【Commentary】On June 6, West China Hospital of Sichuan University held a press conference on "Asia's first laryngeal transplant". It is reported that the team of Professor Chen Fei of the Department of Otolaryngology-Head and Neck Surgery of the hospital recently successfully performed allogeneic laryngeal-trachea-thyroid transplantation for a 5-year-old man whose laryngeal cancer recurred after surgery. This is the first allogeneic laryngeal-tracheal-thyroid transplant in Asia.

It is understood that 9 years ago, Mr. Zhou faced the risk of total laryngectomy. Such patients will lose normal laryngeal structure, tracheal ventilation, and vocalization, severely affecting the ability to breathe, swallow, and communicate. In the past, such patients could only communicate simply by using artificial larynx, electronic larynx, etc. With the advancement and innovation of medical technology, through the transplantation of healthy laryngeal tissues and organs, the patient's laryngeal structure and vocal function will be preserved, and the patient's quality of life will be guaranteed.

Chen Fei introduced that unlike the relatively mature liver, kidney, heart and lung transplantation, laryngeal transplantation surgery is difficult and complicated. To date, there have been only three well-reported successful throat transplants globally (2 in the USA and 1 in Poland).

Chen Fei, Professor of Otorhinolaryngology, Head and Neck Surgery, West China Hospital, Sichuan University

Laryngeal transplantation has many particularities, the first is that the donor of the larynx is relatively scarce, and the second is that this operation is very difficult, and this operation involves many very small nerves and blood vessels. There is also the problem of perfusion of the larynx (donor) after leaving the body, and then because the operation time is relatively long, it is related to whether there will be rejection of later transplantation and other problems. The larynx is a multi-tissue organ, (larynx) it is not like our liver and kidneys, it (is) a single tissue, (larynx) how it prevents rejection problems, there is no mature experience in this area. The bacterial spectrum of the donor and the bacterial spectrum of the recipient are different, so there may be infection after transplantation, and the infection is a hurdle that everyone must pass, which is also very troublesome.

【Explanation】In the face of difficult challenges, Professor Chen Fei's team carried out a series of matching and preoperative preparations, and repeated discussions between multiple disciplines to determine the surgical plan. The operation anastomosed 6 blood vessels and 4 nerves, and the whole process took 9 hours. Compared with the world's first laryngeal transplant, the operation took much shorter time and greatly ensured the success rate of donor laryngeal-trachea-thyroid transplantation.

Chen Fei, Professor of Otorhinolaryngology, Head and Neck Surgery, West China Hospital, Sichuan University

We started the transplant at 13:07 and completed it at 16:04, which means that in 3 hours and 3 minutes, we completed the reconstruction of 6 small blood vessels and 4 nerves, so our speed is relatively fast.

【Commentary】At present, Mr. Zhou has been able to breathe, pronounce and cough up sputum smoothly through the mouth, and the indicators are stable and recovering well. After 3 months to 6 months, Mr. Chow's swallowing, breathing and articulation functions will return to their optimal state.

【Contemporaneous】Patient Mr. Zhou

I thank West China Hospital for giving me a second life, thank you.

Chen Fei said that the operation broke through the technical bottleneck, and the valuable experience summarized will also provide new options for more such patients who need to improve their quality of life.

Chen Fei, Professor of Otorhinolaryngology, Head and Neck Surgery, West China Hospital, Sichuan University

This surgery was previously unable to be carried out due to the limitations of the conditions, but now that we have broken through this bottleneck, we have a very useful path for patients who need to improve their quality of life. Theoretically, as long as the patient has this demand, we can technically reach maturity, we can do this operation.

He Meikun reported from Chengdu, Sichuan

Responsible Editor: [Li Ji]