Inclusion of the colon in intestinal transplantation.

PURPOSE OF REVIEW: Inclusion of the colon as a component of an intestinal graft has evolved over the past two decades. Initially thought to be hazardous and abandoned by many centers, colon inclusion has now proven to be an integral component of the intestinal transplant graft.The purpose of this review is to summarize the history of colon inclusion, the physiology of the colon, surgical techniques of colon inclusion, and outcome data.

RECENT FINDINGS: Recent studies at centers of excellence report the efficacy and safety of colon inclusion in intestinal transplantation. Quality-of-life indicators, stool patterns, fecal continence, and parenteral nutrition weaning were noted to be improved in recipients of colonic inclusion. Complex intestinal transplant case series were reported with no adverse effects of colon inclusion.

SUMMARY: Colon inclusion provides a necessary function in intestinal transplantation by taking advantages of its physiologic functions of water absorption, residue breakdown, and storage. Current clinical evidence supports the efficacy of selective and cautious use of the colon in intestinal transplantation.