Isles make transplant history
A California man recovers with lungs harvested in Hawaii
Honolulu police rushed surgeon Charles Hoopes to the airport on a mission of mercy for an ailing California transplant patient -- with a set of lungs in an Igloo cooler from the Queen's Medical Center.
The first race of its kind was on. It had to be completed at least 8 1/2 to nine hours after it started with the lungs of a young Honolulu man to be transplanted in a 24-year-old man at the University of California-San Francisco Medical Center.
United Airlines and Transportation Safety Administration officials met Hoopes outside the airport with tickets and took him to the airplane. In California, pilots asked all passengers to remain seated after the five-hour flight so the surgeon could be first off the plane.
The California Highway Patrol escorted him to the hospital. He had been in constant contact with his surgery team, and they had his patient in the operating room with an opening ready for the new lungs.
The transplant patient left the hospital in 19 days -- proposing to his girlfriend 12 days after the June operation.
For the first time in Hawaii, an organ donor's lungs were recovered here and transplanted in a patient in California.
It was a "historic" event in the state's organ donation program, Darryl Ing, Organ Donor Center of Hawaii executive director, said in an interview.
Hawaii has no lung transplant program and has not been able to provide donor lungs for transplants on the mainland because surgeons felt the time from recovery of the lungs to transplant was too long, he said.
"It was a shame we had these viable lungs that were not being transplanted. We were trying to see if there was any possible way we could work out an arrangement."
Then, in June, the lungs of the 22-year-old Honolulu man became available.
"The aloha spirit came through," said Casey Kickertz, director for clinical services at the Hawaii donor center. "Being a little island state allowed this to happen, people doing whatever they could to help."
Surgeons traditionally wanted to transplant lungs, like hearts, within four to six hours after recovery from a donor, which ruled out Hawaii for donations because of the flight time, said Meredith Thompson, transplant coordinator at donor center. The time was expanded in this case, but it was still "monumental," she said. "We had several other patients whose families consented (to organ donation), but we just couldn't facilitate recovery."
A transplant team from UCSF Medical Center happened to be here for a meeting, and organ donor personnel arranged to talk to them about recovering lungs from Hawaii for transplantation, Thompson said.
When they met, on a Friday night, UCSF lung transplant surgeon Hoopes said he had a very sick patient in intensive care on the wait list for a lung, she said.
Later that evening, Thompson said she was informed of a potential organ donor at Queen's.
She called Hoopes and told him the circumstances: The patient at Queen's was 22, a good match in size to the patient in San Francisco and had the right blood type, she said.
Thompson said she approached the family of the potential donor on Sunday morning, and they were aware their son wanted to be an organ donor. He had expressed this on his driver's license. The family honored his wishes and consented, she said, "so we went forward with this."
The lungs had to be offered to the first patients on the waiting list in the national data bank, the United Network of Organ Center, but the first five were all in the east, she said.
Hoopes' patient was No. 6.
The surgeon decided to wait to see if the lungs could be recovered and postponed his Sunday flight back to San Francisco, Thompson said.
He did not have supplies for preservation of the organs, so the California Transplant Donor Network put them together with a cooler and sent them by commercial flight, with courier delivery to his hotel room on Sunday.
He recovered the donor's lungs at Queen's the following morning, on Monday, and took an 11 a.m. (Hawaii time) United Airlines flight to San Francisco that landed at 7 p.m. (California time).
"Even on the mainland they don't traditionally fly with organs on commercial flights because of risk of delays and weather," Thompson said, explaining they usually fly Lear jets to collect organs.
"It was most amazing," Thompson said. "The recipient, who was very, very sick prior to the transplant, was discharged 19 days after the transplant." Even more amazing, she added, in the last week before discharge, he proposed to his girlfriend.
"We would hope they would come here for their honeymoon," Kickertz said.
She said the Organ Donor Center is continuing to talk with the airlines, police and TSA to maintain a relationship and figure out logistics so services will be available if another lung transplant can be arranged. As of Sept. 22, Ing said, 2,870 Americans were waiting for lung transplants.
The young man living with the Honolulu donor's lungs was not the only patient to benefit from the gift. Others received his liver, kidneys, pancreas and tissue, Thompson said.
Ing said the donor center was inspired to work on lung donations after a young mother spoke at a national meeting a few years ago. She said her daughter was No. 1 on the wait list for a lung but never got one. "There were a lot of tears in the audience," he said.