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Thomas E. Starzl, MD, PhD; Marc I. Rowe, MD; Satoru Todo, MD; Ronald Jaffe, MB, BCh; Andreas Tzakis, MD; Allen L. Hoffman, MD; Carlos Esquivel, MD, PhD; Kendrick A. Porter, MD, DSc; Raman Venkataramanan, PhD; Leonard Makowka, MD, PhD; Rene Duquesnoy, PhD

JAMA. 1989;261(10):1449-1457.

Abstract
Two children with the short-gut syndrome and secondary liver failure were treated with evisceration and transplantation en bloc of the stomach, small intestine, colon, pancreas, and liver. The first patient died perioperatively, but the second lived for more than 6 months before dying of an Epstein-Barr virus—associated lymphoproliferative disorder that caused biliary obstruction and lethal sepsis. There was never evidence of graft rejection or of graft-vs-host disease in the long-surviving child. The constituent organs of the homograft functioned and maintained their morphological integrity throughout the 193 days of survival.

(JAMA. 1989;261:1449-1457)

Author Affiliations
From the Departments of Surgery (Drs Starzl, Todo, Rowe, Tzakis, Hoffman. Esquivel, and Makowka) and Pathology (Drs Jaffe and Duquesnoy) and the School of Pharmacy (Dr Venkataramanan), University of Pittsburgh Health Center, University of Pittsburgh, Pittsburgh, Pa; and the Department of Pathology, St Mary's Hospital and Medical School, London, England (Dr Porter).

Footnotes
Reprint requests to Department of Surgery, 3601 Fifth Ave, Falk Clinic, Pittsburgh, PA 15213 (Dr Starzl).

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