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Doctors perform rare larynx transplant in cancer patient

By Dennis Thompson, HealthDay News
Marty Kedian (L) has become the first Mayo patient to undergo a total larynx transplant, and only the third person in the United States to have the procedure. Photo courtesy of Mayo Clinic
Marty Kedian (L) has become the first Mayo patient to undergo a total larynx transplant, and only the third person in the United States to have the procedure. Photo courtesy of Mayo Clinic

For years, Marty Kedian had been without a voice.

Kedian, who hails from Haverhill, Mass., has undergone dozens of surgeries while being treated for a rare form of laryngeal cancer.

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As a result, he was robbed of his voice -- along with the ability to swallow and breathe normally.

"I was alive, but I wasn't living," Kedian said. "I love to talk to people everywhere I go, and I just couldn't. I felt strange, and I wouldn't go out anywhere."

It was completely out of character for the usually gregarious Kedian.

"I'm that guy at the baseball game who doesn't know anyone sitting around them," he said. "And by the end of the game, I'm friends with everyone in my section."

Now, Kedian can return to his role of affable chatterbox, thanks to a total larynx transplant he received at the Mayo Clinic.

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He is the first Mayo patient to undergo a total larynx transplant, and only the third person in the United States to ever have the procedure, doctors said.

Four months after the surgery, Kedian can speak, swallow and breathe on his own.

"Mr. Kedian 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 prior to the cancer," said Dr. David Lott, chair of otolaryngology-head and neck surgery at the Mayo Clinic in Arizona.

"He can also eat hamburgers, macaroni and cheese, almost anything, and swallow with no problem," he added in a Mayo Clinic news release. "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.

Kedian was first diagnosed with cancer in 2013, when he sought medical care after noticing he had trouble swallowing his food.

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Tests revealed he had a rare form of laryngeal cancer called chondrosarcoma, and doctors told Kedian he needed surgery.

His first surgery occurred in 2014, with dozens more following over the next decade. The procedures reduced his voice to a raspy whisper.

Eventually, Kedian 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 that 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 United States. The program expects to perform additional larynx transplants in the coming years.

After being accepted in the clinical trial, Kedian and his wife moved to a temporary home in Phoenix and on Feb. 29 underwent the transplant surgery.

"I wanted this so I could talk and breathe normally with my new granddaughter," Kedian said. "I want to read her bedtime stories with my own voice."

Kedian was a good candidate for the transplant because he was already on immunosuppressive therapy from a previous kidney transplant, said Dr. Girish Mour, medical director of Mayo's Larynx and Trachea Transplant Program.

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"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.

Kedian plans to return to Massachusetts next week.

"Mayo and Dr. Lott have helped me regain my quality of life," he said. "My job now is to get better. My next job will be to show others they can do it too."

A report on the transplant surgery was published Tuesday in the journal Mayo Clinic Proceedings.

More information

The National Cancer Institute has more on laryngeal cancer.

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