A Tale of Two Lungs: Pittsburgh’s Fight Against Acute Respiratory Disease
by Anisah Rafi
“I loved life. Like many cystic fibrosis children I had various surgeries, and inevitably, once I began feeling better, I’d be the one who was riding the IV pole up and down the hospital floor while the nurses chased me frantically.” Battling cystic fibrosis with unyielding positivity, Jon Sacker was striving to keep an active lifestyle -- rock climbing on weekends and running in marathons.
But in May 2012, pulmonologists at Oklahoma City’s Baptist Medical Center detected that Sacker’s deteriorating lungs were critically congested and recommended an emergency double-lung transplant. On May 20, 2012, Sacker’s physicians informed the family that Sacker had only five days to survive without a transplant.
The odds were against him: the average waiting time for an organ donation is roughly five years. Over one-third of patients on the waiting list pass away each year — one patient every minute — before a match is found.
The miraculous match: a high-risk double-lung donation found on May 22, 2012.
In the two years following his surgery, Sacker regained his agility, resumed mountain climbing with his family, ran in health-awareness marathons and gave presentations on organ transplant.
Toward the latter half of 2013, however, Sacker felt the familiar pressure of chest congestion and shortness of breath return. Soon after, Sacker’s pulmonologists confirmed that his immune system was rejecting the lungs. He had since developed an acute respiratory condition following a viral infection. After a winter spent sedated and in and out of the Intensive Care Unit (ICU), Sacker was flown by private MedEvac jet to UPMC Presbyterian in early February 2014 seeking retransplantation for his infected lungs.
At UPMC, Sacker remained under intensive care. Despite his ventilator dispensing the maximum amount of oxygen to his lungs, the carbon dioxide levels in Sacker’s body remained at lethal levels. Pulmonologists discerned that Sacker’s lungs were too toxic to undergo traditional surgical procedures and began devising an equally effective, yet less invasive plan of attack for his ailing condition.
Dr. Christian Bermudez, chief of UPMC’s Division of Cardiothoracic Transplantation, found the solution in the UPMC developed Hemolung Respiratory Assist System, a minimally invasive respiratory dialysis apparatus. The Hemolung RAS provides synthetic relief of lung function by removing carbon dioxide via a simple circuit that oxygenates blood at a low flow rate using a technique called active-mixing.
This groundbreaking active-mixing technique utilizes biochemicals capable of binding to carbon dioxide. Increasing the surface area of the biochemical agents increases the rate of carbon dioxide removal. This innovative technology allows a wide range of patients, who would otherwise rely on more invasive procedures, to have lung protective ventilation.
The dilemma? The Hemolung is only approved in 29 countries; the United States is not one of them.
Recognizing that Sacker was dying, Dr. Bermudez turned to the Food and Drug Administration, which permits physicians’ emergency use of unapproved medical devices under extenuating circumstances with approval from UPMC’s institutional review board. On February 21, as Sacker’s lungs were rapidly waning, Dr. Bermudez received emergency approval for the use of the Hemolung.
After twenty days of Hemolung assistance, Sacker’s lungs had recuperated and a second double-lung transplant was scheduled for March.
Today, Sacker is again recovering from major surgery. His unprecedented success story is a major driving force for the FDA’s approval of Hemolung and subsequent widespread approval by the American health care system.