Zhang Wei-Jie, Liu Dun-Gui, Ye Qi-Fa, Sha Bo, Zhen Fan-Jun, Guo Hui, Xia Sui-Sheng
Institute of Organ Transplantation, Tongji Hospital, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China.
World J Gastroenterol. 2002 Oct;8(5):956-60. doi: 10.3748/wjg.v8.i5.956.
To present a case of combined small bowel and reduced auxiliary liver transplantation.
A 55-year-old patient with short bowel syndrome and TPN-related liver dysfunction received small bowel transplantation combined with a reduced auxiliary liver graft. A liver was added to restore the patient's liver function and to protect the intestinal allograft from rejection. His own liver was not removed.
Without donor pretreatment and by conventional immunosuppresive therapy following transplantation, the patient experienced had only one episode of mild intestinal rejection, which was easily reversed by treatment with Methylprednisolone. No liver rejection occurred. Unfortunately, the patient died of heart and lung failure 30d after transplantation, despite successful graft replacement. Histopathologic examination of specimens after death demonstrated normal structure in both intestinal and liver grafts.
The auxiliary liver graft might play a role in preventing intestinal allograft rejection. However, the observation period in this case is short. Further study is needed to determine the risks, effect on the protecting the small-bowel from rejection, and feasibility of general application of this procedure.
介绍一例小肠联合减体积辅助肝移植病例。
一名55岁患有短肠综合征及与全胃肠外营养（TPN）相关肝功能障碍的患者接受了小肠移植联合减体积辅助肝移植。植入肝脏以恢复患者肝功能并保护肠道移植物免受排斥。其自身肝脏未切除。
在未对供体进行预处理且移植后采用常规免疫抑制治疗的情况下，患者仅发生一次轻度肠道排斥反应，经甲泼尼龙治疗后很容易逆转。未发生肝脏排斥反应。不幸的是，尽管移植物置换成功，但患者在移植后30天死于心肺衰竭。死后标本的组织病理学检查显示肠道和肝脏移植物结构正常。
辅助肝移植物可能在预防肠道移植物排斥中发挥作用。然而，该病例的观察期较短。需要进一步研究以确定该手术的风险、对保护小肠免受排斥的效果以及普遍应用的可行性。
