Objective: To report the first case of non-composite combined liver and intestinal allotransplantation in China. The technical aspects of the case and pros and cons of such an approach versus composite technique were discussed.
Methods: The patient suffered from short bowel syndrome and TPN-related liver damage. A non-composite technique was used in this case. During operation, the whole 380 cm intestine was transplanted with systemic drainage and aortic inflow, while the liver graft was placed in a piggyback fashion. Warm ischemic time of donor graft was 2 min and 30 seconds, and cold ischemic duration for intestinal and liver graft was 6 hours and 40 and 8 hours and 7 utes respectively. Postoperative immunosuppression management includes tacrolimus, methylprednisolone, MMF and Zenapax.
Results: The recipient recovered smoothly with no evidence of rejection on days' follow up. Now he is maintained well on enteral nutrition.
Conclusion: Non-composite technique should be considered in adult recipients, especially those with a history of abdominal infections or multiple laparotomies.