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December 30, 2019

Stanford Medicine achieves 1,000th heart-lung and lung transplant

Alicia Bland, 54, was leaving Stanford’s lung pre-transplant clinic after a routine appointment when she received a phone call that, at first, she thought was a joke. She’d been on the waiting list to receive lungs from a donor patient for only about a month, so she was stunned she was already getting the call.

“They say they have some lungs for me!” she excitedly told her caregiver, Roscoe Little, who accompanies her on appointments. Then she ran down the hall, barely able to breathe, to catch Joell Garner, RN, a pre-transplant coordinator who had been working with her for two years, preparing her for a desperately needed lung transplantation.

“She stopped me in the hallway,” Garner said. “It was amazing to witness. She was like, ‘Oh my gosh. What do I do? They told me they have lungs for me.’ She was completely breathless. I had to tell her to sit down.”

Twenty-four hours later, Bland, who had been struggling to breathe for nearly three decades, had her diseased lungs removed and replaced with the healthy lungs of someone who had recently died and donated their organs. Finally, she could breathe freely again.

“I hope to be able to reach out to his family,” Bland said. “I feel like I’m a part of them now.”

‘Truly takes a village’

Bland’s transplant procedure was the 1,000th by the Heart-Lung & Lung Transplantation Program at Stanford Health Care since Stanford’s first heart-lung transplant in 1981. That year, cardiothoracic surgeon Bruce Reitz, MD, performed the world’s first, operating on Mary Gohlke, a 45-year-old Arizona woman dying of primary pulmonary hypertension. In the years since, about 250 heart-lung transplants have been performed at Stanford along with 750 lung transplants.

“It’s a milestone,” said Gundeep Dhillon, MD, a transplant pulmonologist and medical director of the program. “A lung transplant is something that truly takes a village, one that includes the patient; his or her caretakers; the donor and the donor’s family; our interdisciplinary team of health care providers, including surgeons and nurses; a rehabilitation team; pulmonologists; dieticians; therapists; and more. It’s an amazing team effort.”

Since that first transplant at Stanford in 1981, patient outcomes have continued to improve, Dhillon said, now reaching a five-year survival rate of 60% for heart-lung and lung transplant patients. The survival rate continues to rise due to improvements in surgical techniques, as well as pre- and post-transplant care. But a lung transplant remains a major undertaking for any patient and can often be overwhelming, he said.

“They go through this roller coaster of emotions,” said Dhillon, who, as a pulmonologist, cares for patients before and after surgery. “They’re very sick, and then they’re waiting for the organs to come while further deteriorating. After surgery, there’s a euphoric phase, but being a transplant patient remains a lifelong commitment with continued monitoring by the clinic team and the need to take immunosuppressant drugs.”

Bland couldn’t be happier with the outcome of her lung transplant. Her breathing capacity increased from just 24% to a high of 82% within a few weeks after surgery. For the first time in 13 years, she’s no longer attached to an oxygen tank.

“The transplant team, they’re my angels,” she said. “They gave me a second chance at life.”

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