Editor's note:

In response to the Belt and Road Initiative, and with the aim of sharing expertise and addressing shared health challenges, our hospital has launched the Overseas Promotion Program for New Medical Technologies. If you are interested in any of the medical technologies covered under this program, please feel free to contact the International Cooperation Office at faowch@163.com.

Larynx-Trachea-Thyroid Composite Allotransplantation

Introduction

Performed for the first time in Asia by Professor Fei Chen’s team at West China Hospital in April 2023, Larynx-Trachea-Thyroid Composite Allotransplantation (LTTA) is a pinnacle procedure designed to restore the upper aerodigestive tract in patients with devastating neck defects. It involves transplanting a viable larynx, trachea, and thyroid gland as an integrated functional unit from a donor. This single-stage, life-restoring surgery aims to reestablish the core functions of larynx: respiration through the native airway, natural phonation, smooth swallowing， and endogenous endocrine production, liberating patients from permanent tracheostoma and lifelong hormone dependence.

Clinical Application Effects and Innovation Points

Clinical Application Effects:

Building upon the inaugural success, our team has now successfully completed 7 cases. The outcomes consistently demonstrate robust graft viability and significant functional recovery across all recipients:

•      Reliable Graft Survival: Most of the transplanted complexes have maintained excellent blood supply with no graft loss, a testament to refined microsurgical technique and post-operative management.

•      Multifunctional Restoration: Patients have achieved normal nasal breathing, regained intelligible speech through progressive neural reinnervation, and established stable thyroid function without supplemental hormones.

•      Improved Swallowing: The majority of recipients have transitioned safely from tube feeding to oral intake, a critical milestone in quality of life.

Key Innovation Points:

•      Progressive Technical Evolution: Our work represents a significant evolution from the initial case. We have pioneered the expansion to a comprehensive multi-organ cluster allotransplantation, strategically incorporating adjacent structures like the hypopharynx, cervical esophagus, and parathyroid glands. This approach enables a more anatomical and functional reconstruction for the most complex defects.

•      Holistic Functional Outcomes: This expanded protocol directly translates to superior patient outcomes, including enhanced swallowing efficiency and stable calcium metabolism, thereby delivering a more complete restoration of quality of life.

•      Standardized Protocol: Our cumulative experience with 7 cases has allowed us to establish and refine standardized protocols for donor procurement, Surgical Procedure，immunosuppression, and rehabilitation, enhancing the procedure's reproducibility and safety.

Promotion Value

This program is a flagship demonstration of world-leading surgical innovation at West China Hospital. The successful execution of 7 cases, beginning with a national milestone, provides irrefutable evidence of our mastery in managing the utmost complexities of composite tissue transplantation. It offers a definitive curative solution for head neck tumor patients with no other options, making it exceptionally compelling for international referral. This technology not only attracts the most complex global cases but also firmly establishes our center as an international hub for academic collaboration and advanced surgical training in head and neck reconstruction.