RESUMEN
Intra-abdominal desmoid tumors are a rare and complex clinical problem. These tumors are locally invasive, and surgical ablation represents the mainstay of treatment. When localized at the root of the mesentery, their resection may require extensive excision of the intestine resulting in intestinal failure and life-long total parenteral nutrition. Intestinal transplantation, either autotransplantation or allotransplantation, has been used as a viable option to treat this group of patients. Herein, we describe a series of 4 patients with unresectable intra-abdominal desmoid tumor who underwent cadaveric isolated intestinal and ascending colon transplantation.
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Colon , Humanos , Masculino , Femenino , Adulto , Colon/trasplante , Colon/cirugía , Persona de Mediana Edad , Intestinos/trasplante , Intestinos/cirugíaRESUMEN
There is no optimal reconstruction after radical distal esophagectomy for cancers of the esophagogastric junction. We designed a novel reconstruction technique using pedicled ileocolic interposition with intrathoracic anastomosis between the esophagus and the elevated ileum. Two patients underwent the surgery. Case 1 was a 70-year-old man with esophagogastric junction adenocarcinoma with 3 cm of esophageal invasion. Case 2 was a 70-year-old man with squamous cell carcinoma of the esophagogastric junction; the epicenter of which was located just at the junction. These two patients underwent radical distal esophagectomy and pedicled ileocolic interposition with intrathoracic anastomosis. They were discharged on postoperative days 17 and 14, respectively, with no major complication. Pedicled ileocolic interposition is characterized by sufficient elevation and perfusion of the ileum, which is fed by the ileocolic artery and vein. As a result, we can generally adapt this reconstruction method to most curable esophagogastric junction cancers.
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Adenocarcinoma , Anastomosis Quirúrgica , Carcinoma de Células Escamosas , Neoplasias Esofágicas , Esofagectomía , Unión Esofagogástrica , Íleon , Humanos , Masculino , Unión Esofagogástrica/cirugía , Anciano , Esofagectomía/métodos , Neoplasias Esofágicas/cirugía , Anastomosis Quirúrgica/métodos , Carcinoma de Células Escamosas/cirugía , Adenocarcinoma/cirugía , Íleon/cirugía , Íleon/trasplante , Procedimientos de Cirugía Plástica/métodos , Colon/cirugía , Colon/trasplante , Colgajos QuirúrgicosRESUMEN
Metabolic surgery has been on the rise over the last 2 decades. As more literature has been being published regarding its efficacy in treating metabolic syndrome as well as advancements in surgical training and safety rise with it, metabolic surgery will in no doubt continue to increase in prevalence. Concomitantly, the prevalence of esophageal cancer is increasing. We present two cases of patients who are status post sleeve gastrectomy and require esophagectomy. These patients do not have the availability of a gastric conduit, and colon interposition graft was planned for their reconstructions. We here review the two unique case scenarios as well as an overview of colon interposition technique and workup considerations. The need this reconstruction technique will likely increase in the years to come and metabolic surgery and esophageal cancer both continue to rise.
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Cirugía Bariátrica , Neoplasias Esofágicas , Humanos , Esofagectomía/efectos adversos , Esofagectomía/métodos , Neoplasias Esofágicas/cirugía , Estómago , Colon/trasplante , Cirugía Bariátrica/efectos adversosRESUMEN
INTRODUCTION/PURPOSE: Esophageal strictures due to caustic ingestion (CI) may require repeat esophageal dilations and dilation adjuvants, including local anti-fibrinogenic injection therapy, stent placement, and radial stricture incisions. Refractory strictures require surgical intervention. Pedicled colon patch esophagoplasty (CPE) may avoid the morbidity associated with total esophageal replacement, although reports of its use are limited. Indications and outcomes for CPE in patients undergoing repeat esophageal stricture dilations following caustic ingestion are described according to our local experience and literature reports. MATERIALS AND METHODS: A retrospective review of indications for surgical management of esophageal strictures to tertiary pediatric surgical services between 2015 and 2020 focused on patients undergoing CPE. English-language literature (PubMed, Google Scholar, and Scopus) describing CPE was also reviewed. RESULTS: Eight (12%) out of 65 patients with esophageal strictures requiring 7 or more esophageal dilations with poor response underwent surgical stricture management over a 6 year period, which included stricture resection and re-anastomosis in 2 patients, total esophageal replacement with colon graft in 2 patients, gastric pull-up in 1 patient, and CPE in 3 patients. The patients undergoing CPE were aged 3-8 years and had 17 to more than 25 dilations following caustic ingestion over a 2-5 year period. One patient had a 4 cm stricture; the other 2 had strictures 7 cm in length. A transverse colon patch based on the middle and left colic vessels was utilized in all three, with the vascular pedicle placed retrogastrically via the esophageal hiatus and the patch inlay esophagoplasty concluded via right thoracotomy. Post-operative contrast studies showed near-normal anatomy, and the patients could tolerate full oral diets. During a 9-36 month follow-up period, only 2 patients required dilations of a proximal anastomotic stricture at 1 and 5 months postoperatively. One patient required additional proximal stricturoplasty with advancement of the original graft across the stricture via a cervical surgical approach. CONCLUSION: Colon patch esophagoplasty to restore esophageal luminal continuity and allow a normal diet should be considered for refractory esophageal strictures. CPE had excellent functional outcomes in our 3 patients and should be considered in selected cases instead of total esophageal replacement.
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Cáusticos , Estenosis Esofágica , Esofagoplastia , Niño , Humanos , Esofagoplastia/efectos adversos , Estenosis Esofágica/inducido químicamente , Estenosis Esofágica/cirugía , Constricción Patológica/cirugía , Cáusticos/toxicidad , Colon/trasplante , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
The ischemic complications during the isolation of the substituting oesophageal graft placement and after its placement may lead to graft necrosis and to the need to find a different reconstructive procedure. The most frequent reports of graft necroses occur in the days following the reconstruction. We are presenting the case of a 27-y.o. with full dysphagia as a result of caustic stenosis, in whose case the oesophageal reconstruction was abandoned following the irreversible ischemia of the right colic graft during the vascular isolation, followed by right-side hemicolectomy and ileo-transverse anastomosis. 4 years post the ingestion of a caustic substance and 2 years post the right colic graft ischemic necrosis, we performed an oesophageal reconstruction using a pediculated, cervically revascularized, ileo-colic graft on the left colic vessels. The graft's particularity is that is formed from left and transverse colon and ileum portions, including the ileo-transverse anastomosis performed 2 years prior to the oesophageal reconstruction.
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Cáusticos , Cólico , Esofagoplastia , Anastomosis Quirúrgica/métodos , Cólico/cirugía , Colon/trasplante , Esofagoplastia/métodos , Humanos , Íleon/cirugía , Necrosis , Resultado del TratamientoAsunto(s)
Antiinflamatorios/uso terapéutico , Productos Biológicos/uso terapéutico , Colon/trasplante , Rechazo de Injerto/tratamiento farmacológico , Intestino Delgado/trasplante , Células Madre Mesenquimatosas/citología , Síndrome del Intestino Corto/cirugía , Anciano , Humanos , Masculino , Trasplante HomólogoAsunto(s)
Colon/trasplante , Íleon/trasplante , Laringectomía/efectos adversos , Procedimientos de Cirugía Plástica , Complicaciones Posoperatorias/prevención & control , Colgajos Quirúrgicos , Deglución , Humanos , Laringectomía/métodos , Necrosis/prevención & control , Procedimientos de Cirugía Plástica/efectos adversos , Procedimientos de Cirugía Plástica/métodos , Recuperación de la Función , Reproducibilidad de los Resultados , Colgajos Quirúrgicos/irrigación sanguínea , Colgajos Quirúrgicos/trasplante , Trasplante Autólogo/efectos adversos , Trasplante Autólogo/métodos , Calidad de la VozRESUMEN
OBJECTIVES: Describe a novel technique for repair of cervical esophageal discontinuity. STUDY DESIGN: A 66-year-old female underwent hiatal hernia repair with a Nissen fundoplication. This was complicated by ischemic necrosis of the proximal stomach requiring urgent return to the operative suite for partial gastrectomy, esophageal diversion and subsequent esophagectomy repaired with a colonic interposition graft by Thoracic Surgery. This was further complicated by a cervical esophageal colonic anastomotic leak maturing to a cervical esophageal fistula and necessitating jejunostomy tube placement and consultation to Head and Neck Surgery. METHODS: Case report. RESULTS: In a team approach with Otolaryngology and Thoracic Surgery, she underwent a unique, multilevel repair with a salivary bypass stent bridging the gap between the proximal esophagus and distal colonic conduit. Bilateral local advancement flaps were elevated using the skin lateral to the fistula on each side with a random blood supply pedicled medially. Each flap was rotated medially over the stent and imbricated at midline. Next, a left myogenous pectoralis flap was raised and rotated over the site of imbrication. Lastly, a split thickness skin graft from the thigh was harvested and sutured over the pectoralis flap. Three months postoperatively, the salivary bypass stent was removed and by five months, the fistula was completely closed. With cervical esophageal dilations bimonthly, the patient has graduated to an oral diet without need of her jejunostomy tube for nearly four months. CONCLUSION: This case report describes a novel and efficacious solution to cervical esophageal discontinuity.
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Fístula Esofágica/etiología , Fístula Esofágica/cirugía , Esofagectomía/métodos , Esófago/cirugía , Procedimientos de Cirugía Plástica/métodos , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/cirugía , Colgajos Quirúrgicos/trasplante , Procedimientos Quirúrgicos Torácicos/métodos , Anciano , Fuga Anastomótica/etiología , Fuga Anastomótica/cirugía , Colon/cirugía , Colon/trasplante , Femenino , Fundoplicación/efectos adversos , Fundoplicación/métodos , Gastrectomía , Hernia Hiatal/cirugía , Herniorrafia/efectos adversos , Herniorrafia/métodos , Humanos , Yeyunostomía/métodos , Cuello , Necrosis/etiología , Estómago/patología , Estómago/cirugía , Procedimientos Quirúrgicos Torácicos/efectos adversos , Resultado del TratamientoRESUMEN
BACKGROUND: The aim of the study was to analyze the clinical characteristics and outcomes of patients with de novo secondary adenocarcinoma arising in the operatively transposed colon not exposed to the fecal stream. METHODS: Two investigators collected and reviewed papers from June 1938 to June 2019, reporting patients with adenocarcinoma arising in the transposed colon, not in contact with the fecal stream. RESULTS: Overall, we identified 98 patients with a transposed colonic autograft, positioned as conduit but not in contact with the fecal stream, in whom a secondary de novo adenocarcinoma was diagnosed. In 50% of the patients, the secondary adenocarcinoma was diagnosed at an advanced stage, with a subsequent poor clinical outcome. Earlier diagnosis allowed local resection with long term success. The occurrence of the adenocarcinoma appeared to be closely related to aging, and to clinical evidence of chronic inflammation. CONCLUSIONS: Patients in whom the colon has been surgically transposed to different anatomic positions, away from the fecal stream, can develop a secondary colonic adenocarcinoma with. Aging and chronic inflammation seem to be risk factors for a secondary adenocarcinoma more than time from implant. Screening for polyps and adenocarcinomas in these patients should be considered.
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Adenocarcinoma/etiología , Colon/trasplante , Neoplasias del Colon/etiología , Adulto , Anciano , Anciano de 80 o más Años , Heces , Femenino , Gastrectomía , Humanos , Inflamación/complicaciones , Masculino , Persona de Mediana Edad , Factores de Riesgo , Vagina/cirugíaRESUMEN
BACKGROUND: Colon interposition for total esophageal replacement cases represents one of the most challenging procedures in surgery. A retrospective study has been conducted and suggestions are proposed according to the analysis of 268 patients who underwent colon interposition for esophageal replacement. Complication rates and the duration of hospital stay were retrospectively analyzed. METHODS: A total of 268 patients were operated between 1984 and 2018. In group 1, 164 patients underwent colon interposition without supercharging with neck vessels and in group 2, 104 patients underwent colon interposition with supercharging. Data regarding flap loss, anastomotic leakage, the duration of hospital stay, and stricture formation in the long-term were statistically analyzed and compared between two groups. RESULTS: The success rate of reconstruction was 98,1% (161 of 164 patients) and 99% (103 of 104 patients) for group 1 and 2, respectively. Early complication (anastomotic leakage) rate was 4,9% in group 1 and 1% in group 2. The differences between two groups regarding flap loss and anastomotic leakage rates were not statistically significant (pâ¯=â¯0,495 and pâ¯=â¯0,077, respectively). The hospital stay was 26,3 days for patients without supercharging (group1) and 20,5 days for patients with supercharging (group 2). In group 1, 6,7% (11/164) of patients had narrowing at the junction of the pharynx and colon; however, in group 2, proximal anastomotic stricture formation was observed in only 1% (1/104) of the patients. The stricture rate was significantly lower in group 2 when compared to group 1 (pâ¯=â¯0,021). CONCLUSION: The careful dissection of the marginal artery and supercharging with neck vessels provide lower complication rates in colon interposition for esophageal reconstruction.
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Autoinjertos/irrigación sanguínea , Colon/trasplante , Esofagoplastia/efectos adversos , Esofagoplastia/métodos , Esófago/cirugía , Adolescente , Adulto , Anciano , Fuga Anastomótica/etiología , Autoinjertos/patología , Constricción Patológica/etiología , Disección/métodos , Femenino , Supervivencia de Injerto , Humanos , Tiempo de Internación , Masculino , Persona de Mediana Edad , Cuello/irrigación sanguínea , Estudios Retrospectivos , Trasplante Autólogo/efectos adversos , Trasplante Autólogo/métodos , Adulto JovenRESUMEN
When performing esophageal reconstruction, a colonic pedicle graft is chosen as the next candidate to the stomach because of complications arising from the operation time and vascular anastomosis. Vascular anastomosis is not necessarily required for pedicle grafts, but it is necessary to perform additional vascular anastomosis in some cases. We herein report a case of superdrainage in which anastomosis of the colonic vein and the right internal thoracic vein was effective against congestion. A 68-year-old man with thoracic esophageal cancer and pyloric antrum gastric cancer was referred to our hospital. Complete resection was performed with subtotal esophageal resection and total gastrectomy. We added superdrainage (right internal thoracic vein - ileocolic vein) to the colonic pedicle graft, which showed congestion, and performed esophageal reconstruction. Venous superdrainage using a colonic pedicle graft is effective for esophageal reconstruction.
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Anastomosis Quirúrgica/métodos , Colon/cirugía , Colon/trasplante , Neoplasias Esofágicas/cirugía , Esófago/irrigación sanguínea , Esófago/cirugía , Neoplasias Primarias Múltiples/cirugía , Procedimientos de Cirugía Plástica/métodos , Venas/cirugía , Anciano , Colon/irrigación sanguínea , Gastrectomía/métodos , Humanos , Masculino , Neoplasias Gástricas/cirugía , Resultado del TratamientoRESUMEN
INTRODUCTION: The optimal method of esophageal replacement remains controversial. The aim of this study was to evaluate 30-d outcomes of children in the National Surgical Quality Improvement Project Pediatric (NSQIP-P) database who underwent esophageal replacement from 2012 to 2018. METHODS: Demographics, comorbidities, and procedural technique was identified in NSQIP-P and reviewed. Thirty-day outcomes were assessed and stratified by gastric pull-up or tube interposition versus small bowel or colonic interposition. Categorical and continuous variables were assessed by Pearson's chi-square, Fisher's exact, and Wilcoxon rank-sum tests, respectively. Multivariate logistic regression was performed to estimate the effects of procedure technique and clinical risk factors on patient outcomes. RESULTS: Of the 99 cases of esophageal replacement included, 52 (52.5%) utilized a gastric conduit, whereas 47 (47.5%) involved small bowel/colonic esophageal interposition. Overall risk of complications was 52.5%, the most common of which were perioperative transfusion (30.3%), surgical site infection (11.1%), and sepsis (9.1%). Risk of unplanned reoperation was 17.2%, and risk of mortality was 3.0%. Risk for complications, reoperation, and readmission did not differ significantly between those who underwent gastric esophageal replacement and those who underwent small bowel or colonic interposition. Median operative time was shorter in the gastric esophageal replacement group (5.2 versus 8.1 h, P = 0.009). CONCLUSIONS: Among children in NSQIP-P who underwent esophageal replacement from 2012 to 2018, the risk of 30-d complications, unplanned reoperation, and mortality was relatively frequent and was similar across operative techniques. Opportunities exist to improve preoperative optimization, utilization of blood transfusion services, and infectious complications in the perioperative period irrespective of operative technique. LEVEL OF EVIDENCE: Level III, retrospective comparative study.
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Atresia Esofágica/cirugía , Estenosis Esofágica/cirugía , Esofagoplastia/efectos adversos , Complicaciones Posoperatorias/epidemiología , Mejoramiento de la Calidad , Preescolar , Colon/trasplante , Bases de Datos Factuales , Atresia Esofágica/mortalidad , Estenosis Esofágica/etiología , Estenosis Esofágica/mortalidad , Estenosis Esofágica/patología , Esofagoplastia/métodos , Esofagoplastia/estadística & datos numéricos , Esófago/anomalías , Esófago/patología , Esófago/cirugía , Femenino , Mortalidad Hospitalaria , Humanos , Lactante , Intestino Delgado/trasplante , Masculino , Tempo Operativo , Readmisión del Paciente/estadística & datos numéricos , Complicaciones Posoperatorias/etiología , Reoperación/estadística & datos numéricos , Estudios Retrospectivos , Factores de Riesgo , Estómago/trasplante , Resultado del TratamientoRESUMEN
OBJECTIVE: To study the long-term results of reconstructive procedures for esophageal strictures and evaluate quality life after each type of esophageal repair using own criteria. MATERIAL AND METHODS: The study was conducted among patients who underwent esophageal repair with gastric transplant (172), colonic transplant (25), intestinal transplant (14) and repair of short cervical strictures (7). The age of patients ranged from 5 to 60 years. All patients underwent X-ray and endoscopic examination. Survey also included external respiration function and cardiac function, digestive function, measurement of height and weight, analysis of social aspects (work, study), female genital function. Five-score scale for quality of life assessment was developed. RESULTS: Long-term results were studied in 218 patients for the period from 3 months to 31 years (2002-2017). Excellent and good results were obtained in 180 patients. The best results were obtained after repair of short cervical strictures (4.42 scores), good results - after esophageal repair with gastric (4.14 scores) and intestinal (4.07 scores) transplants. Colonic repair was followed by satisfactory outcome (3.16 scores). CONCLUSION: Gastric and small bowel grafts are preferred for total esophageal repair due to better quality of life in long-term postoperative period.
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Colon/trasplante , Estenosis Esofágica/cirugía , Esofagoplastia/métodos , Intestino Delgado/trasplante , Calidad de Vida , Estómago/trasplante , Adolescente , Adulto , Niño , Preescolar , Humanos , Persona de Mediana Edad , Procedimientos de Cirugía Plástica , Resultado del Tratamiento , Adulto JovenRESUMEN
BACKGROUND: Esophageal replacement is a challenge to the therapeutic skills of surgeons and a technically demanding operation in the pediatric age group. Various conduits and routes have been described in the literature, each with their specific advantages and disadvantages. We carried out this retrospective study to share our experience of esophageal replacement. METHODOLOGY: This study was conducted at the department of pediatric surgery The Children's Hospital and The Institute of Child Health, Lahore. The records of patients treated for esophageal replacement were reviewed. The patients under follow-up were called for clinical evaluation and assessed of long terms complications if any. RESULTS: A total of 93 patients with esophageal replacement were included in the study. Esophageal replacement was done with gastric transposition in 84 cases (90%), colon interposition in 7 cases (7.5%) including one case of redo colonic interposition, and jejunal interposition in 2 cases (2%). Routes of esophageal replacement were trans-hiatal in 71 (76%), retrosternal in 13 (14%), and trans-hiatal with thoracotomy in 9 (10%) patients. Postoperatively, all of the conduits maintained viability. Wound infection was seen in 10 (11%), wound dehiscence in 5 (5%), anastomotic leak in 9 (10%), anastomotic stenosis in 12 (13%), fistula formation in 4 (4%), aortic injury 1 (1%), dumping syndrome 8 (9%), reflux 18 (19%), dysphagia 15 (16%) and death occurred in 12 patients (13%). CONCLUSION: There are problems with esophageal replacement in developing countries. In this context, gastric conduit appeared as the best conduit for esophageal replacement, using the trans-hiatal route for replacement, in the authors' experience.
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Colon/trasplante , Esófago/cirugía , Yeyuno/trasplante , Complicaciones Posoperatorias/epidemiología , Adolescente , Afganistán/epidemiología , Niño , Preescolar , Femenino , Estudios de Seguimiento , Humanos , Lactante , Recién Nacido , Masculino , Estudios Retrospectivos , Estómago/cirugíaRESUMEN
INTRODUCTION: Management after total pharyngolaryngectomy with free ileocolon flaps can be challenging. Adequate postoperative surgical guidelines are essential to avoid complications. Factors, such as agitation, hypotension, or prolonged mechanical ventilation, might compromise final outcomes. Herein, we describe our experience in the early postoperative care of patients after total pharyngolaryngectomy with immediate reconstruction using the free ileocolon flap. METHODS: This is a retrospective review of all patients who underwent total pharyngolaryngectomy and immediate reconstruction using the free Ileocolon flap. Demographics, etiology of resection, neoadjuvant therapy, surgical time, method of sedation, postoperative use of vasopressors, length of intensive care unit (ICU) stay, time of discontinuation of mechanical ventilation, and complications were recorded and analyzed. RESULTS: Between 2010 and 2015, a total of 34 patients underwent total pharyngolaryngectomy and immediate reconstruction using the free Ileocolon flap. The most common cause of total pharyngolaryngectomy was cancer. Twenty-eight patients had neoadjuvant therapy (radiation). The average surgical time was 11.5 hours (range, 8-14.5 hours), average length of ICU stay was 3 days (range, 2-15 days) with an average time for mechanical ventilation cessation of 3 days (range, 1-20 days). Midazolam and dexmedetomidine were the most common sedatives used during surgery and in the ICU period. Three patients required vasopressors due to hypotension, 2 had unplanned self-extubation from the tracheostomy site, 2 experienced postoperative bleeding, 1 had pneumonia, 4 required unplanned return to the operating room, 2 had partial flap loss, and 1 had complete flap loss. CONCLUSIONS: Overall, a majority of patients recovered well postoperatively with minimal complications and low rate of reoperation. Our research provides a foundation to develop a risk-stratified approach to determine the need for an ICU admission or early transfer to floor care.
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Colon/trasplante , Colgajos Tisulares Libres , Íleon/trasplante , Neoplasias Laríngeas/cirugía , Laringectomía , Neoplasias Primarias Múltiples/cirugía , Neoplasias Faríngeas/cirugía , Faringectomía , Cuidados Posoperatorios/métodos , Adulto , Femenino , Humanos , Unidades de Cuidados Intensivos , Laringectomía/métodos , Masculino , Persona de Mediana Edad , Faringectomía/métodos , Estudios Retrospectivos , Factores de TiempoAsunto(s)
Aneurisma de la Aorta/cirugía , Disección Aórtica/cirugía , Implantación de Prótesis Vascular , Quemaduras Químicas/cirugía , Colon/trasplante , Esofagectomía , Implantación de Prótesis de Válvulas Cardíacas , Anamnesis , Esternotomía , Disección Aórtica/diagnóstico por imagen , Disección Aórtica/fisiopatología , Aneurisma de la Aorta/diagnóstico por imagen , Aneurisma de la Aorta/fisiopatología , Quemaduras Químicas/etiología , Cáusticos/efectos adversos , Humanos , Lejía/efectos adversos , Masculino , Persona de Mediana Edad , Resultado del TratamientoAsunto(s)
Colon/diagnóstico por imagen , Colon/trasplante , Procedimientos Quirúrgicos del Sistema Digestivo/métodos , Enfermedades del Esófago/etiología , Enfermedades del Esófago/cirugía , Esofagectomía/métodos , Fluorodesoxiglucosa F18 , Mediastino/diagnóstico por imagen , Mediastino/cirugía , Tomografía Computarizada por Tomografía de Emisión de Positrones/métodos , Radiofármacos , Carcinoma de Células Escamosas/etiología , Colon/cirugía , Epidermólisis Ampollosa Distrófica/complicaciones , Humanos , Masculino , Persona de Mediana Edad , Neoplasias Cutáneas/etiologíaRESUMEN
Intestinal transplant recipients experience a high rate of renal complications secondary to dehydration due to increased ostomy output. It is hypothesized that inclusion of donor colon in the intestinal allograft may improve renal function in patients without functional native colon by improving fluid absorption. A single-center retrospective study of intestinal transplant recipients compared outcomes of patients receiving en bloc colon as part an intestinal allograft (ICTx), and those not receiving colon (CCNTx), as well as a control group of intestinal transplant recipients with functional native colon (ITx). Forty-seven patients (ICTx n = 17, CCNTx n = 15, ITx n = 15) were studied. One-year post-transplant renal function, as measured by change in glomerular filtration rate (GFR) and blood urea nitrogen (BUN) from baseline, was superior in ICTx (mean delta-GFR of -1.31 and delta-BUN of -1.46) compared to CCNTx (-6.54 and 17.54, P = 0.05 and P = 0.17, respectively) and similar to the ITx controls (0.55 and 2.09). Recipients of donor colon experienced a higher rate of ileostomy reversal when compared to CCNTx (62.5% vs. 20%, P = 0.0008), which was similar to the ITx controls (60%). These findings support the inclusion of en bloc donor colon in the intestinal allograft for recipients without functional native colon.