Combined small bowel and reduced auxiliary liver transplantation: case report.
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.
Zhang
Wei-Jie
WJ
Institute of Organ Transplantation, Tongji Hospital, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China. wjzhang@public.wh.hb.cn
Liu
Dun-Gui
DG
Ye
Qi-Fa
QF
Sha
Bo
B
Zhen
Fan-Jun
FJ
Guo
Hui
H
Xia
Sui-Sheng
SS
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*