UK’s voicebox transplant given experts’ approval

The UK’s first voicebox transplant – and only the third worldwide – could be carried out within months after experts gave the go-ahead.

Martin Birchall, professor at the University College London, will lead a team carrying out the procedure on a man or woman whose voicebox has been damaged by cancer or accident, such as swallowing caustic liquids.

Around 1,000 Britons each year have their voicebox (also known as larynx) destroyed, making swallowing, breathing and speaking difficult or impossible.

Other movements – such as straining, coughing, smelling, tasting and even kissing – are problematic.

In October, an American woman, Brenda Jensen, became the first in the world to have a combined voicebox and windpipe transplant.

The first ever transplant was carried out in Ohio in 1998 on Timothy Heidler, whose voicebox was damaged in a motorbike accident.

Now, experts at the Royal College of Surgeons (RCS) in London have given their approval for the first ever procedure in the UK.

In a report on the ethics, technical evidence and patient support required, RCS surgeons said the operation could improve quality of life. Prof. Birchall, 49, said he was delighted by the findings and, with the right preparations, a transplant could take place early next year.

Patients undergo rigorous psychological assessment for the transplant and need a lifetime of immunosuppressant drugs to stop their body rejecting the organ.

He said: “We have been working on this for a long time and this report gives us the green light to go ahead. “It also gives us guidance on aspects such as psychological assessment. It is an incredibly balanced report.

“We have a couple of patients who would be good recipients, and this news will lead to more referrals.

“As well as cancer, voicebox damage can be caused by things like swallowing caustic materials when young. Road traffic accidents are also a common cause.”

Prof. Birchall, who is professor of laryngology at UCL, said a retrieval team, including two or three retrieval surgeons, would be involved in removing the donor organ.

Another team of six surgeons is then required for the 18-hour operation, which will be carried out at the Royal Free Hospital in north west London.

“Loss of a larynx removes many things that make us quintessentially human, through loss of speech, swallowing and altered appearance,” Prof. Birchall said.

The RCS report says it is unclear how patients with a transplanted voicebox will sound after the operation. The larynx creates and controls sound through the interaction of muscle and cartilage in the vocal cords. This is controlled by sensory nerves.

A person’s accent is essentially formed by the way the lips, palate, cheeks and tongue move.

Experts have recommended the procedure, which will be part of clinical trials, only for patients who have suffered irreversible trauma or injury to their voicebox, or who have undergone a total laryngectomy (and now breathe through a hole in their neck) after suffering a benign or low-grade malignant tumour.