• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.9 no.1
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• pp.59-65
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• 1998

Instead of brilliant advancement of the organ transplantation in the medical fields, laryngeal transplantation still has couple of problems to be solved before trial on human. Among them functional restoration of the implanted larynx is the most important point. Recent advancement in animal model studies showed possibility of solving the main problem. Eighteen cases of canine laryngeal transplantation in mongrel dogs were done in this department. One cranial artery and two external jugular veins were connected. External and internal branches of the superior layngeal nerve and anterior and posterior branches of the recurrent laryngeal nerve were connected individually. Only two dogs have lived longer than 4 weeks(4weeks, and 10 1/2weeks) and they died unfortunately due to asphixia caused by obstruction of the cannula. Thirteen dogs only lived five days through 15 days. The main causes of the failure were obstruction of the connecting vein, pharyngocutaneous fistula and the wound infection. Although the result was not good enough to evaluate the functional restoration of the implanted larynx, the implanted larynges from the two dogs lived longer than minimum criteria of long term survival(4 weeks) were relatively good in shape at the time of autopsy. This program will be continued after renovation of the animal lab. facilities.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.10 no.2
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• pp.102-118
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• 1999

In this study, the author developed a new animal model to examine morphological changes and functional recoveries after vertical hemilaryngeal transplantation in the canine. Seven vertical hemilaryngeal transplantations were carried out in the canine. After preparing the host dog removing right sided hemilarynx, hemilarynx of the donor dog was transplanted by hooking up the arteries, veins, nerves and hypopharyngeal mucosa. Especially, recurrent laryngeal nerve was anastomosed at the branch level(anterior and posterior) respectively. After 7 days, for the first evaluation of the transplantation, four out of seven dogs were considered successful. Three dogs survived more than one month, which is the critical period to evaluate the functional recovery after transplantations. After EMG examination, two dogs(#3, #5 dog) showed some functional recoveries. The five-transplanted hemilarynges were sectioned at the arytenoid cartilage region to examine the morphological changes. The results showed that the transplanted hemilarynx appeared normal as control in #5 dog. In addition, #2 dog showed fairly good condition even though died from asphyxia after 9 days out of transplantation. The other. three dogs(#3, #6, #7) showed various levels of atrophy and disappearance of the muscles and cartilages in their larynges. It can be suggested that this model could contribute an advance to preparing human laryngeal transplantation in the future.

• 대한두경부종양학회:학술대회논문집
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• 2000.05a
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• pp.119-120
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• 2000

• Archives of Plastic Surgery
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• v.41 no.5
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• pp.505-512
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• 2014

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.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.6 no.1
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• pp.39-46
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• 2003

Purpose: In a retrospective study for the pediatric patients who underwent liver transplantation in the past 6 years at Samsung Medical Center, the clinical features of 5 patients with posttransplant lymphoproliferative disorder (PTLD) were analyzed. Methods: Between June 1996 and June 2002, 41 pediatric patients underwent liver transplantation. Seven of them died in the postoperative period. Thirty-five including one patient who died of PTLD were finally reviewed. Patients were divided into two groups: high risk group, EBV naive recipients of EBV-positive grafts; low risk group, the patients other than those in high risk group. The authors reviewed age at operation, immunosuppressive agent, postoperative duration until diagnosis, postoperative duration until EBV seroconversion, presence of treatment against rejection, and presenting symptoms of PTLD. Results: Five of 41 patients (12.2%) developed PTLD. All of them belonged to high risk group, and the incidence of PTLD in high risk group was 31.3% (5/16). The mean age at operation was 10.8 months old and the mean duration between operation and diagnosis for PTLD was 9.8 months. Primary EBV infection developed after a median of 6 months after transplantation. One patient was diagnosed as laryngeal and gastrointestinal PTLD and the other four, gastrointestinal PTLD. The following symptoms and signs were seen in the patients: anemia (100%), hypoalbuminemia (100%), fever (80%), diarrhea (80%), gastrointestinal bleeding (80%), and anorexia (60%). Conclusion: PTLD is one of the major complications after pediatric liver transplantation, especially in the group of high-risk recipients. Anemia, hypoalbuminemia, fever, diarrhea and gastrointestinal bleeding were features that are characteristic of PTLD. The common features of PTLD development were: (i) EBV-positive donors placed into EBV naive recipients, (ii) primary EBV infection about 6 months after transplantation, (iii) young age, about 1 year old at operation, and (iv) the requirement for intensive posttransplant immunosuppression.