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Risk Acceptance and Expectations of Laryngeal Allotransplantation

  • Jo, Hyun Kyo (Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School) ;
  • Park, Jang Wan (Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School) ;
  • Hwang, Jae Ha (Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School) ;
  • Kim, Kwang Seog (Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School) ;
  • Lee, Sam Yong (Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School) ;
  • Shin, Jun Ho (Department of Preventive Medicine, Chonnam National University Medical School)
  • Received : 2014.03.26
  • Accepted : 2014.06.14
  • Published : 2014.09.15

Abstract

Background Laryngeal allotransplantation (LA) is a technique involving transplantation of a deceased donor's larynx into a recipient, and it may be substituted for conventional laryngeal reconstruction. There are widely different views on LA, as the recipient is administered continuous, potentially life-threatening, immunosuppressive therapy for a functional or aesthetic result, which is not directly related to life extension. The purpose of this study was to analyze the difference in risk acceptance and expectations of LA between four population groups. Methods A survey was performed to examine patients' risk acceptance and expectations of LA. The survey included 287 subjects in total (general public, n=100; kidney transplant recipients, n=53; post-laryngectomy patients, n=34; doctors, n=100), using a Korean translated version of the louisville instrument for transplantation (LIFT) questionnaire. Results All four groups responded differently at various levels of their perception in risk acceptance and expectations. The kidney transplant recipients reported the highest risk acceptance and expectations, and the doctor group the lowest. Conclusions This study examined the disparate perception between specific population groups of the risks and benefits of using LA for the promotion of the quality of life. By addressing the information gaps about LA in the different populations that have been highlighted from this survey, we suggest that LA can become a more viable alternative to classical surgery with resultant improved quality of life for patients.

Keywords

References

  1. McNeil BJ, Weichselbaum R, Pauker SG. Speech and survival: tradeoffs between quality and quantity of life in laryngeal cancer. N Engl J Med 1981;305:982-7. https://doi.org/10.1056/NEJM198110223051704
  2. Work WP, Boles R. Larynx: replantation in the dog. Arch Otolaryngol 1965;82:401-2. https://doi.org/10.1001/archotol.1965.00760010403012
  3. Ogura JH, Kawasaki M, Takenouchi S, et al. Replantation and transplantation of the canine larynx. Ann Otol Rhinol Laryngol 1966;75:295-312. https://doi.org/10.1177/000348946607500202
  4. Silver CE, Rosen RG, Dardik I, et al. Transplantation of the canine larynx. Ann Surg 1970;172:142-50.
  5. Kluyskens P, Ringoir S. Follow-up of a human larynx transplantation. Laryngoscope 1970;80:1244-50. https://doi.org/10.1288/00005537-197008000-00006
  6. Strome M, Stein J, Esclamado R, et al. Laryngeal transplantation and 40-month follow-up. N Engl J Med 2001;344:1676-9. https://doi.org/10.1056/NEJM200105313442204
  7. Tintinago LF, Herrera DA, Medina E, et al. Ultrasonographic evaluation of a vascularized tracheal transplantation. J Ultrasound Med 2005;24:1145-9. https://doi.org/10.7863/jum.2005.24.8.1145
  8. Duque E, Duque J, Nieves M, et al. Management of larynx and trachea donors. Transplant Proc 2007;39:2076-8. https://doi.org/10.1016/j.transproceed.2007.06.072
  9. Lorenz RR, Hicks DM, Shields RW Jr, et al. Laryngeal nerve function after total laryngeal transplantation. Otolaryngol Head Neck Surg 2004;131:1016-8. https://doi.org/10.1016/j.otohns.2004.02.034
  10. Birchall MA, Lorenz RR, Berke GS, et al. Laryngeal transplantation in 2005: a review. Am J Transplant 2006;6:20-6. https://doi.org/10.1111/j.1600-6143.2005.01144.x
  11. Khariwala SS, Lorenz RR, Strome M. Laryngeal transplantation: research, clinical experience, and future goals. Semin Plast Surg 2007;21:234-41. https://doi.org/10.1055/s-2007-991193
  12. Tobin GR, Breidenbach WC 3rd, Ildstad ST, et al. The history of human composite tissue allotransplantation. Transplant Proc 2009;41:466-71. https://doi.org/10.1016/j.transproceed.2009.01.026
  13. Barker JH, Vossen M, Banis JC Jr. The technical, immunological and ethical feasibility of face transplantation. J Surg 2004;2:8-12. https://doi.org/10.1016/S1743-9191(06)60016-2
  14. Shapiro PA, Kornfeld DS. Psychiatric aspects of head and neck cancer surgery. Psychiatr Clin North Am 1987;10:87-100.
  15. Cunningham M, Majzoub R, Brouha PR, et al. Risk acceptance in composite tissue allotranplantation reconstructive procedures. Eur J Trauma 2004;30:12-6. https://doi.org/10.1007/s00068-004-1369-x
  16. Brouha P, Naidu D, Cunningham M, et al. Risk acceptance in composite-tissue allotransplantation reconstructive procedures. Microsurgery 2006;26:144-9. https://doi.org/10.1002/micr.20227
  17. Barker JH, Furr A, Cunningham M, et al. Investigation of risk acceptance in facial transplantation. Plast Reconstr Surg 2006;118:663-70. https://doi.org/10.1097/01.prs.0000233202.98336.8c
  18. Reynolds CC, Martinez SA, Furr A, et al. Risk acceptance in laryngeal transplantation. Laryngoscope 2006;116:1770-5. https://doi.org/10.1097/01.mlg.0000231309.85984.69
  19. Park SR, Kim JH, Hwang JH, et al. Investigation of risk acceptance and expectations in facial allotransplantation. J Korean Soc Plast Reconstr Surg 2010;37:555-60.
  20. Lee DH, Kim JH, Hwang JH, et al. Investigation of risk acceptance and expectations in hand and foot allotransplantations. J Korean Soc Plast Reconstr Surg 2011;38:427-37.
  21. Kim HM, Kim JH, Hwang JH, et al. Evaluation of reliability and validity of the louisville instrument for transplantation (LIFT) in Korean population. J Korean Soc Plast Reconstr Surg 2011;38:245-50.

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