Original contributions: Case reportsLiverCombined Kidney Transplantation and Splenic Fossa Auxiliary Heterotopic Liver Transplantation in a Highly Sensitized Recipient: A Case Report

- Auxiliary liver can protect the transplanted kidney against hyperacute rejection.
- Combined kidney and splenic fossa auxiliary heterotopic liver transplantation was performed from the same donor for a highly sensitized recipient without preoperative preconditioning.
- Combined kidney and splenic fossa auxiliary heterotopic liver transplantation can be used in renal transplantation for highly sensitized recipients.

BackgroundCombined kidney and auxiliary orthotopic liver transplantation from the same donor is used to treat highly sensitized renal transplant recipients. Auxiliary liver can protect the transplanted kidney against hyperacute rejection.MethodsIn the current case, combined kidney and splenic fossa auxiliary heterotopic liver transplantation was performed from the same donor for a highly sensitized recipient without preoperative preconditioning. No postoperative hyperacute rejection occurred.ResultsSeven days after surgery, preexisting antibody levels rose and decreased after treatment; meanwhile, the function of transplanted kidney returned to normal. During 24 months of follow-up, the grafts showed good blood perfusion and functioned well. The levels of preexisting antibodies, donor-specific antibodies (DSA) and C1q-fixing human leukocyte antigen (C1q-HLA) antibodies, all decreased.ConclusionsCombined kidney and splenic fossa auxiliary heterotopic liver transplantation can be used in renal transplantation for highly sensitized recipients.