American Marty Kedian, who had been without a voice for years and unable to swallow and breathe normally after dozens of surgeries for a rare form of laryngeal cancer, is finally getting his life back.
Four months after a total larynx transplant at the Mayo Clinic in Arizona, he can finally speak, swallow and breathe on his own – being only the third person in the United States to ever have the procedure.
He was also the first Mayo patient to undergo a total larynx transplant, reports USA Today.
“He has already regained about 60% of his voice, which I wouldn’t have thought would happen for at least a year. He still speaks with the same voice and Boston accent he had before the cancer,” said Dr David Lott, chair of otolaryngology-head and neck surgery at the Mayo Clinic.
“He can also eat hamburgers, macaroni and cheese, almost anything, and swallow with no problem, and his breathing also continues to steadily improve.”
Doctors plan to remove the tracheostomy tube when Kedian regains full ability to breathe on his own, Lott said.
Six surgeons at Mayo performed the 21-hour procedure, which included not only the larynx but all the glands, blood vessels, nerves and airways associated with it.
Surgeons first removed Kedian’s cancerous larynx, then replaced it with a donated transplant.
Trouble swallowing
Kedian was first diagnosed with cancer in 2013, when he sought medical care after having trouble swallowing his food. Tests revealed a a rare form of laryngeal cancer called chondrosarcoma, and doctors said he needed surgery.
His first surgery was in 2014, with dozens more over the next decade. The procedures reduced his voice to a raspy whisper.
Eventually, he received a tracheostomy tube so he could breathe through a hole in the front of his neck.
Kedian approached Mayo after his previous doctors told him his only remaining option was to have his larynx completely removed.
“I didn’t want a laryngectomy,” Kedian said. “I wanted to find a way to get my quality of life back.”
At Mayo, Lott is leading the first known clinical trial on laryngeal transplantation in the US. The programme expects to perform additional larynx transplants in the coming years.
After being accepted into the trial, Kedian underwent the transplant surgery on 29 February.
Dr Girish Mour, medical director of Mayo’s Larynx and Trachea Transplant Programme, said Kedian was good candidate for the transplant because he was already on immunosuppressive therapy from a previous kidney transplant.
“Having a patient with an active cancer who already had his own immune suppression allowed us to do the transplant safely – without introducing additional risk – in a way that has rarely, if ever, been done before,” Mour said.
A report on the transplant surgery was published in the journal Mayo Clinic Proceedings.
Study details
Total Laryngeal Transplantation in the Setting of Active Laryngeal Malignancy
David Lott, Girish Mour, Danielle Grandjean et al.
Published in Mayo Clinic Proceedings on 9 July 2024
Abstract
Laryngeal transplantation (LT) is a promising option to restore quality-of-life in patients with severe laryngeal dysfunction or a laryngectomy. These patients may be tracheostomy tube dependent, gastrostomy tube dependent, and may lose their ability to verbally communicate. The loss of these important functions frequently results in social isolation and a severe decrease in quality-of-life. LT has the potential to restore all of these important laryngeal functions. Herein, we report the first known documented LT performed in the setting of laryngeal chondrosarcoma.
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