Introduction: Nonalcoholic steatohepatitis (NASH) is an important cause of cirrhosis and over the past decade has accounted for an increasing proportion of liver transplants in the United States. Unfortunately there is no treatment for NASH except for risk factor modification. The aims of our study were to assess the impact of betaine on liver function tests, homocysteine levels and hepatic fibrosis in a prospective cohort of NASH patients

Experimental small bowel transplantation (SBT) in rats has been proven to be a useful tool for the study of ischemia-reperfusion and immunological aspects related to solid organ transplantation. However, the model is not completely refined, specialized literature is scarce and complex technical details are typically omitted or confusing. Most studies related to acute rejection (AR) use the orthotopic standard, with small sample sizes due to its high mortality, whereas those studying chronic rejection (CR) use the heterotopic standard, which allows longer term survival but does not exactly reflect the human clinical scenario. Various animal strains have been used, and the type of rejection and the timing of its analysis differ among authors. The double purpose of this study was to develop an improved unusual AR model of SBT using the heterotopic technique, and to elaborate a guide useful to implement experimental models for studying AR. We analyzed the model's technical details and expected difficulties in overcoming the learning curve for such a complex microsurgical model, identifying the potential problem areas and providing a step-by-step protocol and reference guide for future surgeons interested in the topic. We also discuss the historic and more recent options in the literature.

The pancreas transplant as a part of multivisceral or multiorgan transplantation has always been approached with caution because of graft pancreatitis, rejection, or technical complications.The multivisceral transplantation is a complicated process, starting from the recipient, the donor selection, the indications, the contraindications, and the postoperative management.Intestinal transplant recipients generally require more profound immunosuppression than patients receiving other solid organs because of the higher immunogenicity of the intestine.Unlike the early years of intestinal transplantation, when technical challenges and vascular events were likely to cause graft loss and patient mortality, the current most common causes of allograft dysfunction are infection and graft rejection. Unlike the early years of intestinal transplantation, when technical challenges and vascular events were likely to cause graft loss and patient mortality, the current most common causes of allograft dysfunction are infection and graft rejection.