Risk Acceptance and Expectations of Laryngeal Allotransplantation

Abstract

BackgroundLaryngeal 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.MethodsA 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.ResultsAll 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.ConclusionsThis 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.

Risk Acceptance and Expectations of Scalp Allotransplantation

“…The present study found results, which echo findings from other international studies and that from the allotransplantation conducted within South Korea [ 5 6 7 12 ]. Despite differences in transplantation type and study populations, the fact that study results were similar indicates that the most influential factor could be "expectations" of the general public group with the lack of knowledge regarding subject matter.…”

“…Recent studies have reported gaps in the knowledge regarding risk acceptance and expectations for composite tissue allotransplantation between experts and non-experts in a number of countries. In South Korea, similar studies have been conducted to evaluate risk acceptance and expectations for allotransplantation of the face, hands, feet, and larynx [ 5 6 7 ]. However, no such survey study has been performed on scalp allotransplantation within South Korea.…”

The current status of human laryngeal transplantation in 2017: A state of the field review

“…Subjective information from the case reports of the two laryngeal transplant recipients reveal patient‐reported improvement in quality of life, although specific quality of life tools were not used. This has been borne out by previously published studies . The first patient went from being unemployed to working as a motivational speaker.…”

“…These considerations are exemplified in the literature to date, as evidenced by the 12 articles identified in our search that centered on public opinion and expert commentary on laryngeal transplantation ethics. [6][7][8][17][18][19][20][21][22][23][24][25] A survey of laryngectomy patients found a relatively strong feeling that laryngeal transplantation was an acceptable procedure. 20 Another study questioned the desirability of laryngeal transplantation when compared with double hand, heart, and lung transplantation in a group of laryngectomy patients, other solid organ transplant recipients, and healthy subjects, demonstrating that laryngectomees were willing to give up an average of 1.2 years of life for successful laryngeal transplantion.…”

“…This has been borne out by previously published studies. [6][7][8] The first patient went from being unemployed to working as a motivational speaker. His principal improvement in quality of life came from being able to communicate emotion through voice.…”