Lung transplants: bridging the gap

FRESNO, Calif.

About 150 patients get a new start with a lung transplant every year, but many more are left waiting. Doctors say a machine traditionally used to help premature babies is doing double-duty by providing a bridge to transplant.

Every breath is a gift for Liesbeth Stoeffler.

"I feel really good," Stoeffler told Ivanhoe. "It's great to breathe in the air, and I can feel my lungs expanding. It's just the best feeling."

The former marathon runner pounds the pavement seven months after a lung transplant. "I am amazed," Stoeffler said.

But that life-saving surgery might not have happened without the help of one machine.

Stoeffler had end-stage cystic fibrosis. Doctors feared a traditional ventilator would damage her lungs even more as she waited for a transplant. Instead, they hooked her up to an ECMO machine, which is typically used for babies with breathing problems.

Tubes connect to veins in the patient's neck and groin. Instead of pushing air into the lungs like a ventilator, the machine bypasses them and directly oxygenates the blood.

"A patient who's on full support with ECMO flow really doesn't need the heart and lungs to work at all and can rest them fully," Mark Hudak, M.D., a neonatologist at the University of Florida College of Medicine in Jacksonville, Fla., told Ivanhoe.

Stoeffler's doctors at NewYork-Presbyterian Hospital/Columbia adjusted the machine to allow her to stay awake, move … even eat. The goal -- keep her strong enough to make it to transplant.

"I was texting," Stoeffler said. "I was emailing. I was so busy, the nurses came to take blood I had to tell them to use this hand because I needed this hand for texting. I never let go!"

The device served as a bridge for 18 days, until the call came: Healthy lungs were available.

"Now I'm doing great," Stoeffler said. "It's just awesome. I've been able to run and go to the park."

Seven months later, she's is working on gaining weight, muscle and a new sense of freedom.

"I just gave it my all, and that's what I'm doing now."

Doctors are using ECMO technology as both a bridge to transplant and a bridge to recovery. It's helping patients with H1N1, COPD and pneumonia.

Department of Thoracic Surgery
NewYork-Presbyterian Hospital/Columbia
(212) 305-7771

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