title: Sclerosing mesenteritis in small bowel transplantation: possible manifestation of acute vascular rejection.
abstract: BACKGROUND
  Acute rejection of human small bowel allografts is characterized by clinical symptoms combined with characteristic morphologic alterations. The typical geographic distribution of acute rejection in the bowel is involvement of the intestinal parenchyma, which can be transmural, particularly when the rejection is more severe. However, little is known concerning the potential for donor-derived soft tissue adjacent to the bowel to become involved by the host alloimmune response.
  
  
  METHODS
  We describe a male patient who, several weeks after combined small bowel and liver transplantation, demonstrated sclerosing mesenteritis with vasculitis and acute rejection of the bowel.
  
  
  RESULTS
  The vascular lesions in the mesentery demonstrated increased IgG deposition and the patient developed an alloantibody to the donor.
  
  
  CONCLUSIONS
  The changes described herein may represent a novel presentation of acute vascular rejection.
authors.affiliation: Department of Pathology, University of Miami School of Medicine, J M H Holtz Center #2101, 1611 NW 12th Avenue, Miami, FL 33101, USA. pruiz@med.miami.edu
authors.forename: P
authors.initials: P
authors.lastname: Ruiz
authors.forename: M
authors.initials: M
authors.lastname: Suarez
authors.forename: S
authors.initials: S
authors.lastname: Nishida
authors.forename: V
authors.initials: V
authors.lastname: de la Cruz
authors.forename: M
authors.initials: M
authors.lastname: Nicolas
authors.forename: D
authors.initials: D
authors.lastname: Weppler
authors.forename: A
authors.initials: A
authors.lastname: Khaled
authors.forename: P
authors.initials: P
authors.lastname: Bejarano
authors.forename: T
authors.initials: T
authors.lastname: Kato
authors.forename: N
authors.initials: N
authors.lastname: Mittal
authors.forename: M
authors.initials: M
authors.lastname: Icardi
authors.forename: A
authors.initials: A
authors.lastname: Tzakis
mesh_terms: D000208:Acute Disease; D000328:Adult; D006084:Graft Rejection / Q000473:pathology*; D006801:Humans; D007421:Intestine, Small / Q000473:pathology* / Q000601:surgery*; D008297:Male; D015436:Panniculitis, Peritoneal / Q000473:pathology* / Q000601:surgery*; D010289:Parenteral Nutrition, Total; D012086:Reoperation; D012598:Sclerosis; D012778:Short Bowel Syndrome / Q000473:pathology / Q000601:surgery; D014184:Transplantation, Homologous / Q000473:pathology*