A. Miyauchi et al., Successful autotransplantation of an adrenal gland using a new method of omental wrapping: Report of a case, SURG TODAY, 29(9), 1999, pp. 960-962
Bilateral total adrenalectomy results in the need for patients to take life
long supplements of adrenal steroids, with the risk of possible Addisonian
crisis. Few reports of the successful autotransplantation of adrenal tissue
in muscular pockets have been documented; however, we describe herein the
case of a 22-year-old woman in whom autotransplantation of an adrenal gland
was successfully performed employing a new method of omental wrapping. The
patient underwent bilateral total adrenalectomy for bilateral pheochromocy
toma at which time adrenal tissue was sliced into 1-2-mm thick pieces, half
of which were placed in muscular pockets in the abdominal rectus muscles,
and the remaining half put onto the omentum and wrapped with it. Laboratory
examinations done 6 months after surgery showed recovery of her adrenal fu
nction, and 4 months later steroid supplements were able to be discontinued
. Scintigraphic studies using [I-131]-iodomethyl-norcholesterol ([I-131]-Ad
osterol) demonstrated clear activity in the omentum, weak activity in the r
ectus muscles, and no activity in the adrenal beds. These findings suggest
that the omentum may be more suitable as an implantation site for adrenal t
issue than muscular pockets.