Operation helps woman to speak again after 11 years

(University College London)

A woman who was unable to utter a word for more than a decade has spoken of a "miracle" after her speech was restored in a pioneering transplant.

Brenda Jensen was unable to speak or breathe on her own before the operation, carried out by a team of international experts including a UK surgeon.

The transplant, which involved an organ from a dead donor, is the first time both the voicebox (larynx) and windpipe (trachea) have been transplanted at the same time.

It is only the second documented larynx transplant worldwide. The first was carried out in Ohio in 1998.

Ms Jensen, 52, described the operation as a "miracle" and a "new beginning", adding: "This operation has restored my life."

Today, she met the full international surgical team who performed the transplant, carried out at the University of California's Davis Medical Centre in October.

Ms Jensen had not spoken for 11 years after complications during surgery for kidney failure in 1999 harmed her voicebox and left her unable to breathe.

During a spell in intensive care and under sedation, Ms Jensen repeatedly pulled out her breathing tube, causing damage to her throat and scar tissue, which meant she could not breathe unaided.

She was left dependent on a tracheotomy tube for breathing and was only able to communicate through a handheld electronic device which produced artificial robot-like sounds.

In an 18-hour operation, surgeons replaced her voicebox, thyroid gland and windpipe, restoring not only her speech but the ability to taste and smell.

Just 13 days after the operation, Ms Jensen, from Modesto, California, spoke to doctors and her family.

Footage of Ms Jensen's first words shows her smiling and saying "Good morning. I want to go home."

While her voice remains hoarse at times, it has improved significantly since the operation thanks to the regeneration of nerves in her throat.

She is now re-learning how to swallow and could soon eat and drink normally again. If all goes well, her tracheotomy tube will be removed.

She said: "I feel so blessed to have been given this opportunity. It is a miracle. I'm talking, talking, talking, which just amazes my family and friends.

"Every day is a new beginning for me. I'm working so hard to use my vocal cords and train my muscles to swallow.

"I'll probably never sing in a choir or anything but it's exciting to talk normally, and I can't wait to eat, drink and swim again."

Ms Jensen, a diabetic who underwent a kidney and pancreas transplant four years ago, was already taking immunosuppressant drugs to prevent those organs being rejected.

This made her a good candidate for the current procedure, which was made possible by a female organ donor killed in an accident.

Although the transplant involved a donor, the voice Ms Jensen speaks with is her own due to the way air moves through her mouth and way sound is articulated by her tongue.

Martin Birchall, professor of laryngology at University College London, was part of the team which gave Ms Jensen back the gift of speech.

He said the operation was more complex than the previous one carried out in Ohio because it involved transplanting much more tissue than before.

He said today: "I have just seen Brenda and she's just stunning.

"Her voice is almost normal and there's far more movement in the area than I would have expected.

"It's very moving."

He said that, until now, patients have only faced reconstructive techniques dating back 150 years.

In the latest operation, Prof Birchall worked closely to ensure the donor organ was removed correctly, and played a key role in repairing nerves.

Lead surgeon on the transplant, Dr Gregory Farwell, from UC Davis, said: "We are absolutely delighted with the results of this extraordinary case.

"The larynx is an incredibly complex organ, with intricate nerves and muscles functioning to provide voice and allow breathing."

Ms Jensen was not considered suitable for other, conventional surgery because the passage of air through her voicebox and windpipe was completely blocked.

Dr Peter Belafsky, from UC Davis, said Ms Jensen was "an exceptional candidate for the transplant because she was highly motivated.

"Anyone who's met Brenda knows that she is a strong and determined individual with a terrific outlook on life despite the many physical challenges she's faced over her lifetime."

Dr John Williams, head of clinical activities at the Wellcome Trust, which funds some of Prof Birchall's research, said: "This is a truly extraordinary achievement and a genuine breakthrough.

"Professor Birchall and colleagues have clearly transformed the life of their patient and their work offers much hope both for patients in need of similar procedures and indeed for research into transplantation and regenerative medicine in general."