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 surgery presented on Monday in Lyon (Central-East) by a medical team that hopes to soon be able to repeat this rare “feat” on a global level.

Patient Karen (49 years old), identified only by her name, had been breathing through a tracheotomy for almost 20 years, without being able to speak, due to complications related to intubation after a heart attack suffered in 1996. .

A few days after the transplant, which took place on 2 and 3 September in Lyon, Karen was able to say a few words. Since then she has been undergoing rehabilitation sessions for her vocal cords, swallowing and breathing with a speech therapist, in the hope of permanently regaining her ability to speak. Her immunosuppressive treatment was increased after the rejection of the transplant began, but on October 26 she was able to return to her home in the south of France.

She was therefore unable to attend the conference on Monday to present the operation, but explained in writing that 10 years ago she had volunteered to participate in this scientific experiment “to return to normal life”. She wrote: “My daughters have never heard me speak,” noting that she was armed with “courage” and “patience” to face the pain and move forward on the road to re-learning.

Professor Philippe Seroz, director of the department of otolaryngology and head and neck surgery at the Croix-Rousse hospital, also expressed his determination before coordinating this unprecedented transplant in France.

Operation “by chance”

The idea for this surgery was born after the world’s first laryngeal transplant, performed in 1998 in Cleveland, United States, for a man who had lost his vocal cords in a motorcycle accident.

The surgeon inquired about the matter, but did not get far, until 2010, when he met “a bit by chance” during a conference, a Colombian colleague who repeated this operation without publishing any information about it.

Doctor Luis Fernando Tentenago Londoño invited him for a week to the Colombian city of Cali 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 arteries and veins that intersect,” according to Professor Siroz.

Over the next decade, he trained with a team of experts, obtained approvals, and began seeking qualified patients. In 2019 she met “Karen”. But the Covid pandemic stopped everything.

Meanwhile, global medical records record 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 the penis

In 2022, the French medical team returned to complete what they had started in this field. All that remains is to find a suitable donor, who requires, for the larynx, “anatomical characteristics completely compatible with the recipient, in terms of sex, weight, height, blood group…”.

This happened on September 1st. After the family’s approval, it was possible to begin the surgery, which lasted 27 hours, of which approximately 10 hours were for the removal of the larynx and 17 hours for the transplant.

12 surgeons and around 50 employees of the University Hospital of Lyon participated in this operation, the first of its kind in France, under the coordination of Professor Syrouz and his colleague Lionel Badet, director of the Department of Urology and Transplant Surgery of the Edouard Herriot Hospital.

Despite the feeling of “pride” for this medical “heroism”, the French medical team remains cautious. Professor Siroz emphasizes that “it is the patient who decides whether the operation will be successful or not”, underlining that it will take 12 to 18 months to restore the motor functions of the larynx, “which is the appropriate time for the regrowth of the nerves” . .” He will therefore wait until she is “completely healthy” before proceeding with the other two throat transplants, for which she has a budget.

Lyon’s hospitals had previously hosted the world’s first hand transplant in 1998, and the first transplant of both hands, in 2000, by Professor Jean-Michel Dubernar, one of the pioneers of organ transplantation, who died in 2021.

Professor Badey remembers having participated in this “transplant adventure” which opens up new specializations. It is expected that in the future, after the arms, forearms and throat, we will see “uterus and penis transplants”.