Contemporaneous chronic rejection of multiple allografts with principal pancreatic involvement in modified multivisceral transplantation

Hidenori Takahashi, Victor Delacruz, Shoib Sarwar, Gennaro Selvaggi, Jang Moon, Seigo Nishida, Debbie Weppler, David Levi, Tomoaki Kato, Andreas Tzakis, Phillip Ruiz

Research output: Contribution to journalArticle

4 Scopus citations


The patient was a 10 yr-old-male with short gut syndrome secondary to Hirschsprung's disease, who underwent a modified (no liver) multivisceral transplant (stomach, pancreas, small and large intestine). The patient experienced malabsorption early in the post-operative course and had been dependent on a combination of enteral and intravenous nutrition. He developed symptoms of bowel obstruction and was suspected to have chronic rejection by an exploratory laparotomy four yr after transplant. Re-transplantation of a multivisceral transplant (stomach, pancreas, liver, small and large intestine) was performed. Microscopic examinations of the explanted allograft organ block revealed varying degrees of chronic rejection in many of the organs but with the pancreatic allograft being affected most severely. The malabsorption symptom following the first transplant may have been caused by the early onset of chronic pancreatic allograft dysfunction. Our case indicates varying severity of chronic rejection among multiple allografts where the pancreatic allograft appeared most susceptible to chronic rejection.

Original languageEnglish
Pages (from-to)448-452
Number of pages5
JournalPediatric Transplantation
Issue number4
StatePublished - Jun 1 2007



  • Chronic rejection
  • Organ transplantation

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Transplantation

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