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The most important factor of this technique for wall procurement lies in the need for proper abdominal closure when the abdominal pressure is elevated, such as in multi-organ or liver transplantations that require further reconstructions. Some key points are the house-shaped flap, meticulous dissection, and individualization of the epigastric and iliac vessels. This technique regards the abdominal wall as a functional organ that must be perfused simultaneously like other abdominal organs and stored with a short warm ischemia time, minimizing subsequent risk of thrombosis. Primary complications include infection, graft-versus-host disease and graft rejection.
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