article = {TCR-2026-1-101}
title = {Endoluminal Vacuum Therapy for Esophageal Anastomotic Leakage Following Multivisceral Transplantation: A Case Report}
journal = {Transplantation Case Reports}
year = {2026}
issn = {2733-2527}
doi = {http://dx.doi.org/10.31487/j.TCR.2026.01.01}
url = {https://www.sciencerepository.org/endoluminal-vacuum-therapy-for_TCR-2026-1-101 
author = {Anna  Laureys,Stijn  Vanstraelen,Caroline  Boelhouwer,Lucas  Wauters,Ingrid  Demedts,Hans  Van Veer,Lieven  Depypere,Laurens J  Ceulemans,Jacques  Pirenne,Tim  Vanuytsel,Philippe  Nafteux,}
keywords = {Endoluminal negative pressure therapy, esophageal anastomotic leakage, gastrointestinal perforation, immunosuppression, multivisceral transplantation, splanchnic ischemia, VACStent®}
abstract ={Background: Esophageal anastomotic leakage is a rare but potentially life-threatening complication, especially following complex surgical procedures like multivisceral transplantation. Endoluminal negative pressure therapy (ENPT) has emerged as a promising, minimally invasive strategy to treat gastrointestinal anastomotic leakage outside the setting of immunosuppression. However, its application in transplant recipients has not been described yet.
Case Presentation: We report the case of a 47-year-old woman who underwent multivisceral transplantation due to diffuse splanchnic ischemia, secondary to celiac trunk and superior mesenteric artery thrombosis. Postoperatively, she developed persistent epigastric pain and respiratory distress, prompting ICU readmission. A CT-scan and upper endoscopy revealed an anastomotic leakage at the level of the esophago-gastric anastomosis. Given her clinical condition, ENPT therapy was chosen after multidisciplinary discussion. A VACStent® prosthesis was positioned endoscopically. Three ENPT sessions resulted in complete resolution of the anastomotic leakage, which was confirmed on contrast gastrografin swallow radioscopy.
Conclusion: Our case illustrates the potential of ENPT in immunocompromised high-risk patients. Consequently, it may be considered a safe and effective alternative to surgical or prosthetic interventions, emphasizing the expanding role of advanced endoscopic therapies in complex postoperative scenarios.}