In 1987, we initiated a program to explore the potential of laryngeal transplantation. The program addressed four issues critical to successful transplantation: revascularization, reinnervation, rejection, and the ethics of transplanting an organ considered by some to be nonvital. In rats, the rate of success of laryngeal transplantation was nearly 100 percent. In these studies in animals, we classified the histologic features of laryngeal rejection; determined the maximal tolerable period of ischemia; evaluated preservative solutions5; determined doses of cyclosporine,prednisone, and adjunct in vitro radiation8; and studied the use of sirolimus and tacrolimus.
In 1998, we performed a total laryngeal transplantation in a man who had sustained a severe traumatic injury to the larynx and pharynx. We describe the procedure and report the results in detail here.