Successful larynx transplant for Californian woman

By Dr. Ananya Mandal, MDJan 20 2011

In a breakthrough, a surgical team in California on Thursday announced that they had successfully replaced the larynx of a 52-year-old woman who hadn’t been able to speak or breathe on her own for more than a decade.

Brenda Jensen, a lifelong diabetes sufferer, lost her voice after she was hospitalized in 1998 for kidney failure. Under sedation, she repeatedly ripped out her ventilation tube, causing permanent damage to her larynx. She is the second person in the world to get a larynx transplant. She underwent an 18-hour surgery last October at the University of California, Davis, Medical Center. The surgical team removed Jensen’s voice box or larynx, her thyroid gland and her trachea. Then, they put a donated organ from an anonymous accident victim into her throat, reconnecting the intricate nerves and muscles needed to bring Jensen’s voice back.

UC Davis surgeon Gregory Farwell the lead surgeon says much of the surgery was done under a high-powered microscope. He explained, “The neck is an unbelievably complex structure… The blood vessels are small. The nerves are incredibly small and there’s a lot of them.” Farwell and his team put together five different nerves each of which are 1 to 2 millimeters, and the suture used is smaller than a human hair, he said. An international team of surgeons came together for the operation. The surgical team included Martin Birchall of the University College London Ear Institute in England and Paolo Macchiarini of the Swedish medical university Karolinska Institute. Dr. Paolo Macchiarini from Stockholm was in charge of removing the donated organ from the accident victim. He said after the operation, “I was very much afraid. When we released the cramps from the artery, we saw these beautiful organs just flushing full of blood and working properly.”

Usually a transplant involved a person taking strong drugs to prevent the body from rejecting a transplanted organ. In Jensen’s case, she was already taking the drugs after a kidney and pancreas transplant five years ago. She was initially on tubes that helped her breathe and eat but was doing swallowing exercises daily. Her sense of smell returned first after air could travel down her nose. Now as she speaks her raspy voice does not sound like the donor, a California woman who died in an accident, because a person’s voice is forged not by the vocal cords but by the sound as it moves through the mouth, tongue and lips, doctors said.