New approach to oxygenation helps patient live long enough for surgery.
Meara Schmidt, 28, almost died a few weeks ago. Lying in her hospital bed at UCLA, the seriously ill cystic fibrosis patient felt herself slipping away and her life flashing by. But then the image of her husband appeared, and she knew she was not ready to go.
With a strong will to live and a generous “gift of life” from an organ donor who provided her with two lungs, Schmidt has now been given a second chance.
Cystic fibrosis is a genetic disease characterized by the build-up in the lungs of thick, sticky mucus that traps infection-causing bacteria. There is no cure, but lung transplantation can help alleviate many of the symptoms.
Schmidt grew up with the condition but always enjoyed activities like hiking, cooking and singing. However, her illness started getting worse about two years ago. Walking became an exercise in logistics as she was constantly forced to calculate if she had enough breath to get from point A to point B.
In March of this year, she developed respiratory failure and was admitted to Ronald Reagan UCLA Medical Center with the goal of getting a double lung transplant. While candidates considered “high risk” are often declined by most transplant programs, UCLA is well-recognized for accepting individuals like Schmidt who have drug-resistant lung infections and other patients who suffer from collagen-vascular diseases such as scleroderma, individuals experiencing chronic rejection who need re-transplantation, older patients, lymphoma patients, and those with heart problems.
However, a series of dramatic medical ups and downs had Schmidt “on” the transplant list, then “off” the list. At one point, her right lung stopped functioning, her left lung only partially worked and a machine that provided oxygen had to be dialed up to 100 percent.
Twice, when her tracheostomy and mechanical ventilation was insufficient to provide enough oxygen, she was put on a last-ditch life-support system called extra-corporeal membrane oxygenation, or ECMO, which took over her breathing function through a cannula surgically placed in her neck.
But she would not give up.
In fact, while on ECMO and attached to a tower of medicine lines and pumps, she was able to get up and walk. Traditionally, patients on ECMO are sedated and immobile, but a new innovative ambulatory ECMO approach has been shown to help certain patients gain strength and muscle mass in preparation for surgery. With this new “bridge” approach, Schmidt was not sedated but alert and able to walk, which helped keep her well enough for transplant surgery. She was also working hard to gain weight and fight off various disease-related infections.