Fig. 5.

Multivisceral transplantation: The native abdominal viscera is resected and the composite graft, including the liver, stomach, pancreaticoduodenal complex, and small intestine, are transplanted en bloc. The arterial supply is established through the superior mesenteric artery and celiac trunk graft through a conduit to the aorta and venous drainage through the hepatic veins to the inferior vena cava, when the liver is included (as shown) and through the graft portal vein to the cava when recipient liver is retained. The gut continuity is restored by anastomosing the esophagus or gastric remnant with the stomach graft (transplanted organs are shaded). (Reproduced with permission from [32].)