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Liver transplantation is the treatment of choice for most patients with end-stage liver disease. The major challenges in this and the next decade are to: make available more organs for transplantation through maximization of the donor pool, design more effective and less toxic immunosuppressive regimens, and extend long-term survival. Intestine transplantation is standard therapy for patients with intestinal failure and complications resulting from total parenteral nutrition. Clinical management of the intestine transplant recipient is complex and requires a great deal of expertise; acute rejection, sepsis, dehydration, and malabsorption remain as clinical management problems.