2023-11-20 15:38:03
A patient regains her speech thanks to a laryngeal transplant for the first time in France
A woman recently benefited from the first laryngeal transplant in France, in a surgical intervention presented on Monday in Lyon (central east) by a medical team that hopes to soon be able to repeat this rare “achievement” on the global level.
The patient, Karen (49 years old), who was identified only by her first name, had been breathing through a tracheostomy for nearly 20 years, without being able to speak, due to complications related to intubation following a heart attack she suffered in 1996.
A few days following the transplant, which took place on September 2 and 3 in Lyon, Karen was able to say a few words. Since then, she has followed vocal cord, swallowing and breathing rehabilitation sessions with a speech therapist, in the hope of permanently regaining the ability to speak. Her immunosuppressive treatment was increased following the onset of rejection of the transplanted organ, but she was able to return to her home in the south of France on October 26.
Therefore, it was not possible for her to participate in the conference to present the operation on Monday, but she explained in writing that she volunteered 10 years ago to participate in this scientific experiment “to return to normal life.” She wrote: “My daughters never heard me speak,” stressing that she was armed with “courage” and “patience” to face the pain and move forward on the path of re-learning.
Professor Philippe Seroz, Head of the Department of Otolaryngology, Head and Neck Surgery at Croix-Rousse Hospital, also expressed his determination before coordinating this unprecedented transplant in France.
Operation “by chance”
The idea of this surgical intervention arose following the world’s first laryngeal transplant, performed in 1998 in Cleveland, United States, for a man who lost his vocal cords in a motorcycle accident.
The surgeon inquired regarding the matter, but he did not go far, until 2010, when he met “a little by chance” during a conference, a Colombian colleague who repeated this operation without publishing any information regarding it.
Doctor Luis Fernando Tentenago Londoño invited him to the Colombian city of Cali for a week to teach him how to retract the larynx, “which is one of the most complex aspects” because this organ “contains very small nerves, and is supplied with blood vessels by very small intersecting arteries and veins,” according to Professor Siroz.
Over the next decade, he trained with a team of experts, obtained approvals, and began searching for qualified patients. In 2019, he met “Karen.” But the Covid pandemic stopped everything.
Meanwhile, the world’s medical records note two laryngeal transplants, one in California in 2010 and another in Poland in 2015. This number is not large; Because these operations are not given any priority; Laryngeal dysfunction leads to severe disability, but does not pose a threat to patients’ lives.
The uterus and penis
In 2022, the French medical team returned to complete what they started in this field. What remained for him was to find a suitable donor, which for the larynx requires “anatomical characteristics that are completely compatible with the recipient, in terms of gender, weight, height, blood type….”
This happened on September 1st. After the family’s approval, it became possible to begin the surgical intervention, which lasted 27 hours, including regarding 10 hours to remove the larynx and 17 hours to transplant it.
12 surgeons and regarding 50 employees from Lyon University Hospital participated in this operation, the first of its kind in France, under the coordination of Professor Seroz and his colleague Lionel Badet, Head of the Department of Urology and Transplant Surgery at Edouard Hérieux Hospital.
Despite the feeling of “pride” in this medical “heroism”, the French medical team remains cautious. Professor Siroz points out that “it is the patient who will determine whether the operation is successful or not,” noting that it will take 12 to 18 months for motor functions in the larynx to be restored, “which is the appropriate time for nerve regrowth.” So, he will wait until she is “completely healthy” before proceeding with the two other throat transplants, for which he has a budget.
Lyon hospitals previously hosted the first hand transplant in the world in 1998, and the first transplant of both hands, in 2000, at the hands of Professor Jean-Michel Dubernar, one of the pioneers of organ transplantation who died in 2021.
Professor Badey recalls that he participated in this “transplantation adventure” that opens up to new specializations. It is expected that following the arms, forearms and throat, we will witness “uterus and penis transplants” in the future.
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