title: Combined small bowel and reduced auxiliary liver transplantation: case report.
abstract: OBJECTIVE
  To present a case of combined small bowel and reduced auxiliary liver transplantation.
  
  
  METHODS
  A 55-year-old patient with short bowel syndrome and TPN-related liver dysfunction received small bowel transplantation combined with a reduced auxiliary liver graft. A liver was added to restore the patient's liver function and to protect the intestinal allograft from rejection. His own liver was not removed.
  
  
  RESULTS
  Without donor pretreatment and by conventional immunosuppresive therapy following transplantation, the patient experienced had only one episode of mild intestinal rejection, which was easily reversed by treatment with Methylprednisolone. No liver rejection occurred. Unfortunately, the patient died of heart and lung failure 30d after transplantation, despite successful graft replacement. Histopathologic examination of specimens after death demonstrated normal structure in both intestinal and liver grafts.
  
  
  CONCLUSIONS
  The auxiliary liver graft might play a role in preventing intestinal allograft rejection. However, the observation period in this case is short. Further study is needed to determine the risks, effect on the protecting the small-bowel from rejection, and feasibility of general application of this procedure.
authors.affiliation: Institute of Organ Transplantation, Tongji Hospital, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China. wjzhang@public.wh.hb.cn
authors.forename: Wei-Jie
authors.initials: WJ
authors.lastname: Zhang
authors.forename: Dun-Gui
authors.initials: DG
authors.lastname: Liu
authors.forename: Qi-Fa
authors.initials: QF
authors.lastname: Ye
authors.forename: Bo
authors.initials: B
authors.lastname: Sha
authors.forename: Fan-Jun
authors.initials: FJ
authors.lastname: Zhen
authors.forename: Hui
authors.initials: H
authors.lastname: Guo
authors.forename: Sui-Sheng
authors.initials: SS
authors.lastname: Xia
mesh_terms: D017809:Fatal Outcome; D006084:Graft Rejection / Q000473:pathology; D006801:Humans; D007421:Intestine, Small / Q000637:transplantation*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000473:pathology; D012778:Short Bowel Syndrome / Q000601:surgery*