Diagnosis and treatment of acute rejection in the first case of human living-related small bowel transplantation with a long-term survival in China.
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.
Song
Wei-Liang
WL
Department of Gastrointestinal Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China. chenggong9999699@sohu.com
Wang
Wei-Zhong
WZ
Wu
Guo-Sheng
GS
Li
Meng-Bin
MB
Li
Ji-Peng
JP
Ji
Gang
G
Dond
Guang-Long
GL
Zhang
Hong-Wei
HW
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
D007166:Immunosuppressive Agents