The world’s first human tongue transplant has been successfully carried out by doctors in Austria.

Surgeons at Vienna’s General Hospital carried out the 14-hour operation on a 42-year-old patient on Saturday. The patient had a malignant tumour in his mouth that meant his tongue had to be removed. The patient is doing well, confirmed the doctors at a press conference on Tuesday.

Rolf Ewers, who lead the team, says he hopes that with his new tongue the patient should be able to talk and eat as normal. However, his sense of taste is unlikely to be restored, Ewers told the BBC.

Until now, tongue transplant surgery has only been carried out in animals. Suppressing the immune system sufficiently so a transplant is not rejected is a particular problem with the tongue. This is because the mouth is a non-sterile environment due to the eating of food, meaning there is a high risk of infection.

The patient is currently in intensive care because of this risk. Ewers says he hopes the operation will become more routine over the next few years.

The surgeons at the hospital say they normally use transplants of the small intestine to try to compensate for the loss of soft tissue when all or part of a tongue has to be removed.

The small intestine is soft and able to produce mucus, making it suitable for the mouth. But a major problem is that its small size means that extra space remains in the oral cavity.

“In combination with the loss of the voluntary motor activity, this results in a severe obstruction to the patient’s articulation and ingestion of food,” says a statement from the Austrian team. “The aim of transplanting a donor’s tongue is to compensate for the deficit in volume.”

During the surgery, the nerves of the donor tongue were hooked up to the nerves stumps left in the recipient’s mouth. This will hopefully allow the nerves to work properly leading to “total functional restoration”, they say.

“A lot of immunosuppressant therapy would be required to promote acceptance,” Peter Rowe, chairman of the British Transplantation Society’s ethics committee told the BBC. “One would have to weigh up the benefits of a transplant with the various risks of suppressing the immune system, which raises the risk of infection, and, in the long term, of further malignancies.”
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