title: Combined Kidney Transplantation and Splenic Fossa Auxiliary Heterotopic Liver Transplantation in a Highly Sensitized Recipient: A Case Report.
abstract: BACKGROUND
  Combined kidney and auxiliary orthotopic liver transplantation from the same donor is used to treat highly sensitized renal transplant recipients. Auxiliary liver can protect the transplanted kidney against hyperacute rejection.
  
  
  METHODS
  In the current case, combined kidney and splenic fossa auxiliary heterotopic liver transplantation was performed from the same donor for a highly sensitized recipient without preoperative preconditioning. No postoperative hyperacute rejection occurred.
  
  
  RESULTS
  Seven days after surgery, preexisting antibody levels rose and decreased after treatment; meanwhile, the function of transplanted kidney returned to normal. During 24 months of follow-up, the grafts showed good blood perfusion and functioned well. The levels of preexisting antibodies, donor-specific antibodies (DSA) and C1q-fixing human leukocyte antigen (C1q-HLA) antibodies, all decreased.
  
  
  CONCLUSIONS
  Combined kidney and splenic fossa auxiliary heterotopic liver transplantation can be used in renal transplantation for highly sensitized recipients.
authors.affiliation: Department of Urology, Xijing Hospital, Fourth Military Medical University, Shanxi, China.
authors.forename: G
authors.initials: G
authors.lastname: Zhang
authors.affiliation: Department of Urology, Hanzhong Central Hospital, Shanxi, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: Department of Urology, Xijing Hospital, Fourth Military Medical University, Shanxi, China.
authors.forename: W
authors.initials: W
authors.lastname: Qin
authors.affiliation: Department of Urology, Xijing Hospital, Fourth Military Medical University, Shanxi, China.
authors.forename: L
authors.initials: L
authors.lastname: Yu
authors.affiliation: Department of Urology, Xijing Hospital, Fourth Military Medical University, Shanxi, China.
authors.forename: G
authors.initials: G
authors.lastname: Wu
authors.affiliation: Department of Urology, Xijing Hospital, Fourth Military Medical University, Shanxi, China.
authors.forename: S
authors.initials: S
authors.lastname: Ma
authors.affiliation: Department of Urology, Xijing Hospital, Fourth Military Medical University, Shanxi, China.
authors.forename: F
authors.initials: F
authors.lastname: Wang
authors.affiliation: Department of Urology, Xijing Hospital, Fourth Military Medical University, Shanxi, China.
authors.forename: R
authors.initials: R
authors.lastname: Qin
authors.affiliation: Department of Urology, Xijing Hospital, Fourth Military Medical University, Shanxi, China.
authors.forename: X
authors.initials: X
authors.lastname: Yang
authors.affiliation: Department of Hepatobiliary Surgery, Xijing Hospital, Fourth Military Medical University, Shanxi, China.
authors.forename: K
authors.initials: K
authors.lastname: Tao
authors.affiliation: Department of Hepatobiliary Surgery, Xijing Hospital, Fourth Military Medical University, Shanxi, China.
authors.forename: S
authors.initials: S
authors.lastname: Yue
authors.affiliation: Xijing Orthopedic Hospital of the Fourth Military Medical University, Shanxi, China.
authors.forename: G
authors.initials: G
authors.lastname: Zhao
authors.affiliation: Department of Hepatobiliary Surgery, Xijing Hospital, Fourth Military Medical University, Shanxi, China.
authors.forename: Z
authors.initials: Z
authors.lastname: Yang
authors.affiliation: Department of Biochemistry, University of Washington, Seattle, Washington.
authors.forename: J
authors.initials: J
authors.lastname: Yuan
authors.affiliation: Department of Hepatobiliary Surgery, Xijing Hospital, Fourth Military Medical University, Shanxi, China.
authors.forename: K
authors.initials: K
authors.lastname: Dou
authors.affiliation: Department of Urology, Xijing Hospital, Fourth Military Medical University, Shanxi, China. Electronic address: jianliny@fmmu.edu.cn.
authors.forename: J
authors.initials: J
authors.lastname: Yuan
mesh_terms: D000906:Antibodies / Q000097:blood*; D005260:Female; D006084:Graft Rejection / Q000276:immunology; D006680:HLA Antigens / Q000276:immunology; D006801:Humans; D007668:Kidney / Q000276:immunology; D016030:Kidney Transplantation / Q000379:methods*; D008099:Liver / Q000276:immunology; D016031:Liver Transplantation / Q000379:methods*; D008875:Middle Aged; D014019:Tissue Donors; D066027:Transplant Recipients
chemical_list: D000906:Antibodies; D006680:HLA Antigens