Rectum Transplant can it be done?

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rickker20
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Rectum Transplant can it be done?

Postby rickker20 » Mon Jan 24, 2011 12:34 am

You hear about heart and kidney transplants but have there been a Rectum transplant? Can it be done? If you lost your rectum to cancer can you attached one? I think it would be very painfull surgery.
Rectal Cancer 6/09
Stage 1 T2
9 days of 5fu
2 days of Avastin
5 weeks of Radiation
Lar 9/09 failed
Pull thru surgery 10/09
Rectum Removel,38 lymph nodes remove all cancer free
6 weeks of 5fu & Folfox
Bag reversal 6/10 & Port remove
Cancer free

Surroundedbylove
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Re: Rectum Transplant can it be done?

Postby Surroundedbylove » Mon Jan 24, 2011 8:45 am

We effectively have that with colonic j-pouches and ileal j-pouches. These are both replacements for the rectum made out of part of the colon or part of the ileum. However, the issue is the anal sphincter muscles. If the rectal tumor is too low, then the surgeons can't get adequate margins and preserve the anal sphincter muscles. The anal sphincter muscles are basically what give us all control.
Surroundedbylove

Rectal Cancer @ 43, '08
Clinical: T3,N2a,MX (IIIB)
6 wks XELOX & radiation
LAR, colonic j-pouch, & temp ileo '09
Surgical: ypT3,ypN0,ypMX (0 of 20 nodes)
FOLFOX; XELOX
Ileo Takedown '09
SIL Dx 2014 - Rectal T3

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BrownBagger
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Location: Central NYS

Re: Rectum Transplant can it be done?

Postby BrownBagger » Mon Jan 24, 2011 9:33 am

I don't know. Just before my surgeon put me under for my first surgery, he mentioned that he "just finished building a new rectum for another guy." I'm sure he was talking about more than just a j-pouch, which is what he gave me. I probably have a third of my rectum left. I've never heard of a rectal transplant, but I think based on what he said that some kind of total reconstruction surgery is possible.
Eric, 57
Dx: 3/09, Stage 4 RC
Recurrences: (3/lung)
Major Ops: 5/ RFA: 3
Chemo Rounds (career):110
Bicycle miles post-dx 10,477
Motto: Live your life like it's going to be a long one, because it just might, and then you'll be glad you did.

Lee
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Re: Rectum Transplant can it be done?

Postby Lee » Mon Jan 24, 2011 10:33 am

I believe it is possible to recreate a rectum using "parts", but I have not heard of a rectum transplant. I had all of my rectum removed during my surgery, I knew I would be waking ups with a perm colostomy. Sometimes I think it would be nice to "poop" the old fashion way and wonder if something can be done. But also know I probably would not do anything about it. I had serious bathroom issued as a result of radiation, my colostomy gave me my life back and I don't want to go down that path of no rectal control again.

Lee
rectal cancer - April 2004
46 yrs old at diagnoses
stage III C - 6/13 lymph positive
radiation - 6 weeks
surgery - August 2004/hernia repair 2014
permanent colostomy
chemo - FOLFOX
NED - 10 years and counting!

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Terry
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Re: Rectum Transplant can it be done?

Postby Terry » Mon Jan 24, 2011 2:59 pm

I have never heard of a rectum transplant.
DX 7/3/07
Chemo, radiation, 20 mo. chemo, IMRT, cyberknife, 6/11 lobectomy.
1/16 resection perm. colostomy intraop. rad.
PET 2/12 nose, thyroid, liver, lngs
Folfox 3/12
Lord I know You'll keep me here until
you know I cannot suffer any longer!

wifeandmom
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Re: Rectum Transplant can it be done?

Postby wifeandmom » Mon Jan 24, 2011 3:04 pm

I actually asked my surgeon that very question! If I understood him correctly, he said that "rectum transplants" are not done because the area has so much necessary immune activity (lots of lymph nodes? idk --- I didn't ask a lot of questions) that the chance of rejection would be unacceptably high. He said that transplants are usually reserved for life-saving procedures (again, I didn't ask him about things like cornea transplants). I wonder if someday scientists will find a way to "grow" a new rectum from a person's own stem cells ..........
Dx 4/09
Rectal CA T3 N0 M0
Neo-adj. rad/Xelox
Surgery 8/25/09 LAR, temp ileo
Reversal 10/09
Fistula
Surgery 12/21/09 temp ileo
ICU 12/30/09
8 rounds Xelox
Surgery 9/9/10 fix fistula, redo anastomosis
Reversal surgery 12/23/10
Hernia surgery 5/19/11

74bravo
Posts: 43
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Location: Southern Maryland

Re: Rectum Transplant can it be done?

Postby 74bravo » Mon Jan 24, 2011 5:23 pm

I honestly don't think that the ability to regenerate is off in the too distant future. They are working now on printing organs (just a theory right now...but it's a step in the right direction). If you look here http://www.medgadget.com/archives/2005/04/inkjet_printing.html you will see at the least they were working on it. There are some newer links where they are printing skin grafts and the like and being grown in a lab setting http://www.medgadget.com/archives/2010/11/in_situ_skin_bioprinting_for_burn_wounds.html, so I think once they get this worked out that it won't be long before they advance.

weisssoccermom
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Location: Pacific NW

Re: Rectum Transplant can it be done?

Postby weisssoccermom » Mon Jan 24, 2011 7:43 pm

As others have said, I'm not sure why the medical community would even consider researching this question when they have other solutions which are equally viable.

Question Rickker as to your signature.
Were you dxd as a stage I?? I don't understand why, if being dxd stage I, you would get 2 days of Avastin - any Avastin at all for that matter. It's not a drug that is approved or even indicated for stage II much less stage I. Why only 9 days of 5FU??
Why FOLFOX after surgery??
Dx 2006 IIA rectal cancer
6 wks rad/Xeloda
1st attempt transanal excision 11/06
11/17/06 XELOX 1 cycle
5 mths Xeloda only - blood clots 1/07
transanal excision 4/20/07 path-NO CANCER CELLS!
NED now and forever!
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chrisca
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Location: Portland, Oregon

Re: Rectum Transplant can it be done?

Postby chrisca » Mon Jan 04, 2016 5:24 am

It's been a while since you asked, but it appears work is being done:
http://www.realclearscience.com/journal_club/2013/07/16/first_anorectal_transplant_on_human_cadaver_106594.html

It will be a while before anything on a live human though.
DX: 12/2010 rectal cancer age 51
Stage T3N0M0 2 cm from anal verge
neoaduvant rad/chemo Xeloda
Rectal resection
Xeloda round 2
ileostomy reversal 11/2011
Successful adhesion X-lap 8/2013
Ongoing LAR syndrome but NED

ozziej
Posts: 165
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Re: Rectum Transplant can it be done?

Postby ozziej » Mon Jan 04, 2016 7:01 am

I recall reading a couple of months ago about the successful transplantation of a small intestine and I remember thinking that it may not be that long before rectal transplants are a possibility. I'm old enough to remember the first successful heart transplant..who knows? Maybe I will have to amend my organ donor card to exclude my non-existent rectum...
Jan :)
F 56 dx 11/14 Stage 1 RC (post EMR)
No neo-adjuvant or adjuvant chemo/RD
3/15 ULAR (open) temp loop ileo
5/15 ileo reversal
NED and hoping to stay that way!! : )

midlifemom
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Location: NJ

Re: Rectum Transplant can it be done?

Postby midlifemom » Mon Jan 04, 2016 7:29 am

Surroundedbylove wrote:We effectively have that with colonic j-pouches and ileal j-pouches. These are both replacements for the rectum made out of part of the colon or part of the ileum. However, the issue is the anal sphincter muscles. If the rectal tumor is too low, then the surgeons can't get adequate margins and preserve the anal sphincter muscles. The anal sphincter muscles are basically what give us all control.


There is now a device to assist the esophageal sphincter with reflux - wonder it a similar device could be used for anal sphincter?
I cannot paste the link to the article here - technically inept I suppose - butt a Google search on "device to control reflux" will bring it up.
Stage 3 cc - dx Jan '14 at age 53, cea 2.9
t2n2m0, KRAS mutant, MSS
Folfox x12 Feb - Aug 2014
9/2014 - cea 2.4
Nov '14 cea 27.7
2 liver masses
Dec '14 left lobectomy and HAI insertion
Jan '15 starting FUDR and FOLFIRI
Aug '15 dropped fudr, liver clear, adding avastin for lung things. Cea 4.3
Three avastin, no shrinkage yet......

teachpdx
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Location: Portland, OR

Re: Rectum Transplant can it be done?

Postby teachpdx » Sat Jan 09, 2016 7:25 pm

As a rectumless person I would say that comparing a J-pouch to a rectal is not a good analogy in any way shape or form. I miss my rectum. Yes, I can poop. Butt I have very little control over when it comes out. Once I start going it's almost impossible not to yield to the will of my colon. It needs to empty using ONLY gravity - no matter how many trips to the bathroom. THAT does not simulate the rectum at all to the best of my recollection. I would have had many more accidents in my life if not SITTING in a car after already having gone and needed to be somewhere. My gluts are rock solid, and woe to anyone who tries to slow me down on the way to the bathroom when I've reached my destination.

I too have often wondered about a rectal transplant, but the bacteria issue makes a lot of sense. Not exactly a sterile environment :shock:
4/24/12 RC T3N1M0 age 53
5/23-7/2 - 26 chemorad - Xeloda
7/16 Lynch- MSH2
8/28 LAR w/ temp ileo, CR, 0/11,M0, hysterectomy
10/13 6 cycles Xeloda - completed only 1 1/2 due to HFS
3/12/13 - reversal
8/13 NED
6/15 - HFS gone!

plastikos
Posts: 168
Joined: Wed Jan 14, 2015 6:09 am

Re: Rectum Transplant can it be done?

Postby plastikos » Sat Jan 09, 2016 7:45 pm

Organ transplants, including bowel, have been done before. In cancer patients per se I would think one major issue would be the immunosuppression postop. Theoretically any leftover tumor cells could thrive if the immune system were knocked out.
Diagnosed with St. IV Colon Ca, 37, male, Kras wild type, MSI-high
11/2014 Right Hemicolectomy + Liver Resection
12/2014 - 6/2015 FOLFOX + Cetuximab
Liver MRI 2/2015 - Clean
PET-CT 7/2015 - Clean
Liver MRI & PET scan 10/2015 - 2 liver mets
Liver resection 10/2015
Started FOLFIRI 11/2015

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peanut_8
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Location: California Central Coast

Re: Rectum Transplant can it be done?

Postby peanut_8 » Sat Jan 09, 2016 8:50 pm

Recently engineered vaginal transplants have been transplanted. I'd like to think that rectal transplants will happen also.
peanut
Terri aka peanut
diagnosed Jan 14, RC stage 2a, age 56
permanent colostomy
MSS
April 14, 28 chemo/rad with Xeloda
June 14 adjuvant Xeloda 6 rounds
currently NED


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