World First: Donor Tissue Repair, No Anti-Rejection Drugs
Surgeons at UZ Leuven, Belgium’s largest university hospital, have achieved a world first by repairing severe damage to patients’ abdomens and chests using donor tissue from deceased individuals—without requiring lifelong anti-rejection medication. The groundbreaking technique, announced on September 3-4, 2026, represents a double world premiere in transplant medicine.
A Double World First
According to VRT NWS, the Leuven team has achieved two historic milestones: performing abdominal wall transplants without immunosuppressive medication for the first time, and using donor abdominal wall tissue for complex reconstructions in the chest for the first time. The results were published in two prestigious scientific journals: Annals of Surgery and The Journal of Thoracic and Cardiovascular Surgery.
Why This Matters: The Problem with Current Techniques
Large, gaping wounds in the abdominal wall, chest wall, or diaphragm have traditionally required synthetic meshes to restore structural integrity. However, in patients with infections, these synthetic materials can become infected themselves and may need to be surgically removed. Biological materials derived from animals offer an alternative but are expensive and don’t always provide sufficient strength for human reconstruction.
The Leuven surgeons developed a different solution: using the rectus fascia—the strong connective tissue layer surrounding the rectus abdominis muscles, commonly known as the “six-pack” muscles—from deceased donors. This tissue is strong, flexible, and fully biological.
How the Technique Works
Unlike classical organ transplants such as kidney, liver, or lung transplants, this tissue transplant does not require lifelong immunosuppressive drugs. Prof. dr. Laurens Ceulemans, thoracic and transplant surgeon at UZ Leuven and coordinator of abdominal wall transplants, explained the mechanism to VRT NWS: “We see that the abdominal wall tissue of the deceased donor is fully incorporated into the recipient’s tissue. The blood vessels that supply the transplanted tissue come from the recipient, not the donor. And you cannot reject your own blood vessels. The tissue essentially becomes part of the body.”
The donor tissue becomes revascularized by the recipient’s own blood vessels, essentially transforming into “self” tissue. This was first demonstrated in animal models and in the lab during Dr. Nele Van De Winkel’s PhD research at KU Leuven.
More Than 80 Successful Procedures
The Leuven team has already performed more than 80 abdominal wall transplants. The technique builds on the first abdominal wall transplant in Belgium, performed by Ceulemans in 2020 on two patients who had undergone intestinal transplants. At that time, patients still received immunosuppressive medication. Now, the team has proven that such medication is not needed and that donor tissue can be used in other locations throughout the body.
In one notable case described by Ceulemans, an 80-year-old woman who had received radiation therapy years earlier for a breast tumor developed a new tumor in her chest wall. After surgical removal left a large defect, surgeons used the donor abdominal wall tissue to cover the chest wall with strong, flexible biological material—eliminating the need for synthetic mesh or muscle flaps from elsewhere in the body.
Practical Advantages Beyond Immunosuppression
Beyond eliminating the need for lifelong anti-rejection drugs, the technique offers several practical advantages. Donor tissue can be stored for up to one month, making it available when a patient unexpectedly needs complex reconstruction. Additionally, no matching blood type is required between donor and recipient, significantly simplifying the logistics of the procedure.
As noted in the UZ Leuven press release, the donor tissue functions as a strong biological repair material that surgeons can tailor for use in various parts of the body where strong, flexible, and infection-resistant tissue is needed. The technique has already been successfully applied for reconstructions of the diaphragm, pericardium (heart sac), and chest wall, as well as in exceptional damage to the pelvic region.
Expanding Applications and Future Research
The Leuven researchers are now exploring additional applications where strong biological support tissue is needed. A key future application is the repair of congenital diaphragm defects in children. In cases where the opening in the diaphragm is too large to close with existing techniques, donor abdominal wall tissue could offer a biological alternative to synthetic material.
Researchers are also investigating applications in pelvic floor surgery, particularly for severe bladder prolapse where strong supportive tissue is needed to restore anatomy. These applications are currently being studied in the lab and in the hospital setting.
Prof. Ceulemans presented the results at the European Surgical Association (ESA) congress in Rome, where he received the first prize for his research. The team is now working to share the technique with other hospitals through workshops and international collaborations. UCLouvain has already successfully applied the technique in one patient.
Looking Ahead: Challenges and Milestones
Prof. Ceulemans has cautioned that if more hospitals adopt this technique, there could eventually be a shortage of suitable donors. The team is actively researching ways to increase the availability of donor tissue. In Belgium, legislation states that everyone is an organ and tissue donor unless they have indicated otherwise during their lifetime.
The innovation builds on a rich transplant legacy at UZ Leuven, whose transplant program began in 1963. In autumn 2026, the hospital is expected to reach the historic milestone of 10,000 transplants—the first hospital in Belgium to achieve this feat.
As Prof. Ceulemans noted in the KU Leuven Stories feature on his transplant work: “The discovery that we can use this tissue not only for abdominal wall repair but also for defects in almost all places in the body suddenly creates many new possibilities in medicine.”
For patients facing complex reconstructive surgery, this technique offers a promising new path—one that could spare them from a lifetime of immunosuppressive drugs and their associated risks, including increased vulnerability to infections and certain cancers. The implications extend far beyond Belgium, potentially transforming how surgeons worldwide approach complex tissue repair.