secondary to short gut syndrome, inflammatory bowel disease, trauma, and sequelae of chronic parenteral nutrition dependence. Wound complications after ITx are very common, and abdominal wound closure cannot be immediately achieved in half of cases.

CASE PRESENTATION:

A 25-year-old man sustained an abdominal crush injury causing complete loss of his small intestine, requiring an isolated ITx in March 2016. He lost his graft because of early exfoliative rejection in November 2016. Five months after enterectomy and the immunosuppression-free period, he underwent multivisceral retransplantation in April 2017. His post-transplant course was complicated by wound healing problems that improved with treatment of his malnutrition, quantified by increasing albumin, total protein, prealbumin, weight, body mass index, and total psoas muscle area over a period of 19 months after retransplant.

CONCLUSION:

To our knowledge, this is the first case described of long-term wound follow-up after a multivisceral (re)transplantation, with corresponding nutrition information and images of the wound.

• Authors: Angela M Chen, Abdulkadir Isidan, Carlos Vega, Kutay Saglam, Plamen Mihaylov, Jonathan A Fridell, Chandrashekhar A Kubal, Richard S Mangus, Burcin Ekser
• Journal: Transplantation proceedings (Transplant Proc) Vol. 52 Issue 9 Pg. 2839-2843 (Nov 2020) ISSN: 1873-2623 [Electronic] United States
• PMID: 32576477 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2020 Elsevier Inc. All rights reserved.

Topics

• Abdominal Injuries (pathology)
• Adult
• Humans
• Intestines (transplantation)
• Liver Transplantation (adverse effects)
• Male
• Pancreas Transplantation (adverse effects)
• Parenteral Nutrition, Total
• Postoperative Complications (diet therapy, etiology)
• Reoperation
• Stomach (transplantation)
• Wound Healing