XXXX laryngeal transplantation: preliminary studies and a new heterotopic allotransplantation model.

@entity1 @entity9472 @entity1667 @entity295 @entity235 @entity205 @entity618
While transplantation of the larynx may eventually be useful in post-laryngectomy reconstruction, three criteria must first be met before @entity1 transplants can be attempted: transplant viability must be high, immunosuppression must be safe and effective and functional recovery of the larynx must occur. To study these first two criteria, a total of 11 @entity235 larynx transplants were performed: 3 autografts, 6 orthotopic allografts and 2 heterotopic allografts. The rationale and technical performance of these different transplant procedures are reviewed in detail. Orthotopic transplant recipients received @entity205 ( @entity9472 ) while the heterotopic allograft recipients received @entity618 and @entity1667 in addition to @entity9472 . Overall, 9 of 11 of the transplants remained viable. In contrast, all 3 autografted animals developed esophageal-cutaneous fistulas; 2 developed @entity295 and were sacrificed on post-operative days (POD) 5 and 28, respectively. The third survived for 91 days and demonstrated a high degree of regeneration in the recurrent and superior laryngeal nerves of the transplant. Orthotopically transplanted @entity235 also had a high morbidity and perioperative mortality (5 of 6 animals). The single "long-term" survivor was treated with @entity9472 alone, but developed complete transplant rejection on POD 33. The two heterotopic transplant recipients had no perioperative morbidity and the combination of @entity9472 , @entity618 and @entity1667 given these latter animals was effective in the long-term prevention of rejection. One of these heterotopic recipients died of @entity295 on POD 68 while the other remained alive and well on POD 168. Our present findings show that currently available microsurgical techniques allow experimental @entity235 laryngeal transplantation to be done with significantly high transplant viability rates. (ABSTRACT TRUNCATED AT 250 WORDS)
