First Successful Transplant of Larynx

Surgeons at the Cleveland Clinic (OH, USA) have announced the first successful transplant of a human larynx. The operation was performed in 1998 and was reported in the May 31, 2001, issue of The New England Journal of Medicine (www.nejm.org).

The surgeons transplanted the entire pharyngolaryngeal complex, including six tracheal rings and the thyroid and parathyroid glands, into the male recipient. On the third day after the transplant, the patient spoke his first word in 20 years. By 16 months, the patient's voice had increased its natural quality and by 36 months, his voice sounded normal and served all his verbal needs. The patient was reported to be very pleased by the results. After transplantation, the patient had no problems swallowing and experienced only one episode of rejection, which was successfully treated.

Surgeons began planning the procedure a year before the actual transplant took place, addressing four issues they felt were critical to a successful transplant: revascularization, reinnervation, rejection, and the ethics of transplanting an organ not considered to be vital. In rats, laryngeal transplantation showed an almost 100% rate of success. The surgeons used these animal studies to help them determine the best preservative solutions, maximal tolerable period of ischemia, and doses of cyclosporine.




Related Links:
Cleveland Clinic
New England Journal of Medicine