Laryngeal transplantation, I

Laryngeal transplantation has the potential to restore voice, breathing, and swallowing in patients with severe laryngeal dysfunction. Following the first successful human composite laryngeal transplant in 1998, significant advancements have been made in an effort to expand the applicability of laryngeal transplantation to a larger cohort of patients. The main areas of focus have included efforts to reduce or bypass the need for immunosuppression and to establish volitional control of the laryngeal musculature through reinnervation or pacing techniques. This chapter details the world's first human composite laryngeal transplantation, describes the lessons learned until its explantation almost 15 years later, and highlights the subsequent composite laryngeal transplantations. We also summarize many of the major studies and findings that have furthered the science and have contributed to the goal of 1 day transplanting a fully functional larynx without the accompanying detrimental effects of immunosuppression.