She lost her speech in 1996, following intubation following a heart attack. Karine, 49 years old, is the first patient in France suffering from a traumatic larynx to be transplanted from this organ unknown, but nevertheless essential. “The larynx is complex. It is a real switcher that allows you to speak, eat and breathe,” recalls Professor Philippe Céruse, head of the ENT and head and neck surgery department at the Croix-Rousse hospital in Lyon (Rhône).
He was the one who led the operation. But, as he emphasizes, this medical feat is a collective work, made possible thanks to the mobilization of the best surgeons in the country, twelve to carry out the operation: “We formed a group which worked for ten years on the subject. » A decade of training, taking advice from eminent colleagues around the world, to, on the weekend of September 2 and 3, achieve one of the greatest exploits of Lyon medicine with this first larynx transplant in France.
“The sampling lasted ten hours and the transplantation seventeen hours,” specifies Professor Céruse. The first incision, on the donor’s body, took place on Saturday at 9:50 a.m., the start of a race against time. The organ harvesting teams began their intervention at 4 p.m. The transfer of the larynx could take place in the evening at 9:45 p.m. The larynx graft on the patient then took one night and one morning.
As the professor explains, the most difficult thing was not grafting the larynx but taking the living graft: “The larynx is innervated by very small nerves and vascularized by very small arteries and veins which intersect, and that you must first disconnect before you can reconnect. »
Long months of rehabilitation
Two months after this feat, Karine, the transplant patient, finally begins to speak, in a low voice. But she still can’t eat. It will probably take at least six more months to achieve this. If, according to Professor Céruse, the forty-year-old is not yet satisfied with her voice “which she finds terrible”, Karine is still happy to be able to communicate again with her loved ones, according to a verbatim transmitted by the medical team: “I wanted to have a transplant about ten years ago to return to a normal life. My daughters had never heard me. As for my husband, he had forgotten the sound of my voice! »
For the mother, it’s now time for rehabilitation. Perhaps the longest and most difficult part, with ups and downs. This is why the medical team, and in particular Professor Lionel Badet, head of the urology and transplantation department at the Édouard-Herriot hospital in Lyon, is cautious: “Patience and uncertainty, that is the price to pay . She left for a year of voice, swallowing and breathing rehabilitation. You have to wait for the nerve regrowth of the larynx which requires twelve to eighteen months. »
It is only at the end of this long period of reconstruction that we will know whether the first larynx transplant carried out in France was a success or a failure. The Hospices Civils de Lyon recall that before this great first, only three transplants were officially referenced in the world, with mixed results. In France, around fifteen patients suffering from laryngeal trauma and eligible for a transplant have been identified.