At 2:20 a.m. on Jan. 24, Julie Thiry received a phone call that changed her life.
For 50 years, Thiry lived with cystic fibrosis. The progressive, genetic disease caused thick, sticky mucus to build up in Thiry’s lungs. This buildup limited her ability to breathe and led to severe lung infections. After being hospitalized numerous times, the Stanchfield, Minn., resident was placed on the lung transplant list.
Thiry’s early-morning call came from a care coordinator with the University of Minnesota Health Transplant Care lung transplant program. Doctors had found a lung donor match for Thiry. She and her husband Patrick hurried to University of Minnesota Medical Center in Minneapolis. Within hours, Thiry underwent a double-lung transplant.
Thiry’s transplant procedure came just as the University of Minnesota Health lung transplant team was celebrating a major milestone: In January 2018, the program—widely regarded as one of the largest and most successful in the country—conducted its 1,000th lung transplant.
Cardiothoracic Surgeon Rosemary Kelly, MD, led the 1,000th transplant procedure.
“Everyone was excited to be part of this milestone,” said Kelly. “Each transplant gives someone who struggled to breathe another chance to live his or her life. This is what our care providers do day in and day out—and we have been doing it successfully all these years.”
Thiry is a testament to the program’s success. She was diagnosed with cystic fibrosis when she was just three months old. At the time of her diagnosis the life expectancy was two years.
“My mom was a nurse and knew the importance of medication and bronchial drainage,” she said. Thiry benefited greatly from her mother’s expertise and constant care, but she also had another advantage. For more than 20 years, Thiry was treated by Pediatrician Warren Warwick, MD, a University of Minnesota doctor who nationally known pioneer in the treatment for cystic fibrosis and inventor of the “percussive vest.” The wearable vest inflates and deflates rapidly, causing a high-frequency vibration that loosens mucus that builds up in the lungs of cystic fibrosis patients.
When she was 26, Julie began using the device to help clear her own lungs of mucus and reduce the risk of life-threatening lung infections. Though the vest was instrumental in helping Thiry maintain her health, she was hospitalized in 2005 for the first time with a severe lung infection. After another significant hospitalization in 2009, Thiry left her job in banking and was placed on disability. By February 2016, she was using the percussive vest four times a day.
“My doctor said it was time to start preparing for ‘end of life,’ or to begin preparations for a double lung transplant,” Thiry said. While she weighed the pros and cons of a transplant, she was again hospitalized. At that point, Thiry and her family made the decision to be placed on the lung transplant list. After six days on the list, she underwent her successful surgery on Jan. 24.
Immediately after the procedure, Thiry noticed a difference in her health.
“I knew it would be different but I didn’t know it would be so good,” she said. “The energy level is amazing. It used to be a chore to get up and do therapy to just breathe. It’s a new world.”
In recent years, rapid medical advances in lung transplant care have led to continual improvements in patient outcomes and have increased the number of lung transplants that doctors are able to conduct.
Few people are better positioned to comment on those changes than Pulmonologist Marshall Hertz, MD, a lung transplant specialist who directs the University of Minnesota Health lung transplant program. Hertz was here for the program’s first transplant in 1986. He sees two new frontiers opening up for the future of lung transplantation.
The first frontier—“breathing lung” technology—is already available. Breathing lung devices pump blood and oxygen through a pair of donor lungs during transport, Hertz said, simulating the conditions inside the human body and keeping the organs healthier prior to surgery to place them in the recipient. The technology also allows doctors to continuously monitor the health of the organs. A University of Minnesota Health surgeon performed the first breathing lung transplant in the Midwest in 2013. Participation in clinic studies is ongoing. Transplant specialists anticipate that this technology will soon be the standard of care for lung transplantation.
“This is the biggest change and improvement in transplantation in last 30 years—and we’re uniquely poised as a leader in the world for lung transplantation,” said Cardiothoracic Surgeon Stephen Huddleston, MD.
Breathing lung technology also allows doctors to accept a greater number of donor organs. In the past, doctors were forced to reject more donor lungs because of the damage lungs would sustain during transportation.
“Before the use of this device we would turn many lungs down,” Huddleston said, “But now we can connect the lung to the device and improve it for transplant, increasing the likelihood it won’t be rejected.”
The other frontier for innovation is bio-engineering. Researchers are exploring the use of stem cells to help lungs repair themselves. One day, doctors may also be able to “construct” a set of lungs for a person using stem cell techniques, Hertz said. No matter the technology, the University of Minnesota Health program will continue to be in the forefront of transplant care, Hertz said.
“We have an amazing multidisciplinary team,” said Hertz. In addition to transplant surgeons, nursing staff, physical therapists, rehabilitation therapists, pharmacists and dietitians are all integral in helping patients achieve successful outcomes. “The transplant culture is embedded here—going back to 1986 when Dr. John Najarian was the surgical director of the organ transplant program and Stuart Jamieson performed the first lung/heart transplant. Innovation and compassion are woven into the fabric of our program.”
That transplant culture has helped Julie Thiry set and accomplish new goals. In the past, regular exercise seemed out of reach for her. But now, Thiry has purchased a bike, walks two miles a day and plans to participate in a 5K race.
One of the biggest surprises Thiry experienced after the surgery was also one of the simplest: She is now able to belly laugh. “I couldn’t really laugh because it would lead to coughing, so I suppressed laughing. One day I was laughing, my belly was shaking and it felt so good. Friends say they never saw me laugh before.”
The process has been emotional in other respects, too.“I am always thinking of the donor and their family and what they are missing,” Thiry said. “Life is not fair. Why did I get that gift and they had to suffer? I now want life to be simpler and more purposeful and [I want to ] give to others. This changes your perspective. It’s good.”