Strategic Development of a Larynx and Trachea Transplantation Program: The Mayo Clinic Arizona Experience

Medical advances have enabled the realization of vascularized composite allografts and to date have demonstrated reasonably successful graft survival rates. Larynx and Trachea Transplantation (LT) has long been contemplated as a therapeutic option for severe laryngeal trauma and patients following total laryngectomy. Progress has been limited most likely due to lack of awareness as an option, technical and surgical expertise, limited transplant centers worldwide, need for multidisciplinary engagement from hospital leadership, Otolaryngology, and transplant medicine to build a successful program. As one of the first programs to exist in the United States, we have had to create new pathways, develop new workflows, work with numerous regulatory bodies, educate many people about the need for an LT, and learn many lessons along the way. The objectives of this paper are to help others navigate the complexities of creating a new LT transplant program so that this important treatment option may become more available to patients worldwide. We will provide a checklist for developing an LT program and discuss our experiences with the strategic development of an LT transplant program in an academic medical institution.