title: 'Prope' tolerance in a noncompliant living related small bowel transplant recipient after severe rejection.
abstract: Advances in immunosuppression and surgical technique have greatly improved patient outcomes after intestinal transplantation. However, the procedure remains one of the most challenging among solid organ transplantation as a result of the high rate of acute rejection, sepsis, and posttransplantation lymphoproliferative disorder. Recently, clinical trials to explore tolerance protocols in humans have been initiated, including small bowel transplant recipients, with results not always reproducible. The concept of operational tolerance is more meaningful in the clinical setting when physiological stability of graft function is achieved in the absence of maintenance immunosuppression. We report the intriguing case of a living related small bowel transplant recipient who developed clinical "prope" tolerance to the graft after treatment of severe acute rejection despite continuous noncompliance with immunosuppressive therapy.
authors.affiliation: Division of Transplantation, Department of Surgery, University of Illinois at Chicago, Chicago, IL, USA.
authors.forename: Massimo
authors.initials: M
authors.lastname: Asolati
authors.forename: Giuliano
authors.initials: G
authors.lastname: Testa
authors.forename: Antonio
authors.initials: A
authors.lastname: Gangemi
authors.forename: Howard
authors.initials: H
authors.lastname: Sankary
authors.forename: José
authors.initials: J
authors.lastname: Oberholzer
authors.forename: Enrico
authors.initials: E
authors.lastname: Benedetti
mesh_terms: D000328:Adult; D001706:Biopsy; D006084:Graft Rejection / Q000276:immunology*; D006801:Humans; D007082:Ileum / Q000637:transplantation*; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D019520:Living Donors; D008297:Male; D023001:Transplantation Tolerance / Q000276:immunology*; D014184:Transplantation, Homologous / Q000276:immunology* / Q000473:pathology; D016312:Treatment Refusal
chemical_list: D007166:Immunosuppressive Agents