The Laryngoscope V C 2017 The American Laryngological, Rhinological and Otological Society, Inc. Systematic Review The Current Status of Human Laryngeal Transplantation in 2017: A State of the Field Review Giri Krishnan, MBBS; Charles Du, BMSc (Hons); Jonathan M. Fishman, BM BCh (Oxon), MA (Cantab), FRCS (ORL-HNS), DOHNS, PhD; Andrew Foreman, B.Physio, BMBS (Hons), PhD, FRACS; David G. Lott, MD; Gregory Farwell, MD, FACS; Peter Belafsky, MD, PhD; Suren Krishnan, MBBS, FRACS, OAM; Martin A. Birchall, MD, FRCS, FMedSci Objectives: Human laryngeal allotransplantation has long been contemplated as a surgical option following laryngecto- my, but there is a paucity of information regarding the indications, surgical procedure, and patient outcomes. Our objectives were to identify all human laryngeal allotransplants that have been undertaken and reported in the English literature and to evaluate the success of the procedure. Data Sources: MEDLINE, Embase, Current Index to Nursing and Allied Health Literature, Web of Science and Scopus, and the Gray literature. Review Methods: A comprehensive search strategy was undertaken across multiple databases. Inclusion criteria were case reports of patients who had undergone human laryngeal allotransplantation. Information regarding indications, operative techniques, complications, graft viability, and functional outcomes were extracted. Results: A total of 5,961 articles, following removal of duplicates, matched the search criteria and were screened, with five case reports relating to two patients, ultimately fulfilling the entry criteria. Conclusions: Two laryngeal transplants have been reported in the medical literature. Although both patients report improved quality of life relating to their ability to communicate with voice, further research is necessary to shape our under- standing of this complicated operation, its indications, and its functional outcomes. Key Words: Larynx, transplantation, transplant recipients. Laryngoscope, 00:000–000, 2017 INTRODUCTION Effective rehabilitation of patients following total laryngectomy can be difficult with suboptimal speech and swallowing outcomes, as well as significant psycho- social issues associated with the resultant stoma. 1 Human laryngeal allotransplantation has long been con- templated as a therapeutic option for these patients; however, inadequate vocal cord function and a continued reliance on tracheostoma for airway have impeded pro- gress in this field. Subsequently, a shift of emphasis to alternative reconstructive options has occurred. We performed a systematic review on human laryn- geal allotransplantation to give an accurate update on its current clinical status. Our objectives were to identify all human laryngeal allotransplants that have been undertaken and reported in the English literature and to evaluate the success of these. We also aimed to identi- fy and evaluate the extent of research undertaken in this area to understand the direction of future research. METHODS Search Strategy A three-step search strategy was utilized in this review to identify published and unpublished studies on human laryngeal allotransplantation. An initial limited search of MEDLINE was performed using the terms “larynx” and “transplant,” followed by an analysis of the text words contained in the title and abstract, and of the index terms used to describe the article. Further relevant keywords and index terms were devised and used to construct a comprehensive search strategy for each database (see Supporting Information, Appendix I, in the online Additional Supporting Information may be found in the online version of this article. From the Department of Otolaryngology–Head and Neck Surgery (G.K., C.D., A.F ., S.K.), The Royal Adelaide Hospital, Adelaide, South Aus- tralia, Australia; Department of Otolaryngology–Head and Neck Surgery (J.M.F ., M.A.B.), UCL Ear Institute, University College London, London, United Kingdom; Department of Otolaryngology–Head and Neck Sur- gery (D.G.L.), Mayo Clinic, Phoenix, Arizona, U.S.A.; Department of Oto- laryngology, Division of Head and Neck Surgery (G.F ., P .B.), University of California Davis, Sacramento, California, U.S.A. Editor’s Note: This Manuscript was accepted for publication December 28, 2016. This study was conducted at The Royal Adelaide Hospital, Ade- laide, South Australia, Australia. The authors have no funding, financial relationships, or conflicts of interest to disclose. Send correspondence to Giri Krishnan, MBBS, Department of Oto- laryngology–Head and Neck Surgery, Level 5 North Wing, The Royal Adelaide Hospital, Frome Road, Adelaide, SA, 5000 Australia. E-mail: sgirikrishnan@gmail.com DOI: 10.1002/lary.26503 Laryngoscope 00: Month 2017 Krishnan et al.: Human Laryngeal Transplantation in 2017 1