Clinical Research
Copyright ©The Author(s) 2005. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 14, 2005; 11(34): 5332-5335
Published online Sep 14, 2005. doi: 10.3748/wjg.v11.i34.5332
Diagnosis and treatment of acute rejection in the first case of human living-related small bowel transplantation with a long-term survival in China
Wei-Liang Song, Wei-Zhong Wang, Guo-Sheng Wu, Meng-Bin Li, Ji-Peng Li, Gang Ji, Guang-Long Dond, Hong-Wei Zhang
Wei-Liang Song, Wei-Zhong Wang, Guo-Sheng Wu, Meng-Bin Li, Ji-Peng Li, Gang Ji, Guang-Long Dond, Hong-Wei Zhang, Department of Gastrointestinal Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, Shaanxi Province, China
Author contributions: All authors contributed equally to the work.
Supported by the National Natural Science Foundation of China, No. 30070742
Correspondence to: Wei-Liang Song, Department of Gastrointestinal Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, Shaanxi Province, China. chenggong9999699@sohu.com
Telephone:
Received: December 8, 2004
Revised: January 23, 2005
Accepted: January 26, 2005
Published online: September 14, 2005
Abstract

AIM: 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.

CONCLUSION: The correct diagnosis and treatment of acute rejection are the key to the long-term survival after living-related small bowel transplantation.

Keywords: Rejection; Comprehensive diagnosis; Small bowel transplantation