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Larynx Transplant

Arthur Caplan, Duncan Purves
A quiet revolution is occurring in the field of transplantation. Traditionally, transplants have involved solid organs such as the kidney, heart and liver which are transplanted to prevent recipients from dying. Now transplants are being done of the face, hand, uterus, penis and larynx that aim at improving a recipient's quality of life. The shift away from saving lives to seeking to make them better requires a shift in the ethical thinking that has long formed the foundation of organ transplantation. The addition of new forms of transplants requires doctors, patients, regulators and the public to rethink the risk and benefit ratio represented by trade-offs between saving life, extending life and risking the loss of life to achieve improvements in the quality of life...
April 19, 2017: Journal of Medical Ethics
Nick J I Hamilton, Martin A Birchall
PURPOSE OF REVIEW: This article reviews the latest developments in tissue engineering for the larynx with a specific focus on the treatment of laryngeal cancer. RECENT FINDINGS: Challenges in tissue engineering a total larynx can be divided into scaffold design, methods of re-mucosalization, and how to restore laryngeal function. The literature described a range of methods to deliver a laryngeal scaffold including examples of synthetic, biomimetic, and biological scaffolds...
2017: Current Otorhinolaryngology Reports
Deepa Devadas, Minnie Pillay, Tintu Thottiyil Sukumaran
The superior laryngeal artery is the principal artery supplying the laryngeal mucosa, musculature, and glands. Knowledge of variations in the origin of superior laryngeal artery could prove to be very useful during reconstructive surgeries of the larynx, partial laryngectomy, laryngeal transplantation, and also during procedures like super-selective intra-arterial chemotherapy for laryngeal and hypolaryngeal cancers. However, relatively few studies have been done on the superior laryngeal artery in comparison to its clinical importance...
December 2016: Anatomy & Cell Biology
Thibaut Raguin, Agnès Dupret-Bories, Christian Debry
Research has been fighting against organ failure and shortage of donations by supplying artificial organs for many years. With the raise of new technologies, tissue engineering and regenerative medicine, many organs can benefit of an artificial equivalent: thanks to retinal implants some blind people can visualize stimuli, an artificial heart can be proposed in case of cardiac failure while awaiting for a heart transplant, artificial larynx enables laryngectomy patients to an almost normal life, while the diabetic can get a glycemic self-regulation controlled by smartphones with an artificial device...
January 2017: Médecine Sciences: M/S
M Molitor
Transplantation in reconstructive surgery has been performed for more than 20 years, although the official beginning of these procedures is considered the first successful transplantation of the hand in 1998. The original name "Composite Tissue Transplantation" has been used less frequently; more common is the term "Vascularized Composite Allotransplant", which better describes the basis of the procedure. There have been so far approximately 180 transplantations performed, the exact number is difficult to find...
December 0: Acta Chirurgiae Plasticae
Maria Hortlund, Laila Sara Arroyo Mühr, Hans Storm, Gerda Engholm, Joakim Dillner, Davit Bzhalava
Immunosuppression involves an inability to control virus infections and increased incidence of virus-associated cancers. Some cancers without known viral etiology are also increased, but data on exactly which cancer forms are increased has been inconsistent. To provide a reliable and generalizable estimate, with high statistical power and long follow-up time, we assessed cancer risks using comprehensive, population-based registries in two different countries and from two different immunosuppressed patient groups (solid organ transplant recipients (OTRs) and long-term dialysis patients (LDPs))...
March 1, 2017: International Journal of Cancer. Journal International du Cancer
Parthak Prodhan, Amit Agarwal, Nahed O ElHassan, Elijah H Bolin, Brandon Beam, Xiomara Garcia, Michael Gaies, Xinyu Tang
BACKGROUND: Less than 2.7% of infants undergoing congenital heart disease operations have difficulty weaning from invasive mechanical ventilation. In such instances, clinicians may choose to perform tracheostomy. Limited literature has examined tracheostomy placement specifically in infants with hypoplastic left heart syndrome (HLHS). This study evaluated the risk factors for tracheostomy placement in infants with HLHS and examined the outcomes of these infants before their first hospital discharge...
April 2017: Annals of Thoracic Surgery
Anil Gungor, Lindsey Pennington, Senthil Sankararaman, Samer Zaid-Kaylani, Majed Aldin Jeroudi
Nasal type extranodal natural killer/T-cell lymphoma (ENKTL) is a rare lymphoma in the USA and Europe but endemic in East Asia and in areas of South and Central America. Clinically natural killer cell lymphomas are divided into three categories; nasal, non-nasal and aggressive lymphoma/leukemia subtypes. ENKTL, nasal type occurs in the nose and can extend to the upper aero-digestive tract as reported in this longitudinal case study. This is a longitudinal report of progress of a 14-year-old boy with ENKTL originating in the nasal cavity with subsequent extension and recurrence in the contralateral nose, nasopharynx, larynx and trachea presenting with varying degrees of respiratory problems and eventually, respiratory distress...
November 2016: American Journal of Otolaryngology
Allison F O'Neill, Eelam A Adil, Alexandria L Irace, Laura Neff, Ian J Davis, Antonio R Perez-Atayde, Stephan D Voss, Olga Weinberg, Reza Rahbar
OBJECTIVE: Post-transplant lymphoproliferative disorder (PTLD) is a rare complication of immunosuppression with little consensus on its evaluation and management. The purpose of this contemporary review is to describe a pediatric patient with PTLD of the airway and review the literature to provide multidisciplinary recommendations regarding management. DATA SOURCES: Retrospective chart and literature review. REVIEW METHODS: A pediatric patient with PTLD of the airway is described...
July 2016: International Journal of Pediatric Otorhinolaryngology
Christopher Johnson, Priyanka Sheshadri, Jessica M Ketchum, Lokesh K Narayanan, Paul M Weinberger, Rohan A Shirwaiker
Infection or damage to the trachea, a thin walled and cartilage reinforced conduit that connects the pharynx and larynx to the lungs, leads to serious respiratory medical conditions which can often prove fatal. Current clinical strategies for complex tracheal reconstruction are of limited availability and efficacy, but tissue engineering and regenerative medicine approaches may provide viable alternatives. In this study, we have developed a new "hybrid graft" approach that utilizes decellularized tracheal tissue along with a resorbable polymer scaffold, and holds promise for potential clinical applications...
June 2016: Journal of the Mechanical Behavior of Biomedical Materials
Alberto Bonetta, Laura Bandera, Giandomenico Roviello, Ines Cafaro, Alberto Bottini, Daniele Generali
The oncological treatment for advanced stage head and neck cancer is based on a combination of cisplatin and cetuximab, and radiotherapy. However, very few data are available on this multimodal approach for this type of cancer in pancreas and renal recipients. We report the case of a pancreas and renal recipient being treated with combined chemoradiotherapy for a locally advanced squamous cancer of the larynx. The patient was under treatment with ciclosporin-based immunosuppressive therapy at the time of cancer diagnosis, which was then replaced by everolimus...
June 2016: Anti-cancer Drugs
Nicola Williams
In recent years much research has been undertaken regarding the feasibility of the human uterine transplant (UTx) as a treatment for absolute uterine factor infertility (AUFI). Should it reach clinical application this procedure would allow such individuals what is often a much-desired opportunity to become not only social mothers (via adoption or traditional surrogacy arrangements), or genetic and social mothers (through gestational surrogacy) but mothers in a social, genetic and gestational sense. Like many experimental transplantation procedures such as face, hand, corneal and larynx transplants, UTx as a therapeutic option falls firmly into the camp of the quality of life (QOL) transplant, undertaken with the aim, not to save a life, but to enrich one...
July 2016: Bioethics
Zurab Kakabadze, Konstantine Mardaleishvili, George Loladze, Ivane Javakhishvili, Konstantine Chakhunasvili, Lika Karalashvili, Natia Sukhitashvili, Gocha Chutkerashvili, Ann Kakabadze, David Chakhunasvili
BACKGROUND AND OBJECTIVES: Squamous cell carcinoma is the most common pathological type among the cancers of the larynx. Standard treatment for squamous cell carcinoma of the larynx is the combination of chemotherapy, radiotherapy, and laryngectomy. Pharyngocutaneous fistula is a common complication of laryngectomy. We hypothesized that decellularized and lyophilized human amnion/chorion membrane can be an effective, non-invasive method of treating pharyngocutaneous fistula. METHODS: A total of 67 patients with laryngeal squamous cell carcinoma were retrospectively analyzed after treatment in a prospective trial...
April 2016: Journal of Surgical Oncology
Maria Siemionow
Over the past 20 years, the fields of biomaterial sciences and tissue engineering have evolved into new clinically relevant applications including regenerative medicine and cell based therapies. Tissue engineering therapies are based on different types of materials and scaffolds combined with cells and submitted to engineering processes in order to create bio-scaffolds which will improve or replace biological functions. Despite the effort, only a few therapies, such as bone, cartilage and nerve, succeeded in clinical applications...
December 2015: Journal of Materials Science. Materials in Medicine
Pierluca Piselli, Patrizia Burra, Augusto Lauro, Umberto Baccarani, Giuseppe M Ettorre, Giovanni B Vizzini, Maria Rendina, Massimo Rossi, Giuseppe Tisone, Fausto Zamboni, Ilaria Bortoluzzi, Antonio D Pinna, Andrea Risaliti, Laura Galatioto, Giovanni Vennarecci, Alfredo Di Leo, Francesco Nudo, Daniele Sforza, Giovanni Fantola, Claudia Cimaglia, Diana Verdirosi, Saverio Virdone, Diego Serraino
This study quantified the risk of head and neck (HN) and esophageal cancers in 2770 Italian liver transplant (LT) recipients. A total of 186 post-transplant cancers were diagnosed-including 32 cases of HN cancers and nine cases of esophageal carcinoma. The 10-year cumulative risk for HN and esophageal carcinoma was 2.59%. Overall, HN cancers were nearly fivefold more frequent in LT recipients than expected (standardized incidence ratios - SIR=4.7, 95% CI: 3.2-6.6), while esophageal carcinoma was ninefold more frequent (SIR=9...
July 2015: Transplant International: Official Journal of the European Society for Organ Transplantation
N Scott Howard, Abie H Mendelsohn, Gerald S Berke
OBJECTIVES/HYPOTHESIS: The direct study of human phonation is limited by the invasive and painful nature of human laryngeal neuromuscular manipulation. As a platform for the study of human phonation, indirect models have been utilized for decades such as animal, cadaveric, and computational. We sought to develop a research method allowing direct scientific control of virtually living larynges to expand our ability to understand human phonation. STUDY DESIGN: Canine and porcine models...
June 2015: Laryngoscope
Olivier Fain, Arsène Mekinian, Delphine Gobert, Cam-Anh Khau, Nicolas Javaud
Angiotensin Converting Enzyme inhibitors (ACE-I) use is a frequent cause of AE and must be suspected systematically in all patients with AE. The risk of AE is increased in: black people, transplanted patients, those who take gliptins or immunosuppressants (mTOR i). Angiotensin converting enzyme inhibitors induced angioedema (ACE-I AE) can occur a few days to several years after the beginning of this treatment and persist a few months after stopping it. ACE-I AE affect mainly the face and particularly the tongue but also the abdomen...
January 2015: La Presse Médicale
David G Lott, Jeffrey R Janus
Tissue regeneration in otorhinolaryngology-head and neck surgery is a diverse area filled with specialized tissues and functions. Head and neck structures govern many of the 5 senses, swallowing, breathing, communication, facial animation, and aesthetics. Loss of these functions can have a severe negative effect on patient quality of life. Regenerative medicine techniques have the potential to restore these functions while minimizing the risks associated with traditional reconstruction techniques. This article serves as a review and update on some of the regenerative medicine research in this field...
December 2014: Mayo Clinic Proceedings
Hyun Kyo Jo, Jang Wan Park, Jae Ha Hwang, Kwang Seog Kim, Sam Yong Lee, Jun Ho Shin
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...
September 2014: Archives of Plastic Surgery
Jonathan M Fishman, Katherine Wiles, Mark W Lowdell, Paolo De Coppi, Martin J Elliott, Anthony Atala, Martin A Birchall
INTRODUCTION: Prosthetic materials, autologous tissues, cryopreserved homografts and allogeneic tissues have thus far proven unsuccessful in providing long-term functional solutions to extensive upper airway disease and damage. Research is therefore focusing on the rapidly expanding fields of regenerative medicine and tissue engineering in order to provide stem cell-based constructs for airway reconstruction, substitution and/or regeneration. AREAS COVERED: Advances in stem cell technology, biomaterials and growth factor interactions have been instrumental in guiding optimization of tissue-engineered airways, leading to several first-in-man studies investigating stem cell-based tissue-engineered tracheal transplants in patients...
October 2014: Expert Opinion on Biological Therapy
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