‘A miracle in the making’ | Health beat
Dennis Lee Boss is breathing calmly for the first time in years.
He is the first Spectrum Health patient to receive a new lung as part of a major clinical trial.
His life after the operation? “A miracle in the making,” he said.
For Boss of Shelbyville, Michigan, the health journey began more than four years ago when he suffered a collapsed lung. He still remembers the severe pain.
“I started coughing and chopping and gasping for air and couldn’t stop,” he said. “Usually I could catch my wind, but not this time.”
His wife and daughter called an ambulance.
He spent the next 45 days in the hospital.
But, like many patients with chronic lung problems, recovery has been curvy.
The day after he went home, his lungs collapsed again. He went back to the hospital, this time for a couple of weeks.
On the list
At about the same time, his COPD worsened. He had to take oxygen. The simplest activities, like going to the mailbox, became too much.
Doctors will be the Spectrum Health Richard DeVo’s Heart and Lung Transplant Program told him a transplant was his best hope of survival. Influenced by friends and family, he decided to continue the trial.
He began the complex process of qualifying for a transplant, including several tests to see if he was healthy enough to survive the surgery.
On October 1st, he made the list.
He joined an estimated 107,000 people in the U.S. waiting for their phones to ring with transplant news.
Boss, 61, also knew the odds.
A new name is added to the list every nine minutes. According to data, around 17 people waiting for a transplant die every day Federal statistics.
But one afternoon in early November, just as he had just signed up for a routine appointment for lung therapy, his cell phone rang.
“They had a pair of lungs for me,” he said. “I called my wife who was shopping with my daughter. I went home. There she met me and we grabbed my bag, which was already packed. We made it to the hospital at 4 p.m. “
Lung transplants are extremely complex procedures. They are also relatively rare and reserved as a last resort for those with chronic lung disease and poor survival.
An estimated 2,000 lung transplants are performed in the United States each year, compared to about 18,000 kidney transplants. The Spectrum Health team performs approximately 50 lung transplants each year.
Typically, they are used for those who are bedridden or, like Boss, are extremely limited in their activity tolerance.
But Boss’s experience took on a special meaning.
Research conducted by Lung Bioengineering, which is currently being tested in 14 locations across the US, is exploring a new way to test donor lung function prior to transplant – in a way that minimizes organ waste.
“The donated lungs are from deceased patients and we are grateful for their generosity in making a transplant possible,” said Gayathri Sathiyamoorthy, MDwho specializes in lung, critical care and internal medicine at Spectrum Health.
But all too often the lungs go unused.
According to some estimates, up to 50% are unsuitable for transplants.
“Sometimes the X-ray looks bad or the oxygen levels are low,” said Dr. Sathiyamoorthy, “and these findings are of concern for poor lung function, although they may not be fully expanded or contain some extra fluid.”
This new study evaluates lungs used with the ex vivo lung perfusion machine versus lungs that do not in similar patients.
The lungs included in the study are taken from the donor’s body and flown immediately Lung bioengineering Silver Spring, Maryland, facility where they are attached to an artificial respiratory and circulatory system.
From there, doctors can fully expand and examine the organs.
“You can determine if the lung is really damaged and should be disposed of, or if it can be used on a patient (who is participating in the study),” she said.
The Spectrum Health transplant team has used a similar testing procedure for several years. But this study evaluates a newer device and procedure, said Dr. Sathiyamoorthy. By mid-April, the Spectrum Health team had made four referrals to Lung Bioengineering, resulting in three more transplants.
“Our hope is that with this technology we can improve our ability to deliver (suitable) lungs to our patients,” she said.
Against the clock
While Dr. Sathiyamoorthy’s explanation sounds simple, the process is running in an extremely tight time frame.
Within hours, she said, the lungs were flown to Maryland and hooked up to the experimental device.
They are then supplied with blood or “artificially kept alive,” said Dr. Sathiyamoorthy. “And we can buy some time to assess the lungs to make sure their function meets our standards.”
The lungs are evaluated for several hours.
What if they don’t seem perfect? You are excluded for a transplant and can be used for other research instead.
“And if the pair of lungs looks good, it will be removed and flown straight to us so that we can give it to our patient within a few hours,” said the doctor.
In his case, Boss and his family had to wait and see if the new lungs would get the green light.
“The transplant team warned me that I might have to wait months or even years for lungs to become available,” he said. “I knew how lucky I was to get the call in less than 40 days.”
In the end he passed.
Boss remembers little of the transplant procedure.
Edward Murphy, MD, Head of Cardiovascular Surgery at Spectrum Health, performed the transplant.
“This study increases our confidence in the lungs that we transplant our patients,” said Dr. Murphy. “By participating in the clinical trial, we have the opportunity to work with lung transplant experts.”
He is pleased that Spectrum Health is able to offer this level of treatment to patients like Boss while expanding the knowledge base of the entire scientific community.
After his transplant, Boss spent three days in intensive care. He has only a vague memory of that time.
When he moved into his own room, he could breathe on his own – and he realized how amazing that was.
After three weeks, he returned home from the hospital. He was feeling better every day.
“I’m tinkering in the garage again,” he said. “I can even walk down the street without breathing.”
He wishes that anyone with debilitating lung disease could have this chance of a lung transplant.
“If I could, I would tell all of them that this process is so worth it. Yes, it takes time to recover. You have to be patient. Just as my COPD didn’t happen overnight, neither will my recovery. “
By participating in this study, the Spectrum Health transplant team hopes more people will join Boss on their way to transplant.
“Most of us just don’t think about breathing,” said Dr. Sathiyamoorthy. “It’s just something that happens in the background.
“But for patients who have difficulty breathing every day, it’s a wonder what Lung transplant can do for them. When they go home they are usually out of oxygen and can breathe normally for the first time in years. “
That kind of wondrous transformation never gets old, she said.
“I first saw a lung transplant while exercising at the Cleveland Clinic,” said Dr. Sathiyamoorthy. “And I quickly realized what an incredible job it was.”
As a pulmonologist, she is used to seeing patients who are breathless and struggling.
“We’re trying to help with medicines and inhalers,” she said. “But after a transplant, patients come back as a new person – and that’s just amazing.”
Boss is full of gratitude. Although it’s still too early, he thinks that at some point he will write to thank his donor’s family.
“Whoever you are, I know you have to grieve,” he said. “But I want to thank you. Without them it would not have been possible. “
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