{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:20:35Z","timestamp":1753878035486,"version":"3.41.2"},"reference-count":17,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,1,9]],"date-time":"2023-01-09T00:00:00Z","timestamp":1673222400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82170662"],"award-info":[{"award-number":["82170662"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Sensitization to human leukocyte antigen (HLA) creates an immunological barrier to intestinal transplantation (ITx). Current desensitization therapies are limited and ineffective in the most highly sensitized patients. A co\u2010transplanted whole liver transplant can protect a kidney, heart, or intestinal allograft from antibody\u2010mediated injury. Whether an auxiliary partial liver allograft provides effective protection for highly sensitized intestinal transplant recipients is unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Two patients with strong HLA donor\u2010specific antibody at high titer against their deceased donors underwent combined auxiliary partial liver and ITx across a positive cross\u2010match. The left lateral lobes from the combined\u2010graft recipients and the right liver lobes from the deceased donors were transplanted as a domino procedure to other four patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Two combined\u2010graft recipients have had an uneventful postoperative course without major complications at a 12\u2010 and 24\u2010month follow\u2010up, respectively. Intestinal graft function has been excellent with no evidence of humoral or cellular rejection. While a positive cross\u2010match turned negative, titers of donor\u2010specific HLA antibodies gradually declined over time after transplant. The left liver lobes procured from the combined\u2010graft recipients were successfully transplanted into two pediatric patients (age 1.9, 2.4\u00a0years) and the right lobes from two deceased donors were successfully transplanted into two adult patients. All transplant procedures went well, without post\u2010operative complications related to the splitting technique.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our results indicate that an auxiliary liver transplant can effectively protect a co\u2010transplanted intestinal allograft against rejection and suggest that this combined procedure may serve as a useful therapeutic adjunct for a highly sensitized intestinal transplant candidate.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.14865","type":"journal-article","created":{"date-parts":[[2022,11,23]],"date-time":"2022-11-23T11:53:54Z","timestamp":1669204434000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Successful combined auxiliary partial liver and intestinal transplantation in two highly sensitized, cross\u2010match positive patients"],"prefix":"10.1111","volume":"37","author":[{"given":"Guosheng","family":"Wu","sequence":"first","affiliation":[{"name":"Intestinal Transplant Center The First Affiliated Hospital Zhejiang University School of Medicine  Hangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chaoxu","family":"Liu","sequence":"additional","affiliation":[{"name":"Intestinal Transplant Center The First Affiliated Hospital Zhejiang University School of Medicine  Hangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nan","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery The First Affiliated Hospital Zhejiang University School of Medicine  Hangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xile","family":"Zhou","sequence":"additional","affiliation":[{"name":"Intestinal Transplant Center The First Affiliated Hospital Zhejiang University School of Medicine  Hangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Long","family":"Zhao","sequence":"additional","affiliation":[{"name":"Intestinal Transplant Center The First Affiliated Hospital Zhejiang University School of Medicine  Hangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuntao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery The First Affiliated Hospital Zhejiang University School of Medicine  Hangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wentong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Intestinal Transplant Center The First Affiliated Hospital Zhejiang University School of Medicine  Hangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tingbo","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary and Pancreatic Surgery The First Affiliated Hospital Zhejiang University School of Medicine  Hangzhou China"},{"name":"Zhejiang Provincial Key Laboratory of Pancreatic Disease The First Affiliated Hospital Zhejiang University School of Medicine  Hangzhou China"},{"name":"Zhejiang University Cancer Center Zhejiang University  Hangzhou 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