Monday, March 31, 2008

An Easter renewal: 3 receive new lungs

"I'm so thankful there's a donor out there. My family is appreciative. It's something you can't thank somebody enough."

From in Oklahoma:

Three lives lost, three lives saved.
Surgeons at the Nazih Zuhdi Transplant Institute at Integris Baptist Medical Center transplanted three lungs into three patients over Easter weekend.

The total for 2007 was 10 lungs. Baptist is the only hospital in the state to perform lung transplants, according to the United Network for Organ Sharing.

The weekend's transplant efforts also included two livers and one kidney.

A weekend marathon
"We started at midnight on Friday night and finished about 4 in the morning (Monday),” said Dr. John Chaffin, the surgeon who performed the three lung transplants. "When the organ is available, you have to stop everything else.”

Nellie Penner of Meade received a new lung on Easter.

Penner, 57, was diagnosed with pulmonary fibrosis — a scarring of the lungs — five years ago. She had been on oxygen for more than three years. Although she now is able to breathe without it, she still habitually reaches for her mask before remembering she doesn't need it anymore.

"There's just nothing like losing your independence and not being able to do the simplest things for yourself,” she said.

Twice she had a false alarm in which an organ was available that turned out to be unusable. The third time was the charm.

Penner was placed on the lung transplant waiting list Aug. 10. Dr. Nicolas Jabbour, director of the transplant institute, said lung transplant wait times are considerably less at Baptist than elsewhere.

Surgeons have performed 148 lung transplants at Baptist since 1990.

The medical perspective
Dr. Remzi Bag, a pulmonologist and chief of the transplant institute's lung division, said lungs are among the hardest organs to harvest, and transplant recipients require the most challenging care. They are prone to infection and must receive pulmonary rehabilitation. "Despite the fact that they are very difficult to take care of, they can live a very long life,” Bag said. More than 85 percent have no limitation on their daily activities after receiving a lung.

He said only 15 to 30 percent of organ donors can be lung donors.

"Lungs are damaged so oftentimes,” he said.

Bag said he would like Easter weekend's activity to be typical, but the number of donors must increase to allow that to happen. He would like to perform 40 lung transplants a year within two years. He also wants to increase awareness of lung transplants at the hospital.

"They don't know that a lung transplant program exists in Oklahoma,” he said of some Oklahoma doctors. "If you don't know that the treatment exists, you're more shy to bring it up to your patients.”

Jabbour explained the number of people who are involved directly and indirectly with an organ transplant.

The transplant center's organ recovery team must be ready at a moment's notice to travel to recover an organ; lungs may be harvested within a roughly 50-mile radius of Oklahoma City. The transplant coordinator must immediately begin marshaling the doctors and nurses and notify the patient that an organ is on its way. Doctors must determine whether the organ is a match, which requires lab personnel.

There must be an operating room and space in the transplant intensive care unit available. Non-clinical staff ensures insurance coverage and prepare the patient's food.

"To pull three transplants like this on Easter weekend, you can imagine the logistics,” he said.

Two of the three lungs came from out-of-state donors.

Chaffin said lung transplant recipients typically have chronic obstructive pulmonary disease, pulmonary fibrosis and pulmonary hypertension. Many developed lung problems from smoking.

Many doctors tell these people to accept that there is nothing to be done.

The ones who receive transplants will have been "run through a gauntlet” of tests and evaluations to make sure the organs go to the most appropriate recipient.

Chaffin emphasized the role donors' families play.

"We make a big point of telling people when they sign their driver's license that they want to be organ donors that they communicate it to their families as well,” he said.

Getting her life back
When Penner leaves the hospital in a few days and Oklahoma City in about two months, she plans to go to the mall and shop with her family. She plans to see her brother in Tennessee. She plans to bowl, an activity she enjoyed before she became sick.
"You've got to move those muscles. There's a lot that I haven't moved in a long time,” she said. "There's just so much that I'm just looking forward to being able to do.”

She's never been to her grandchildren's games. She's never seen them in cheerleading outfits or playing basketball. They asked, but she was too sick to go. Now, she feels stronger each day.

"I'm going to see one of their ballgames. That's the first thing I'm going to do,” she said.

Penner would like to thank the donor's family and to encourage Oklahomans to consider organ donation. Her first thought upon finding out she would receive the lung was how grateful she was.

"People need them so desperately,” she said of donated organs. "I'm so thankful there's a donor out there. My family is appreciative. It's something you can't thank somebody enough.”

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