fine-tuned assortment of medications keeps Wright from rejecting
the lung she received more than ten years ago through Emorys
then-fledgling lung transplant programthe lung that has
kept her alive far beyond what was expected, when she was suffering
from emphysema so severe she couldnt walk from one end
of her house to the other without sitting down to rest.
fifty-nine, Wright was the second patient and the first woman
to receive a lung transplant at Emory Hospital. She also is
the programs longest survivor.
its creation in 1993, Emory Hospitals lung transplant
programnow called the McKelvey Lung Transplantation Centerhas
performed just over one hundred transplants. As Georgias
only lung transplant program, it has averaged about ten transplants
are likely to be the only lung transplant program in the state
for a while, due to the complexity of the procedure, says
McKelvey Center director Clint Lawrence, who has been with the
program from its inception.
on by a $20 million gift in 2001 from Andrew McKelvey (the founder
of TMP Worldwide, whose holdings include the Internet career
portal Monster.com) and the addition of a third surgeon, Emorys
program is expanding rapidly.
we can do the next hundred lung transplants in five years. I
think thats a realistic goal, says surgeon David
Vega. Emory has made a concerted effort to make lung transplantation
a priority, and a lot of energy is being put into the program.
Of course, none of this would be possible without families agreeing
and consenting to the donation of their loved ones organs
during a time of real tragedy for them.
a thousand lung transplants are performed in the United States
each year, with recipients chosen from a waiting list of about
four thousand. Lung transplantationwhich involves removing
or both diseased lungs and replacing them with donor organs
that match in blood type and sizehas become an important
treatment for the end stage of several diseases, including emphysema
(which accounts for about half of lung transplants), cystic
fibrosis, pulmonary fibrosis, and pulmonary hypertension.
kidney transplants, we dont have anything like dialysis
that can tide these patients over, says McKelvey Scholar
and transplant surgeon Seth Force (left). These are patients
who have a one- to two-year life expectancy. So their transplants
are really lifesaving.
can attest to that. A smoker since high school, she quit after
watching her father die of emphysemabut not until she
had the disease, which causes shortness of breath and difficulty
the time she was placed on the transplant list in 1993, the
Wright was unable to go shopping, cook dinner, or walk to the
basement because any exertion winded me so badly.
She was put on portable oxygen and told that, without a transplant,
she wouldnt live to see fifty.
call came on October 11, after just four months on the waiting
remember it was a Sunday evening and [my husband] Kent and I
were watching the Braves in the World Series playoffs. The transplant
coordinator called and told me they thought they had found a
lung, she says. The last thing I remember was being
taken in to surgery about eleven p.m. When I woke up, I was
on the ventilator and it petrified me. I couldnt talk.
was panicking so much they put me back under. But I could tell
the difference immediately. I was out of bed by that afternoon.
was home seventeen days later with a new left lung and within
six months was feeling well enough to travel an to work in her
antique booth at a nearby flea market.
thing that bothered me the most is that someone had to die for
me to live, said Wright, who knows only that her donor
was eighteen or nineteen and died in an auto accident in North
Georgia. Then a nun said to me one day, You dont
have any say over what happens. It was beyond my control.
So I quit worrying.
now volunteers as a mentor for others who are waiting for or
recovering from a lung transplant. I just lost a lady
Ive been mentoring for three years. She passed away on
Friday. She and I became really good friends, just e-mailing
back and forth, sharing experiences. Ive had such phenomenal
luck and been blessed so much, but theres no guarantee.
Everyones body reacts totally differently.
recipients have the lowest five-year survival rate of any transplant
recipients due to chronic rejection: 85 percent of recipients
survive for one year after surgery, 71 percent for three years,
and 54 percent for five years, according to national averages
from the U.S. Scientific Registrys 2000 annual report.
the research portion of the McKelvey Center is focused on developing
new medical therapies for lung disordersin hopes of warding
off the need for transplantsand improving lung transplant
patients outcomes following surgery.
are on an immunosuppression regimen for the rest of their lives
or they will reject their new lungs, says Force. Even
so, eventually the terminal airway becomes filled with scar
tissue. This will happen to every lung transplant patient if
they live long enough.
came to Emory last summer from Barnes-Jewish Hospital at Washington
University in St. Louis, one of the most active lung transplantation
centers in the world. He was recruited to Emory as part of the
programs push to find a surgeon dedicated solely to thoracic
sugery, especially lung transplants.
are huge resources here, almost like Ive never seen before,
says Force, a boyishly enthusiastic thirty-six-year old. In
the past, lung transplant patients in Georgia were being sent
to the University of Alabama at Birmingham or to Duke. But Emorys
program is ready to explode.
opportunity to be part of that expansion convinced Force to
relocate to Emory with his wife, Sara, a high-risk obstetrician
at Northside Hospital. As a new, first-time father to year-old
Asher, Force is gratified when he is able to provide his patients
extra years with their families and children.
most rewarding cases Ive had are the patients who were
in wheelchairs, basically incapacitated, a month or two away
from dying, and then a month after the surgery they are up walking,
youthful, with effervescent personalities, he says. After
a transplant, there are no limits on your physical activity.
There have been lung recipients who have run the Boston Marathon.
They can sky dive or scuba dive. We just dont want them
walking into a smoke-filled room.
smokers who wish to receive transplants must test nicotine-free
for six months prior to the transplant. Recidivism rates
after the transplant are very low, Force says.
transplantation is a relatively new procedure, but there have
been rapid improvements since the first successful single lung
transplant was performed in 1983 in Toronto. Breakthroughs in
tissue typing and immunosuppressant drugs have allowed for a
larger number of organ transplants and a longer survival rate
for transplant recipients.
now have a better idea of which lungs to accept and which to
decline, says Force, who must often make a long-distance
determination. For example, Ill get a call that
there is a set of lungs available in Pittsburgh, and Ill
get the story on the donor, a history, maybe an X-ray. Then
I have to decide whether to accept the lungs. Last Friday, I
accepted a set of lungs at seven in the morning and procurement
took place at eleven that night99 percent of lungs are
taken from brain-dead donors where the heart is still beating,
so they are trying to place all the organs. The heart is first,
then the lungs, then the liver and kidneys.
about a third of donor lungs are acceptable for implantation,
due to disease, injury, or illness. The lungs are the
only organ open to the external environment, Force says,
so they are at the mercy of anything coming in.
the lungs are selected and the donor is notified, speed is critical.
The patient is prepped, the lungs are flown in, and the goal
is to get the blood flowing through the fragile organs in as
little time as possiblethe average is three hours for
a single lung transplant, six hours for a double.
has performed thirty lung transplants since coming to the McKelvey
Center, including surgery on Emorys hundredth recipientforty-five-year-old
whose lungs were damaged by a congenital birth defect that caused
pulmonary hypertension (high blood pressure in the lungs), lost
more than twenty pounds in the two years she was on the waiting
list, dipping to a frail eighty pounds.
was so tiny and have a rare blood type, so a lot of people thought
there was no hope, says Brown, a native of Taiwan who
now lives in Suwanee, Georgia, with her husband, Eric, and sixteen-year-old
daughter, Annie. I usually pray only for joy and for peace,
but the pain was getting so bad, I prayed to God to either let
me die or to give me a lung. . . .
wanted to see my daughter get married, she says softly.
Then I am happy.
call came on October 28, 2003. I was shaking on the way
to the hospital, says Brown. Sometimes it was discouraging
because the wait was so long, but I tried to keep my faith.
I knew the day would arrive.
operation, a milestone for the transplant center, was filmed
by the University health communications staff. On the tape,
Force narrates the operation as he removes Browns diseased
lungs, separates the donor lungs, and implants first the left,
then the right. We used to implant both at once,
he says. Now, we split the lungs in half and the complication
rate has come down considerably.
a months recovery, Brown returned home for the winter
holidays. Before, I pulled my oxygen tank behind me in
a wagon all day, Brown says. Now, I feel free. Breathing
is much, much better. I can cook my husbands and daughters
favorite dishes and walk on the treadmill about forty minutes
year, she is planning a trip back to Taiwan to visit her brother
and best friend.
were all wishes I had, but now I can do them. I feel pretty
lucky, Brown says. Lucky one hundred.