Challenges in Cadaveric Skin Graft Survival in Organ Transplant Recipients on Immunosuppressive Regimens: A Case Report
Summary: Two cases of lower extremity wounds in solid organ transplant patients (on chronic immunosuppression) showed initial cadaveric allograft adherence/granulation but delayed failure (4–8 weeks) due to rejection. Patients declined autologous STSG, opting for local care. Report stresses unpredictable long-term efficacy in this population, influenced by comorbidities/transplant timing, and advocates alternatives like cellular/acellular/matrix products (CAMPs) for sustained healing in chronic/immunosuppressed wounds, including DFU-like scenarios.
Key Highlights:
- Cases: Initial success (pink granulation at 2 weeks) but disintegration by 4–8 weeks.
- Factors: Immunosuppression insufficient vs rejection; comorbidities (e.g., diabetes).
- Alternatives: CAMPs for temporary coverage/prep for reconstruction; NPWT adjunct.
- Implications: Extended monitoring; non-surgical options preferred in high-risk patients.
- Relevance: Informs DFU management in diabetics/transplant recipients.
- Authors: Steven Tohmasi, Carolyn Tsung, Ariana Naaseh.
Keywords: cadaveric graft, immunosuppression, organ transplant, allograft rejection, chronic wounds, CAMPs