Endorectal pull-through of transplanted colon as part of intestinal transplantation.

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.