Simultaneous liver transplantation may reduce the risk of intestinal transplant rejection. We have recently developed two new models of combined liver/intestine transplantation (LIT) in the rat to study this phenomenon. Herein, we report our experience with LIT using a single donor (SD) or multiple donors (MD). Large volumes of fluid were required to prevent a drop in the mean arterial pressure during the anhepatic phase in the SD recipients. Many of the SD recipients died of intraoperative hypovolemic shock (57%). The MD recipients had a shorter anhepatic time (12 +/- 1 minutes vs. 17 +/- 2 minutes; P less than 0.01) and a shorter warm intestinal ischemia time (15 +/- 1 minutes vs. 32 +/- 2 minutes; P less than 0.01). Operative mortality rates were much lower in the MD recipients (10% vs. 68%; P less than 0.01). The long-term survival rate using MD was 71% at 1 month. Graft function was normal in the long-term survivors. LIT with MD provides a good model to study the immunological effects of multivisceral grafting.