当前位置： SCI文献检索 > TRANSPLANTATION PROCEEDINGS期刊下所有文献 > Management of larynx and trachea donors.

Management of larynx and trachea donors.

Abstract：

INTRODUCTION:Laryngeal transplantation is a possibility for patients with irreversible laryngeal disease, such as complex trauma and larynx cancer. The objective of performing this procedure was to solve problems that these patients face with a laryngectomy. The medical literature has reviews about larynx transplantations, but almost nothing about the larynx donor. The following is our experience on management of these donors. MATERIALS AND METHODS:Selection criteria was as follows: (1) 18-50 years old; (2) gender and ABO blood type matched between donor and recipient; (3) No abuse of tobacco, cocaine, and marijuana, (4) tracheal intubation time <3 days; and (5) time in the intensive care unit <7 days. The preservation was simple hypothermia with larynx infusion via the carotid artery with University of Wisconsin solution. RESULTS:Between 2001 and 2006, we managed 25 donors, among whom 12 grafts were discarded. The 13 larynx donors were of average age 27.2 +- 7.9 years and their cause of death was head trauma. Each was of male and 12 were multiorgan donors. Three donors had previous consumption of tobacco and 2 donors of marijuana. There were 2 cases of acute rejection episodes. Graft survival rate at 2 years was 90%. DISCUSSION:These donors may have differences from other multiorgan donors: (1) they do not require strict fluid management; (2) vasoactive agents may be used in higher doses than in organ donors, and (3) the larynx tolerates hemodynamic instability. It was necessary to use some donors who had used addictive substances, showing that some selection criteria may be flexible. There was no conflict between thoracic surgeons and larynx surgeons. The priority always was for life-saving organs. Family consent was sometimes difficult because of the retrieval times and body donor reconstruction. The larynx surgery retrieval demanded an additional 2-5 hours during routine multiorgan donor surgery, and always the family asked about body reconstruction. The body appearance was always preserved.

journal_name

Transplant Proc

journal_title

Transplantation proceedings

authors

Duque E,Duque J,Nieves M,Mejía G,López B,Tintinago L

doi

10.1016/j.transproceed.2007.06.072

subject

Has Abstract

pub_date

2007-09-01 00:00:00

pages

2076-8

issue

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(07)00788-9

journal_volume

pub_type

杂志文章

在线工具

Management of larynx and trachea donors.