Risk acceptance in laryngeal transplantation.
OBJECTIVE
Advancements in the fields of head and neck surgery and immunology have paved the way for new quality of life-improving procedures such as larynx transplantation. To quantitatively assess the risks versus benefits in larynx transplantation, we used a questionnaire-based survey (Louisville Instrument For Transplantation [LIFT]) to measure the degree of risk individuals are willing to accept to receive different types of transplantation procedures.


METHODS
The LIFT contains 237 standardized questions incorporating standard gamble and time tradeoff outcome measures as well as questions assessing body image perception, depression, self-esteem, optimism, socially desirable responding, and demographics. Respondents were questioned on the extent to which they would trade off specific numbers of life-years, or sustain other costs, in exchange for receiving seven different types of transplant procedures. For this study, we questioned 243 individuals in three study populations with differing life experiences: healthy individuals, organ transplant recipients, and laryngectomees.


RESULTS
All populations questioned perceived risks differently based on their varied life experiences and would accept differing degrees of risk for the different transplant procedures. Organ transplant recipients were the most risk-tolerant group, whereas laryngectomees were the least risk-tolerant.


CONCLUSIONS
By questioning individuals with life experiences directly relevant to the risks and benefits associated with larynx transplantation, this study provides an empiric basis for assessing risk versus benefit in this new quality of life-improving procedure.
Reynolds
Christopher C
CC
Department of Surgery, University of Louisville, Louisville, Kentucky, USA.
Martinez
Serge A
SA
Furr
Allen
A
Cunningham
Michael
M
Bumpous
Jeffrey M
JM
Lentsch
Eric J
EJ
Banis
Joseph C
JC
Vasilic
Dalibor
D
Storey
Barckley
B
Wiggins
Osborne
O
Maldonado
Claudio
C
Perez-Abadia
Gustavo
G
Barker
John H
JH
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D001828:Body Image; D003863:Depression / Q000523:psychology; D006084:Graft Rejection / Q000503:physiopathology; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D007825:Laryngectomy / Q000523:psychology; D007830:Larynx / Q000637:transplantation*; D008016:Life Change Events; D008136:Longevity; D008875:Middle Aged; D016377:Organ Transplantation / Q000523:psychology; D011788:Quality of Life; D018570:Risk Assessment; D012309:Risk-Taking; D012649:Self Concept; D012928:Social Desirability; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
D007166:Immunosuppressive Agents