Survival of Fittest
By Lisa Ashley Warshaw
Michael Young is among the longest living lung transplant survivors in the world. In 1993, the 59-year-old Grand Prairie resident received a lung transplant at St. Paul University Hospital after pulmonary fibrosis had ravaged his lungs. He was the fourth person to undergo lung transplant surgery at UT Southwestern Medical Center.
Before his transplant, Young’s lung function was so diminished that he spent his days on oxygen and confined to his La-Z-Boy chair. At night, he was forced to sleep sitting up in order to breathe.
“Before my operation, I wasn’t even capable of walking across my small yard to the mailbox,” Mr. Young recalled. “After my operation, I walked out of the intensive care unit and realized I had the capacity to breathe again. It was the most joyous moment in my life.”
When UTSW began its Lung Transplant Program in 1990, doctors decided to start slow, focusing on providing cutting-edge care for people stricken with debilitating lung diseases.
“We wanted to be sure we were giving the best quality care with the greatest potential outcome,” said Dr. W Steves Ring, Professor of CardioThoracic Surgery and co-founder of UT Southwestern’s Lung Transplant Program. “So, in the beginning, we were highly selective of the cases we tackled.”
In the program’s early days, the majority of patients – including Mr. Young – underwent unilateral lung transplantation. As the program developed, it expanded to bilateral lung transplantations and more severe, complex cases.
The complexity of lung transplant cases increased with the introduction in 2005 of the Lung Allocation Score (LAS). The scoring system, overseen by the United Network for Organ Sharing, is a risk-adjusted waiting list that gives preference to patients who have the greatest potential benefit from a lung transplant.
“The LAS changed the complexion of who we are transplanting,” said Dr. J. Michael DiMaio, Associate Professor of CardioThoracic Surgery. “The technique hasn’t changed, but who we are transplanting has changed dramatically. The old scoring system was pretty much just like in a bakery: You take a number and wait. So those people who were actually more well could wait in line longer to get their lungs, and those waiting for the bread to come and were sick would simply die. When the way you allocated lungs changed, the sickest people came to the front of the line.”
Mr. Young’s long survival post-transplant is a testament to the goals of quality care and favorable outcomes for the program set forth by Dr. Ring and Dr. Randall Rosenblatt, former medical director of the program. Today, the multidisciplinary lung transplantation team continues to exceed national survival rates and takes great pride in the outcomes of patients such as Mr. Young.
UTSW Lung Transplant Program milestones
Sept. 24, 1990 – First lung transplant operation
July 28, 1994 – First double-lung transplant
March 17, 2003 –100th transplant
March 14, 2009 – 200th transplant
March 29, 2012 – 300th transplant
Dr. DiMaio holds the Laurence and Susan Hirsch/Centex Distinguished Chair in Heart Disease.