by Michelle Dupler, Herald Staff Writer thenewstribune.com
Dave Cox said he had just gotten home from work on a Friday evening in April when a Benton County sheriff's deputy pulled up to the home he shares with his wife, Karla.
The deputy had a message for the couple who live between West Richland and Benton City -- someone in Seattle was trying to reach them.
Karla Cox took the number and dialed. A moment later, her husband heard her say, "You've got lungs for me?"
Within minutes, the two were packing their Chevy Tahoe to leave for Seattle, where Karla would become the 500th patient to receive a lung transplant at the University of Washington Medical Center.
Karla Cox, 55, spent six years being sick and three years on a waiting list before getting the pair of lungs that will allow her to once again do simple things like walk around the block, go to the grocery store or play with her seven grandchildren.
The Richland native was living in California with her husband when diagnosed with primary pulmonary hypertension but returned to the Tri-Cities to be closer to family when she fell ill. Doctors aren't sure how she developed the disease.
Her parents and the couple's children and grandchildren all live in the Tri-Cities, she said.
Dr. Michael Mulligan, the surgeon who performed Cox's double-lung transplant in April, said pulmonary hypertension is a form of high blood pressure that attacks the lungs. Mulligan and the Coxes attended a news conference Tuesday at the medical center to discuss the operation.
Blood flows from the heart to the lungs to receive oxygen and then back to the heart to be pumped throughout the body. But the pressure in Cox's lungs was so intense it wasn't allowing enough blood through, Mulligan said.
Doctors tried drugs and even boring a hole between the two upper chambers of her heart to allow more blood to flow through. That kept her alive, but she became so weakened she could only rarely get out of bed, he said.
Her husband said an entire wall of kitchen cabinets was filled with medicine and equipment for Karla.
"That's the way we lived for six years," he said.
Replacing her lungs would be her best chance for survival.
"At one point, she became so sick we didn't know if she would tolerate the operation," Mulligan said. "When you're doing something of that magnitude to someone who is bed-bound, you can have a bad outcome."
With the help of her husband and what Mulligan described as "sheer will," Cox put enough weight back on so that she'd be able to undergo surgery.
But she had another hurdle to face. Her body was producing so many antibodies -- the proteins the immune system uses to neutralize foreign objects -- that it was difficult to find a transplant that would be a match.
And Mulligan said lungs are more vulnerable to rejection than other transplanted organs -- heart, liver or kidney.
"People do badly when their lungs reject," he said. "It's the only organ that's in constant contact with the environment, breathing in the exhaust from a bus. They're far more vulnerable to infection."
Because of the increased risk of infection, survival rates for lung transplant patients are lower than other kinds of transplants, but Mulligan has aggressively worked to give patients better odds of surviving and thriving.
In 1998, about 48 percent of people survived five years after a lung transplant, both at UW and nationally, he said.
By 2009, those rates have climbed to 65 percent at the UW, while remaining about 48 percent nationally.
The one-year survival rate for UW lung transplant patients has risen from 60 percent in 1998 to more than 90 percent now, Mulligan said. Nationally those rates went from 75 percent to about 80 percent.
The program performs about 60 transplants for year, most of them replacing both lungs, he said.
"It makes us one of the top three or four programs in North America," Mulligan said. "We have really been able to pull away from the pack."
One way the program has done that is by taking patients other transplant programs have deemed too sick -- like Cox, whom Mulligan said had been on the transplant list at UCLA before surgeons there decided there was no effective strategy to treat her.
"We really felt like maybe it wasn't going to happen," Dave Cox said.
But the call came and Karla Cox was given a new lease on life.
Her transplant means she'll no longer will experience pulmonary hypertension and should be able to return to a normal life.
"She should have an excellent recovery and excellent longevity," Mulligan said. "I saw her today and she looks well. She went from being able to walk maybe 40 feet to walking four city blocks."
Cox was discharged from the hospital about a week ago, but will have to remain near Seattle for about two months while she continues rehabilitation.
"Right now it's a little tiring, but I'm getting stronger," she said. "It feels good to get out. I will be able to cook now and play with my grandkids."
The Coxes and Mulligan all emphasized the importance of organ donation in helping people like Karla.
"Really, you touch a myriad lives when you're able to do this, and the only way we can do this is when you donate organs," Mulligan said. "This needs to be a grass-roots community effort to try to take care of one another. Your neighbor could be the one who donates to save your spouse or your child someday."
For more information organ and tissue donation, visit http://www.organdonor.gov/
“You Have the Power to Save Lives – Sign Your Donor Card & Tell Your Loved Ones of Your Decision”
Register to be a donor in Ontario or Download Donor Cards from Trillium Gift of Life Network
For other Canadian provinces click here
In the United States, be sure to find out how to register in your state at ShareYourLife.org or Download Donor Cards from OrganDonor.Gov
In Great Britain, register at NHS Organ Donor Register
In Australia, register at Australian Organ Donor Register
Your generosity can save up to eight lives with heart, kidneys, liver, lungs, pancreas and small intestine transplants. One tissue donor can help up to 100 other people by donating skin, corneas, bone, tendon, ligaments and heart valves
“You Have the Power to Save Lives – Sign Your Donor Card & Tell Your Loved Ones of Your Decision”
Register to be a donor in Ontario or Download Donor Cards from Trillium Gift of Life Network
For other Canadian provinces click here
In the United States, be sure to find out how to register in your state at ShareYourLife.org or Download Donor Cards from OrganDonor.Gov
In Great Britain, register at NHS Organ Donor Register
In Australia, register at Australian Organ Donor Register
Your generosity can save up to eight lives with heart, kidneys, liver, lungs, pancreas and small intestine transplants. One tissue donor can help up to 100 other people by donating skin, corneas, bone, tendon, ligaments and heart valves
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