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Breathing new life
MUSC
re-establishing lung-transplant program,
only one in South Carolina
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by David Quick
The Post and
Courier
It’s something most of us take for granted. Breathing. Simple
breathing.
But take a few seconds to think about the life of former police officer
Corey Roper.
 Kim Phillips,
director for the MUSC transplant center, talks to Corey Roper about the
process of getting a lung transplant.
Corey Roper, 40, of Johns Island, has scleroderma and has difficulty
breathing, particularly in hot, humid weather. Just a 40-yard walk from
his car, up a small set of stairs into the MUSC transplant center
office, left him winded and fatigued.
Timothy Whelan, M.D., and William Yarbrough, M.D., are part of MUSC’s
team for a new lung-transplant program. Whelan is the medical director
and Yarbrough is a lung-transplant surgeon.
Roper speaks in a tender voice, as if it hurts to speak louder,
because, in fact, living his life is a daily struggle. For example, he
has difficulty bending over because of fluid in his lungs. He can’t cut
the lawn or ride a bike with his daughter. And a short walk from his
parked car and up one set of stairs into a building in downtown
Charleston on a summer day left him winded and exhausted.
“It was like I walked from here to James Island,” says Roper,
describing the exertion. “It’s like somebody was suffocating me.”
Roper first started noticing problems in 1995 when he worked as a
police officer for the State Ports Authority in North Charleston and
the fumes from the nearby Westvaco plant made him “cough and gag.” It
became so bad that his doctor requested that the SPA transfer him.
In 2006—four years after being diagnosed with scleroderma, an
autoimmune disease that attacks the organs—one of Roper’s lungs
collapsed and he was hospitalized. A month later, the other lung did
the same. His doctor said that Roper would need a lung transplant, but
because of the risks involved with working, he retired.
Currently, he is on the list for lung transplants at New York
Presbyterian Hospital, where he must travel for routine check-ups three
times a year.
He and others who are in his pulmonary rehabilitation class at MUSC,
however, have reason to celebrate this year.
After 13 years, MUSC is re-establishing its lung-transplant program.
Keeping lungs in
S.C.
MUSC had a program for about three years in the 1990s and performed
about 25 lung transplants, but the administration realized it wasn’t
quite ready for the program because of the intensity of the transplant
operations and placed a moratorium on the program, according to Fred
Crawford, M.D., who was head of the surgery and cardiothoracic
departments at the time.
“Lungs are a whole other story,” says Crawford, famed for heart
transplants. “The patients are sicker, more complicated and require
more recovery time.”
At the time, he says, MUSC didn’t have enough intensive-care hospital
beds or staff.
“It overwhelmed our nursing and resident staff,” says Crawford. “Lung
transplants require much more than a surgeon.”
However, with the completion of the new Ashley River Tower, it gave
MUSC the facilities to restart the program, starting with some key
additions.
The school recruited two key staffers, Whelan of the University of
Minnesota and Yarbrough of Stanford University, to be the lung
transplantation medical director and a heart and lung-transplant
surgeon, respectively.
The MUSC lung-transplant program expects to get approval from the
federally commissioned United Network for Organ Sharing in September
and to perform a transplant in early fall.
Re-establishing the program and being the only lung-transplant program
in South Carolina has other implications.
In recent years, the state’s organ-procurement organization, LifePoint,
has secured about 60 viable lungs annually and currently is on track
for 100-plus this year. Those lungs have been sent out of state. With
the MUSC program, it gets first dibs, which bodes well for residents of
South Carolina who have reached the end of medical therapies and simply
need new lungs.
Most of those patients now are on waiting lists at Duke University. And
while they may join the list for MUSC, it won’t negate their ability to
be on waiting lists at other hospitals. One reason patients from
S. C., and particularly the Charleston area, may want to have surgery
at MUSC is that postsurgery recovery can take up to a year and requires
being near the hospital where the surgery was done. Whelan is
enthusiastic about MUSC’s potential for creating a new niche in
lung-transplant surgery and research. “We have a tremendous team of
pulmonologists, the appropriate mix of patients and an appropriate
donor pool to be successful,” says Whelan. “There’s no question in my
mind that MUSC will have a successful lung-transplant program.”
Cost and
effectiveness
A lung transplant is an expensive surgery, particularly for an average
survival rate of about five years. The total bill—surgery, drugs and
follow-up —tends to run $250,000 to $300,000.
While Whelan says it’s easy to put a dollar amount on the cost of the
surgery, it’s more difficult to answer questions of whether it’s worth
doing. As for the relatively short life spans after surgery, he notes
that there are always exceptions and that as more transplants are done,
doctors will learn more about how to extend lives.
16 years and
counting
Selma Tennant of Sumter was the third recipient of a lung transplant at
MUSC in 1994, when she was 28 and the mother of two daughters.
Tennant had rheumatoid arthritis, which led to the development of
“bronchiolitis obliterans,” an obstructive lung disease in which the
bronchioles, small airway branches, are compressed and narrowed by scar
tissue and inflammation. It left her unable to do routine duties as a
mother and dependent on oxygen 24 hours a day, and caused her
5-foot-1-inch body to wither to 87 pounds. She received a single lung
transplant, the rheumatoid arthritis went into remission and she
watched her family grow up.
“I saw both my girls graduate and get married. I also have a grandson
now.”
Like many organ transplant patients, Tennant has remained close to the
MUSC program, its staff and other patients, and she’s happy that lung
transplants will be part of it once again.
MUSC transplant
team
Dr. Timothy Whelan -- medical director for the lung transplant program
Dr. William Yarbrough -- surgical director for the lung transplant
program
Dr. John S. Ikonomidis and Dr. Chadrick Denlinger, cardiothoracic
surgeons who also will be doing lung transplants
Editor's
note: The article ran in the Aug. 24 issue of The Post and Courier and
is reprinted with permission.
Friday, Sept. 3, 2010
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