Surgeons at Hassenfeld Children’s Hospital at NYU Langone and the NYU Langone Transplant Institute reached a historic milestone when they used a lung transplant to treat a 16-year-old girl with cystic fibrosis whose organs were irreversibly damaged. The surgery took place on May 20, 2021, marking the first-ever pediatric lung transplant performed at NYU Langone Health.
Cystic fibrosis, which affects more than 30,000 Americans, is among the most common lung diseases in childhood. Although there is no cure for cystic fibrosis, there are various treatments available that may help relieve symptoms and reduce the risk of complications. Lung transplant is an option for select individuals who have severe lung disease caused by cystic fibrosis and others with end-stage lung disease; it improves their quality of life when medical management alone can no longer maintain lung health and physical function.
“As one of only a few medical centers in the United States certified to perform pediatric lung transplants, Hassenfeld Children’s Hospital—in collaboration with NYU Langone’s lung transplant program—offers a high level of expertise and experience,” says Catherine S. Manno, MD, the Pat and John Rosenwald Professor of Pediatrics and chair of the Department of Pediatrics at NYU Langone. “For patients 12 years of age and older, we provide effective treatment options and excellent multidisciplinary care through every stage of the lung transplant process.”
What Led to the Patient’s Double Lung Transplant
The patient—identified by her first name, Alejandra—was born with cystic fibrosis, an inherited disease that causes the body’s mucus to become thick and sticky. The primary concern was her lung function, which declined rapidly, as is sometimes the case in patients with cystic fibrosis. The mucus, which accumulated in her lungs, made it difficult to breathe.
Two to four times a day throughout her childhood, Alejandra would undergo nebulizer treatment with a special vest to shake loose the mucus in her lungs. Daily physiotherapy, dozens of pills, and intravenous antibiotics all became a large part of her life, as the condition gradually worsened and her lung function declined. Because Alejandra was hospitalized frequently, she has been unable to finish out the school year for most of her life.
Alejandra was brought to NYU Langone in September 2020 for a comprehensive evaluation to see if she would be a good candidate for a transplant. Luis F. Angel, MD, professor in the Departments of Medicine and Cardiothoracic Surgery and medical director of NYU Langone’s lung transplant program, led the team evaluating Alejandra. “This past year especially brought challenges, as Alejandra needed round-the-clock help just to breathe,” says Dr. Angel.
“I couldn’t get out of bed or even walk to the bathroom without having problems with my breathing,” says Alejandra. Doctors told her that without a lung transplant, she would not have long to live. Dr. Angel put her on the transplant waiting list on April 13, 2021. Five weeks later, Alejandra and her family got a call that a donor organ was available. (The typical wait time for a pediatric lung transplant is four to six months.)
The transplant procedure was performed by Stephanie H. Chang, MD, surgical director of NYU Langone’s lung transplant program, and T.K. Susheel Kumar, MD, pediatric lung and heart surgeon at Hassenfeld Children’s Hospital at NYU Langone.
“We delivered a successful intervention when time was running out,” says Dr. Chang. “This was possible due to our team’s position at the forefront of innovative approaches to meet the demand for available lungs combined with a multidisciplinary team, including pediatric surgery expertise from Dr. Kumar.”
Alejandra’s First Breaths with New Lungs
Alejandra was in the hospital for nine days after the surgery. She remembers the remarkable feeling of breathing on her own for the first time in years. “The second I woke up after surgery, I already felt a tremendous difference. I am so thankful for the gift of life. I can finally breathe with ease again. For me, receiving my new lungs is a miracle,” she says.
The patient took the next big step in her recovery and returned to high school this past September for her senior year. “This will be the first year I’ll be able to go to school and finish out the year,” Alejandra adds, most looking forward to playing soccer, going to prom, and graduating.
“Organ transplantation offers a great promise for children with end-stage lung disease. Our primary goal is to foster a successful transplant and in doing so, provide new lungs for a child and get them back to their active lives,” says Eleanor Muise, MD, assistant professor in the Department of Pediatrics and pediatric pulmonologist at Hassenfeld Children’s Hospital at NYU Langone. Dr. Muise joined NYU Langone this year to work within the pediatric transplant program and care for children who are waiting for or who have already received lung transplants.