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diagnosis and treatment of acute rejection in the first case of human living-related small bowel transplantation with a long-term survival in China

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World Journal of Gastroenterology 2005年第34期11卷 5332-5335页

作者： Wei-Liang Song Wei-Zhong Wang Guo-Sheng Wu Meng-Bin Li Ji-Peng Li Gang Ji Guang-Long Don Hong-Wei Zhang Department of Gastrointestinal Surgery Xijing HospitalFourth Military Medical University Xi'an 710032 Shaanxi Province China

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.

关键词： Rejection comprehensive diagnosis Small bowel transplantation

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