[Combined transplantation of liver and small intestine in an adult. First case in France. Surgical aspects].
BACKGROUND
We report hare the first adult case of combined liver-small bowel transplantation performed in France.


METHODS
A double liver + small bowel graft was transplanted in a 21-year-old patient hospitalized for 4 years for a short bowel syndrome requiring total parenteral nutrition. The patient also had severe hepatic fibrosis. The immediate post-operative period was uneventful. Two and one-half years after the double graft, the patient is on strictly oral nutrition, no longer has a stomy and lives a normal life in his home.


CONCLUSIONS
The advent of tacrolimus has led to long-term success of bowel grafts, developed earlier in children and now possible in adults. Combined liver-small bowel transplantation is formally indicated in patients with cirrhogenic liver disease associated with ineversible small bowel failure.
Azoulay
D
D
Centre Hépato-Biliaire, Hôpital Paul Brousse, Villejuif, Université Paris-Sud. daniel.azoulay@pbr.ap-hop-paris.fr
Savier
E
E
Castaing
D
D
Saliba
F
F
Vasseur
B
B
Emile
J F
JF
Vahédi
K
K
Samuel
D
D
Matuchansky
C
C
Messing
B
B
Bismuth
H
H
D000328:Adult; D000367:Age Factors; D005500:Follow-Up Studies; D005602:France; D006801:Humans; D007421:Intestine, Small / Q000637:transplantation*; D008103:Liver Cirrhosis / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D010288:Parenteral Nutrition; D012778:Short Bowel Syndrome / Q000601:surgery*; D016896:Treatment Outcome