Transplantation of the Canine Larynx

Abstract

Auto-and allotransplantation of the canine larynx were performed. In the autotrans-plantation experiment, the completely excised larynx was replanted in the former place after 1 or 2 hours preservation. In the allotransplantation experiment, the heparinized donor cadaver was preserved in a hypothermic chamber under perfusion from one side of the common carotid arteries which were damped bilaterally at the upper and lower parts of the diverging portion of the cranial thyroid arteries. Following 24 hours storage in this setting, the larynx was removed and transplanted to the recipient. The vessel anastomosis vas performed on the unilateral common carotid artery and on the lingual, facial and external maxillary veins bilaterally. For the nerve anastomosis, the pedicled nerve muscle graft method was deviced, that is, laryngeal nerve pedicled intrinsic laryngeal muscle block was implanted on the corresponding muscle of the transplanted larynx. Temporary tracheotomy was performed and nutrition, antibiotics and immunosuppressive administration were provided by preliminary gastrostomy during the period of intensive care. Endoscopic observation showed almost normal movement of the vocal cords with normal color and tone in 5 weeks after operation and servived over 2 years in the autotransplanted cases and inwards movement of the vocal cords to the paramedian position at the time of phonation in 8 weeks postoperatively in the allotransplanted cases. Azathioprine and steroid were administrated as the immunosuppressive agent. At present, the longest servival time of animals along with their allotransplanted larynges is 65 days.