Structural modifications of the gastric tube transplant were studied during the delayed period after esophagoplasty carried out for benign diseases of the esophagus. Adaptive and pathological reactions manifesting in atrophic and sclerotic changes in the mucosa formed the basis for transplant reorganization. The leading morphological markers were degeneration and hypersecretion of the foveolar epithelium, focal atrophy of the fundal glands with foci of pyloric metaplasia, hypertrophy and fibrosis of the muscle plate, and stromal sclerosis. Abundant polymorphonuclear infiltration of the mucosa with lymphoid follicular hyperplasia were observed in H. pylori contamination of the gastric transplant.