2nd US Larynx Transplant Performed From The IAL News April 2011

. It is still considered experimental and therefore

not covered by Medicare or other insurance. The per-

son must take anti-rejection drugs for the rest of their

lives. Jensen was already taking these drugs after a

kidney-pancreas transplant in 2006.



Neither of these transplant cases involved cancer,

and anti-rejection drugs make it harder to resist the

spread of cancerous cells, as well as make the person

vulnerable to other infections since the immune system

is weakened to keep the transplanted organ from be-

ing rejected. Unlike laryngectomees, both Heidler and

Jenson had a non-functioning larynx to work with or



blood vessels and nerves to which the

transplant could be attached.



Dr. Gregory Farwell lead the surgery

team. He stated that much of the surgery

had to be done while looking through a

high powered microscope. "The neck is

an unbelievably complex structure," he

said. "The blood vessels are small. The

nerves are incredibly small and there's a

lot of them." In Brenda's surgery Dr. Far-

well and his team had to put together five

different nerves each of which is smaller

than a human hair.



According the NPR story, "Larynx

transplants almost never occur, say phy-

sicians, because they're rarely a life-

Brenda Jenson, 2nd U.S. saving procedure." This is in contrast to

larynx transplant recipient heart, lung and liver transplants.



Friends and family are amazed when

she speaks including her 12 year old granddaughter

who had only previously heard her AL which she re-

ferred to as her "talkie-talkie."



Friends who had not heard her voice in two de-

cades were able to recognize "hints" of her old voice. It

has been pointed out that much of what gives people

their individual voices is the shape of the throat, mouth,

nose and sinuses; along with the words a person uses

and how they put them together.



Brenda said, "I feel so blessed to have been given

this opportunity. It is a miracle. I'm talking, talking, talk-

ing, which just amazes my family and friends."

The second larynx transplant in the USA was per-

formed in October, 2010, at the UC Davis Medical Cen-

ter in Sacramento, California. The surgery, performed

on 52 year old patient Brenda Charett Jenson, took

place in an 18-hour operation. The surgery replaced

her larynx, trachea (windpipe) and thyroid gland from a

donor who had died in an accident. The medical team

who performed the surgery, including specialists from

Sweden and England, had spent almost two years

training for the operation, including practicing their

skills using animals and donated human cadavers.

The first larynx transplant in the world was done

at the Cleveland Clinic on patient Tim

Heidler more than a dozen years ago in

1998. For much of the time since then the

Cleveland Clinic and others searched for

another suitable patient and the money to

pay the high cost of the surgery and the

lifelong follow up medical treatments. UC

Davis paid Brenda's hospital bills and the

doctors donated their time.



Heidler had volunteered for his surgery

after 20 years of using the electrolarynx.

He had been working in construction and

had been riding his motorcycle along a

logging trail to a fire fighting class when he

hit a cable someone had strung between

two trees. His voice box was crushed.

In Brenda Jenson's case, her vocal

cords were damaged more than a de-

cade ago after she repeatedly pulled out

her breathing tube while under sedation in a hospital

for a previous surgery. Like Heidler, she had also used

an electrolarynx and was dissatisfied with the sound it

produced. She said that her AL voice caused people

to hang up on her or "treat her like she was not there."

She said that after putting up with what she saw as

humiliation and teasing, "I was game to go. I wanted

to talk again." Her injury also left her trachea closed so

she had also unable unable to smell.



The surgeons could not tell if the surgery had been a

success for nearly two weeks. When they finally asked

her to speak she responded "I want to go home," she

said, breaking into a smile. Her voice has improved

since then and she is especially delighted that she can

smell again since some air now passes through her

nose. But she continues to breathe through a tracheo-

stomy tube and is relearning how to swallow. At the

present she cannot drink or eat by mouth. In Tim Hei-

dler's case he has also continued to have a stoma.

It has been pointed out that not all patients who Laryngectomees are not sutiable for the transpalant procedures.