Mayo Clinic has launched a first of its kind regenerative transplant program aimed at restoring function for people who need their larynx, or voice box, removed.
In the United States about 60,000 people are living without a larynx, due to disease or trauma. The larynx is a segment of the respiratory tract located in the neck responsible for protecting the airway, swallowing, and producing speech.
After a laryngectomy, the procedure in which the larynx is removed, the patient must breathe through an opening in their neck and communicate by using a machine or a special prosthesis implanted into the throat. Currently, there is no traditional reconstructive option that can restore all vital laryngeal functions.
“A laryngectomy severely alters quality of life. The ability to smell, taste, breathe, swallow and speak are all affected,” says David Lott, M.D., a laryngeal surgeon, associate director of the Center for Regenerative Medicine, and surgical director of the Larynx and Trachea Transplantation Program at Mayo Clinic in Arizona. “When the organ is damaged or removed due to disease, patients quickly realize how large of a role it played in their everyday lives.”
To help improve quality of life for these patients, Dr. Lott and his team have created the Larynx and Trachea Transplantation Program. They established a unique set of protocols which were approved by the United Network for Organ Sharing (UNOS) about a year and a half ago. UNOS regulates and manages the nation’s organ transplant system. Dr. Lott and his team have approval to perform two transplants per year over each of the next five years. The Larynx and Trachea Transplantation Program is the first UNOS-approved program of its kind.
“The larynx is a machine,” says Dr. Lott. “The larynx opens, closes and elevates; there is significant movement within the organ.”
In addition, the larynx contains muscle, tissue, fat, cartilage and bone, which makes for a complex immune environment. These factors can make the larynx much more complicated to transplant than other organs.
The transplantation itself is like putting together a puzzle. Once the donor larynx is ready for implantation, dozens of blood vessels, nerves and other structures must be reconnected. A successful larynx transplant would allow a patient to breathe through their mouth, swallow normally, and produce a human-sounding voice.
“Larynx transplant provides the hope to improve quality of life for patients suffering the effects of severe laryngeal disease or tracheal injury,” says D. Eric Steidley, M.D., medical director of the Larynx and Trachea Transplantation Program. “We’re giving possibilities to patients who don’t have treatment options. It is a very exciting time for us to be in this field.”