Collaboration Increases Number of Lungs, Shortens Transplant Wait List

Sitting on a bed in the infusion room at The Transplant Center at University of Minnesota Medical Center, Fairview, Hannah Olson is hunched over a practice sheet, carefully studying mathematical equations in preparation for a statistics class she wants to take this fall. It's summer, but the 20-year-old Iowa woman is more than happy to be doing schoolwork, a little taste of normalcy she now enjoys.

Since she was diagnosed with cystic fibrosis (CF) at 2 weeks of age, Olson had endured a routine of treatments three times a day, and the need for an oxygen tank last winter, to survive. Now, thanks to a lung transplant earlier this year at the medical center, Olson can breathe easier for the first time in her life.

Four months ago, Olson's disease completely took over her lungs, causing her to be admitted to the medical center.
"She was as sick as I've ever seen a CF patient," says Cynthia Herrington, MD, surgical director of lung transplantation.
Her second night in the hospital, Olson recalls waking up unable to breathe. Turning up her oxygen seemed to help.

A few hours later, it happened again, this time worse. "The last thing I remember that day is staff trying to put a BiPAP [Bilevel positive airway pressure, also known as a respiratory ventilator] on me," Olson says. She was stabilized, but her health took another turn later that day, and she was intubated.

Knowing Olson's health was on a downward spiral, Herrington put her on the waiting list for a lung transplant. Because of her dire condition, her listing score was high, and she was put near the top of the list. In the early hours of the next morning, staff at an organ procurement organization (OPO) called, saying they had a lung donor.

Herrington weighed her options. A snowstorm had brewed, delaying a flight to retrieve the lungs. But Herrington knew Olson was dying; she couldn't wait for another donor. Later that day, a crew flew out to retrieve the lungs while intensivists kept Olson stabilized. By that evening, Herrington was transplanting the lungs into Olson. Shortly after midnight, the surgery was complete, and Olson was breathing air into her new lungs.

"We always say, 'If the lungs aren't just right, we'll wait for the next call.' With Hannah, there was never going to be a next call," says Herrington. "These lungs truly saved her life."

Shortening, then eliminating, the list
Olson's story is at the crux of Herrington's passion to increase the number and availability of donor lungs and transplants. She partnered with colleagues at Mayo Clinic's transplant program in 2004 to share best practices and make consistent protocols for lung donations and transplants.

As a result, University of Minnesota Physicians at the medical center and University of Minnesota Children's Hospital, Fairview, increased their number of lung transplants from 39 in 2003 to 45 last year