Immunosuppressive protocols after laryngeal transplantation: a systematic review.

Acta Otolaryngol

Department of Otolaryngology‑Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Université Paris Saclay), Montigny‑le‑Bretonneux, France.

Published: March 2024

Backgrounds: Larynx transplantation has been successfully performed four times, in 1998, 2010, 2015 and 2023 remained the ultimate goal of voice, feeding and breathing rehabilitation.

Objective: Immunosuppressive protocols used during the previous successful larynx allotransplantation are detailed.

Material And Methods: A systematic review of the literature on PUBMED/Medline, Cochrane and Embase was conducted. Articles relating to actual human larynx transplantations were included.

Results: Bibliography search gathered  = 10 publications related to the performance and follow-up of human laryngeal transplantations.  = 8 publications were included corresponding to  = 3 actual human larynx transplantations performed in 1998 and 2010 in the USA and in 2015 in Poland. Immunosuppression protocols, induction and maintenance strategies, rejection monitoring and history of all the three previous laryngeal grafts were detailed.

Conclusions: Beyond the surgical prowess, larynx transplantation is feasible and associated with a reasonably successful outcome when compared to other solid organ transplants. Immunosuppressive regimen protocols and technologies for the monitoring of the organ viability have evolved.

Significance: The reevaluation of this surgical option serves as the reminder of the critical necessity to implement a meticulous immunosuppression protocol when transplanting this inherently immunogenic composite organ, the larynx.

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http://dx.doi.org/10.1080/00016489.2024.2339341DOI Listing

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