The transverse colon was substituted for the stomach in four patients after total gastrectomy for cancer. Three of them are alive after 21 to 23 years. They are in good condition and fully active. In six patients the esophagus was resected and the colon was interposed transthoracically. Two patients survive 13 to 15 years later. Carcinoma of the urinary bladder was resected three times and colon substituted. In a case of total vaginal aplasia, sigmoid colon was substituted for the vagina. The patient is alive after 17 years and has a normal sexual life. Sixteen patients have had colon transplantations to replace various organs. Seven of them are alive. The average time of survival thus far is 19 years.