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Objective: To study the clinical effect of combined kidney transplantation and splenic fossa auxiliary heterotopic liver transplantation to treat highly sensitized recipients.Methods: Combined kidney transplantation and splenic fossa auxiliary heterotopic liver transplantation from the same donor was used to treat a highly sensitized recipient with panel reactive antibodies (PRA) >50% and preexisting donor specific antibodies (DSA).The hyperacute rejection and the function of renal after the transplant were observed.Serum samples were also collected before and after reperfusion of the liver and each time points after the transplant surgery to detect the antibody level using Luminex technology.