Laryngeal and tracheal transplantation: ethical limitations

Over the last decade, there have been extraordinary developments in the field of transplantation science. As a result, organ transplantation enjoys a success that is unparalleled since its introduction nearly 50 years ago. Progress in the laboratory has translated into less toxic, more effective immunosuppressive therapies that have improved both allograft survival and patient quality of life. Consequently, physicians and their patients look toward a new frontier, the transplantation of non-vital organs. While the transplantation of non-vital organs is technically feasible, as demonstrated by the recent success of a human laryngeal transplant, a variety of ethical concerns must be confronted before tracheal and laryngeal transplantation can be offered to patients as a reconstructive option. When considering the risks and benefits of non-vital organ transplantation, one must consider the immeasurable impact of a procedure on the patient s quality of life. The focus of this article is on quality of life and the role of laryngotracheal transplantation in contemporary medicine.