The Colon Club

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.

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.

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.

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

I have never heard of a rectum transplant.

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 ..........

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.

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??

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.

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

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.

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

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.

Recently engineered vaginal transplants have been transplanted. I'd like to think that rectal transplants will happen also.
peanut