Seven months after a voicebox transplant at the UC Davis Medical Center (UCDMC) allowed a patient to speak on her own for the first time in over a decade, the patient is recovering and voicebox transplant requests are increasing.
In an 18-hour surgery that took place in October 2010, an international team of doctors transplanted a larynx, or voicebox, accompanied by the donor’s thyroid gland and trachea – the windpipe. The patient, a 52-year-old Modesto woman, hadn’t spoken for 11 years.
Doctors noted that what made Brenda Jensen an ideal candidate was the fact that she was already on medications to prevent organ rejection for a kidney-pancreas transplant she received four years before. The thyroid gland was transplanted because the gland is interwoven with the new voicebox, and provides the critical blood supply to both the voicebox and the windpipe.
“We knew she could manage and tolerate the anti-rejection medications and that she didn’t have to just start [on them],” said Ann Sievers, an ear, nose and throat nurse clinician for UCDMC. Sievers was on the team of professionals in charge of Jensen’s care.
Due to a previous surgery in 1999, a breathing tube had irreversibly damaged Brenda Jensen’s voicebox. For 11 years, Jensen could only speak with the assistance of a hand-held electronic device and breathe through a tube in her trachea. Thanks to her recent transplants, Jensen may be able to eventually remove the tube that has been providing an airway passage for her body.
“Her airway is getting better with time – but [the tracheostomy removal] is going to take a few more months,” Sievers said.
Though Jensen has a new voicebox, she still retains her original voice. Speech production is created cognitively and via the movements of the tongue and mouth.
“It doesn’t change because the larynx only creates the energy and vibration to articulate words,” Sievers said.
Jensen has actually informed Sievers that her friends from high school were able to recognize who she was just based solely on her voice and intonation.
Since Jensen’s surgery, many people have contacted Golden State Donor Services (GSDS), the organization that arranged the organ donation, to inquire about voicebox transplants.
However, Tracy Bryan, director of public relations for GSDS, does not think that there will be a large increase in this type of transplants due to the surgery’s intricacy.
“The real estate between your head and body is one of the most complicated areas to remove and replace successfully,” Bryan said.
For this procedure, doctors had to reconnect five nerves, three arteries and two veins.
Bryan also credits the unique transplant history of Jensen that permitted this successful elective surgery.
Normally, larynxes are not even requested or recovered from donors, but this was a particular case, and GSDS approached the donor family for consent.
The usual organs donated are the heart, lungs, liver, pancreas, kidneys and intestines.
“Each donor can potentially save up to eight lives through organ donation and improve another 50 lives through tissue donation,” Bryan said.
For more information on donor services, go to donatelifecalifornia.org.
EVA TAN can be reached at science@theaggie.org.
