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Endorectal pull-through of transplanted colon as part of intestinal transplantation
1Transplantation Institute, University of Pittsburgh Medical Center.
Insights
This study reports the first use of a transplanted large intestine for a pull-through procedure in two children undergoing intestinal transplantation. Both patients recovered, showing improved rectal function after complex surgeries.
Area of Science:
- Gastroenterology and Hepatology
- Transplant Surgery
Background:
- Two pediatric patients with life-threatening conditions underwent intestinal transplantation.
- One patient received a multivisceral transplant (excluding the liver), while the other had a liver, small bowel, and colon transplant.
Observation:
- The native rectum required resection and replacement with the transplanted allograft in both cases.
- A pull-through technique using the allograft colon was employed to avoid a permanent colostomy.
Findings:
- Both patients experienced challenging early postoperative periods due to the complexity of intestinal transplantation.
- Successful recovery was achieved in both cases, with notable improvement in rectal function.
Implications:
- This marks the first documented use of a transplanted large intestine in a pull-through procedure.
- Demonstrates a novel approach for rectal reconstruction following extensive intestinal transplantation in pediatric patients.
Background:
Two children with life-threatening disorders underwent intestinal transplantation; one multivisceral transplantation excluding the liver, and the second transplantation of the liver, small bowel, and colon.
Methods:
Involvement of the native rectum necessitated resection and replacement with the transplanted allograft. To prevent a permanent colostomy, a pull-through of the allograft colon was performed.
Results:
Both patients had a stormy early postoperative course, mainly because of the complexities of intestinal transplantation, but with eventual recovery, including improvement of rectal function.
Conclusions:
These are the first two known cases in which a transplanted large intestine was used for a pull-through procedure.