Waiting for new lungs, and to finally exhale

Just days after finishing the segment about tornado technology—only weeks after I relocated from the UK to the U.S.—I got assigned to the first-ever “TechKnow” sequel.

I had seen Phil Torres’ report on the “heart in the box” and was bowled over by that technology. More properly known as the Organ Care System, or OCS, the machine can prolong the time needed to transport the organ between donor and recipient by keeping blood (and even oxygen) flowing.

So, I couldn't wait to cover a similar innovation from OCS—the so-called “lungs in a box.” Our first stop was the Heart & Lung Institute at St. Joseph's Hospital and Medical Center in Phoenix. The team there were all so highly professional, kind and caring, and I got to see first-hand how the OCS kept the lungs breathing mechanically after removal from the donor body.

The potential for this OCS innovation certainly seems enormous. OCS appears to overcome several obstacles faced by conventional transplant methods. First, imperfect lungs could be reconditioned by flushing it through with nutrients and antibiotics, thus increasing the donor pool. (The whole concept of “reconditioning” sent my mind spinning off into Frankenstein-style fantasies of cupboards stacked full of shiny new pink fluffy breathing lungs; all waiting with bated-breath for their new owners. This felt like science fiction!)

Reconditioning could also help with a second problem: a far bigger demand than supply. One of the major reasons why our lung recipient, Victoria, agreed to be interviewed was to illustrate the desperate need for more organ donation and encourage more people to sign up. Waiting lists for lungs in the U.S. are long, while the donor list is short. Lung recipients have to find a close donor match to their own lungs in terms of size and blood type, to reduce the high risks that the body will try to reject them after the transplant.

At St. Joseph’s, Dr. R. Walia showed me the x-rays and MRI scans for our possible recipient. Victoria, a great-grandmother, was in a desperate situation, as all other medical alternatives had not been fully successful. She was surviving on less than 30 percent lung capacity.

Meeting Victoria took my appreciation of her condition to a whole new level. Victoria welcomed us into her home with a warm smile, open arms—and total exhaustion. I took an instant liking to this special woman who spent her younger days flying herself and her family in Cessna planes, riding motorbikes, hiking and fishing. I was totally inspired by her strength, courage and determination.

Yet it was heartbreaking watching someone who had such a zest for life and was now leashed to an oxygen tank. This was a lady who dreamed of returning to the great outdoors, Halibut fishing and jogging with her dogs—not being confined to home and several meters of tubing that limited her to the confines of her house.

I was also touched by the love between her and her husband of 47 years, Brian, who held her hand tenderly throughout the entire interview. Brian clearly cherished his amazing wife, who was suffering from the same hereditary disease that took Victoria's own mothers life. Memories of meeting this beautiful couple even brings a tear to my eye now. Victoria explained to me that her own mother’s experience of the condition was very different, thanks to advances in medical care, but I also sensed her fear of the consequences of this disease, if innovation failed to intervene.

After meeting the doctors of St. Joseph’s and Victoria, it was now a case of waiting for some donor lungs. The crew and I were on tenterhooks as time passed, so it was unimaginable how agonizing the wait must have been for Victoria. As the hours and days rolled by, it wasn't looking likely that lungs would become available anytime soon. We had to ask, how long should we stay in the Phoenix area, if this might take days, weeks, or maybe even months?

The crew and I returned to our home base in California without having been able to shoot a OCS lung transplant—but more crucially, Victoria was still waiting. I felt emotionally invested and wanted to see her being given another chance of life by receiving a new pair of lungs. I returned to Los Angeles, humbled by how fragile life is and grateful for the health of friends, family and myself.

When we returned from Phoenix on a Thursday afternoon, I took a long weekend to get started on with more of the logistics of my relocation from London to Los Angeles. I secured a place to live by Sunday night, and decided to treat myself to a big food shop. I was planning to cook a big feast and chill before starting a new week in the “TechKnow” offices—which is when I got the call.

It was Joanne, my producer. St. Joseph's had called to say that a donor pair of lungs were about to become available, and that I should keep close to my phone over the next 90 minutes. I needed to start packing a bag to go back to Phoenix. Due to the OCS being part of a clinical trial, doctors were not sure whether the lungs would arrive in a traditional ice cooler or on the OCS machine—or be available at all. It was down to a luck of the draw.

Our travel and production coordinator, Stephanie, informed us that the last flights out for all the crew were around 9pm, and it was pushing on 6pm. We arranged cabs to the airport, not knowing whether the transplant would go ahead or not. It was better to be at the airport, ready to fly, rather than waiting around for confirmations. I had arrived at LAX with an hour to check-in and board this final flight of the day to Phoenix, when Stephanie called to relay the following message: “Shini, Joanne told me to tell you that its all going ahead, the lungs have been assigned to Victoria. And—she said that you'd understand this, even though I have no idea what she’s talking about—she said to tell you it’s OCS!"

I'll never forget this message—I was so happy and excited for Victoria, and she was receiving the lungs on the OCS. I couldn't wait to get to Phoenix now and witness this miraculous procedure unfold. I scurried on through airport security with excitement and trepidation.

The crew were setting up all the camera gear at the hospital by 3am Monday morning, before changing into scrubs—a first-time experience for me. Victoria was to be put under general anaesthesia at approximately 6am. It was a joy to be able to speak with her and Brian before she went under. She was excited that her wait for a new pair of lungs was finally over, but had a real appreciation for major risks she was about to undergo. Brian was so emotional, anxious and almost dumbfounded, he could hardly speak. His distress was understandable, and I welled up as Brian kissed and embraced Victoria before she went under anaesthetic. It wasn't likely to be a goodbye, but no one could be 100 percent certain of that either.

Victoria was then wheeled into the operating room. I wasn't sure how I would react to witnessing the transplant. Knock on wood, I haven't spent much time in hospitals. (Just to put things in context, I passed out when I got my ears pierced when I was 11 years old!) Our experienced cameraman warned me that the typical smells in an OR can make people queasy. By this stage, I hadn't eaten for approximately 18 hours, so was already feeling a little light-headed.

A select few crew members were invited into the OR room. I walked in feeling dizzy, but actually, I think that was caused by the awesomeness of being able to witness something so amazing. Victoria's entire chest cavity had been opened up and I could see straight into her rib-cage, where her heart was beating alongside her frail lungs. My initial queasiness transformed to adrenaline and excitement for Victoria—this was a life-changing opportunity for her, and I was praying that this operation would be a success.

The crew had to maintain a distance from the surgeons at work, but the doctors were all wearing cameras strapped to their foreheads, from which close-up video was transmitted onto television screens in the OR room itself. Doctors and nurses were calling out numbers, passing instruments and relaying technical messages to each other—it was a hive of activity. Then a phone rang to say that the lungs on the OCS machine were in transit to the OR, and the sense of excitement and expectancy in the room reached its climax.

We left Victoria in the OR room to meet up with the OCS and passed Brian in the hallway, who was frantically pacing up and down, calling friends family and anyone to distract him from the worry he was inevitably feeling. Then the elevator doors opened and out burst the technician with the OCS machine. She was closely monitoring the lungs.

The sound of the lungs mechanically breathing was surreal, and we followed these previous organs back to the OR. Once surgeons were ready to make the swap, they held Victoria's old lung and new lung side by side. The difference was night and day. Victoria’s old lung was tiny frail and full of ugly black carbon deposits, while her new donor lung was large, pink and fluffy.

Eventually both lungs had been transplanted and it was time to fully allow blood to flow through the lungs and heart. By this stage, the cameras and I were allowed to come a little closer, which is when I witnessed something miraculous: Victoria’s heart shuddered as the surge of blood took to the new pair of lungs. The doctors rushed to action, reaching for an electrical instrument that would regulate Victoria’s heartbeat. But Victoria's heart regulated naturally, without intervention. It was staggering to watch. Victoria’s strength and tenacity shined through—even when under anaesthesia.  

The surgery took over four hours in the end. The crew and I returned back to LA afterward in order to give Victoria the privacy and space to recover in an ICU. The journey home was a daze to me. We had been up for more than 40 hours straight, and yet all of us were buzzing with awe and admiration for what we had just witnessed.

The whole experience was staggering. I was humbled by this story on our first trip to Phoenix, but this return journey took that sentiment to a whole new level. Victoria was given a new pair of lungs. Lungs, whose respiratory function had been assisted by a remarkable piece of innovation that not only prolonged its health outside of a human body, but also improved its condition.

This was an experience I will never forget. I can't imagine what it felt like for Victoria receiving a new pair of lungs, particularly so close to Christmas. What better gift than the gift of life?