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Editor’s note: Long-term total parenteral nutrition (TPN) is associated with hepatic dysfunction, fibrosis, and cirrhosis. Because of this, patients who are on long-term TPN may ultimately be considered for liver and small bowel transplantation. Some of these patients have no overt hepatic dysfunction and may be considered for small bowel transplantation for reasons other than TPN-associated liver disease. The current article details a case report that indicates that the outcome of isolated small bowel transplantation, even in patients who have liver cirrhosis due to TPN, may be favorable.