title: Diagnosis and treatment of acute rejection in the first case of human living-related small bowel transplantation with a long-term survival in China.
abstract: OBJECTIVE
  To report the comprehensive diagnosis and treatment of acute rejection in the first case of living-related small bowel transplantation with a long-term survival in China.
  
  
  METHODS
  A 18-year-old boy with short gut syndrome underwent living-related small bowel transplantation, with the graft taken from his father (44-year old). A segment of 150-cm distal small bowel was resected from the donor. The ileo-colic artery and vein from the donor were anastomosed to the infrarenal aorta and vena cava of the recipient respectively. The intestinal continuity was restored with an end-to-end anastomosis between the recipient jejunum and donor ileum, and the distal end was fistulized. FK506, MMF and prednisone were initially used for post-transplant immunosuppression. Endoscopic observation and mucosal biopsies of the graft were carried out through the terminal ileum enterostomy; serum was collected to detect the levels of IL-2R, IL-4, IL-6 and IL-8. The change of the graft secretion and absorption was observed.
  
  
  RESULTS
  Acute rejection was diagnosed promptly and cured. The patient was in good health, 5 years after living-related small bowel transplantation.
  
  
  CONCLUSIONS
  The correct diagnosis and treatment of acute rejection are the key to the long-term survival after living-related small bowel transplantation.
authors.affiliation: Department of Gastrointestinal Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China. chenggong9999699@sohu.com
authors.forename: Wei-Liang
authors.initials: WL
authors.lastname: Song
authors.forename: Wei-Zhong
authors.initials: WZ
authors.lastname: Wang
authors.forename: Guo-Sheng
authors.initials: GS
authors.lastname: Wu
authors.forename: Meng-Bin
authors.initials: MB
authors.lastname: Li
authors.forename: Ji-Peng
authors.initials: JP
authors.lastname: Li
authors.forename: Gang
authors.initials: G
authors.lastname: Ji
authors.forename: Guang-Long
authors.initials: GL
authors.lastname: Dond
authors.forename: Hong-Wei
authors.initials: HW
authors.lastname: Zhang
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D006084:Graft Rejection / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D007421:Intestine, Small / Q000637:transplantation*; D019520:Living Donors; D008297:Male; D012778:Short Bowel Syndrome / Q000601:surgery
chemical_list: D007166:Immunosuppressive Agents