Phoenix- Mayo Clinic announces a groundbreaking achievement in organ transplantation, offering hope to thousands who have lost their ability to speak, swallow and breathe on their own due to diminished function or loss of their larynx. A multidisciplinary team of doctors in Arizona performed the third known total larynx transplant in the U.S. The case also marks a medical milestone as the first known total larynx transplant performed as part of a clinical trial and the first on a patient with active cancer in the U.S.
“The surgery and patient’s progress have exceeded our expectations,” says David Lott, M.D., chair of the Department of Otolaryngology (ENT) – Head and Neck Surgery/Audiology at Mayo Clinic in Arizona. “This is a tremendous accomplishment in launching what we believe is the future for laryngeal transplantation.”
A paper by Dr. Lott on the case was published July 9 in the peer-reviewed medical journal Mayo Clinic Proceedings. The larynx, located in the throat, is commonly known as the voice box. Larynx transplantation is a rare and complex procedure, performed only a handful of times in the world. Even more notably, Mayo Clinic’s surgical team successfully performed the larynx transplant on a patient with an active cancer, making it one of the first cases of its kind globally.
Six surgeons at Mayo Clinic conducted the 21-hour transplant, which included the larynx, pharynx, upper trachea, upper esophagus, thyroid and parathyroid glands, blood vessels, and nerves.
The transplant was performed on a Massachusetts man, Marty Kedian, who was diagnosed with a rare form of laryngeal cancer called chondrosarcoma. For 10 years, Kedian underwent dozens of surgeries, which eventually robbed him of his voice and his ability to swallow and breathe normally. Several years ago, Kedian had to undergo a tracheostomy that allowed him to breathe through a hole in his neck. He says the tracheostomy, combined with the loss of his voice, significantly diminished his quality of life. “I was alive, but I wasn’t living,” says Kedian. “I love to talk to people everywhere I go, and I just couldn’t. I felt strange, and I wouldn’t go out anywhere.”
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After years of surgeries, doctors told Kedian his only remaining option was to get a laryngectomy and have his larynx completely removed. He declined. “I didn’t want a laryngectomy. I wanted to find a way to get my quality of life back,” he says.
Kedian found what he was looking for at Mayo Clinic’s Larynx and Trachea Transplant Program, where Dr. Lott was leading the first known clinical trial on laryngeal transplantation in the U.S. After being accepted as a patient for the clinical trial, Kedian and his wife, Gina, moved to a temporary home in Phoenix. On Feb. 29, Kedian became Mayo Clinic’s first patient to undergo a total larynx transplant. “I wanted this so I could talk and breathe normally with my new granddaughter. I want to read her bedtime stories with my own voice,” says Kedian.
Because it was conducted as part of a clinical trial, Mayo’s case is considered a significant pivotal step in making the rare procedure available to a wider population. “Until now, laryngeal transplants have been done as one-offs,” says Dr. Lott. “This clinical trial allows us to conduct a true scientific investigation aimed at thoroughly researching the safety and efficacy of laryngeal transplantation as a trusted option for patients.” The program is approved to perform additional larynx transplants in the coming years.
