HOUSTON (September 16, 2020)
Patient Who Received Double Lung Transfer

UTHealth transplant surgeons at Memorial Hermann were the first in Texas to perform a double lung transplant on a 70-year-old man whose lungs were severely damaged by COVID-19.

Francisco Medellin is a retired construction worker who lived with diabetes and had no other underlying health conditions. He contracted the virus in June and was on antibiotics for seven days. When his breathing continued to get worse and he began to turn blue, his family took him to the Emergency Center at Memorial Hermann The Woodlands Medical Center where he was diagnosed with COVID-19-induced pneumonia and acute respiratory distress syndrome (ARDS), a condition that occurs when fluid buildup prohibits the lungs from filling up with enough air, restricting oxygen from reaching the bloodstream.

“Mr. Medellin’s blood oxygen level was in the 60s, sometimes dipping into the 50s,” said Dr. Soma Jyothula, associate professor of medicine with McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth). “A healthy patient’s oxygen level is around 95. He was extremely ill and, at that point, very lucky to be alive.”

Jyothula said for six weeks doctors tried unsuccessfully to treat him with steroids, Remdesivir – an investigational drug that is thought to stop the coronavirus from producing an enzyme that is needed to replicate itself, and convalescent plasma, a process where plasma is taken from patients who have recovered from COVID-19 and given to those who still have it.

“After all of these treatments he still needed 80 to 100 percent oxygen at rest,” said Jyothula, who is also medical director of the lung transplant program at Memorial Hermann. “At that point, we determined that the only way he would survive was if he underwent a double lung transplant.”

More than 2,700 lung transplants were performed in the United States in 2019 and approximately two-thirds of those were double lung transplants. Jyothula said that patients survive longer when receiving a double lung transplant as opposed to a single lung transplant. He added if a patient makes it to one year post-surgery, many times they have a lifespan of 10 to 12 years.

“The two main reasons a person would get a lung transplant are pulmonary fibrosis and emphysema. Now we can add COVID-19 patients to that list,” said Dr. Manish Patel, associate professor of medicine with McGovern Medical School at UTHealth, surgical director of the lung transplant program at Memorial Hermann and the surgeon who performed Medellin’s transplant. “The most common reason why patients are dying from COVID-19 is lung damage. I believe we are going to see even more patients needing lung transplants in the future because of this virus.”

The United Network of Organ Sharing (UNOS) determines who gets lungs first by using a lung allocation score (LAS) calculator for people over the age of 12. The calculator looks at factors like a person’s blood tests, lung function, their need for oxygen, the medical urgency and how long the patient might survive post-transplant compared to others on the list. The higher the score up to 100, the quicker the transplant. Medellin was one of the sickest patients with a score of 78.4. He was listed for transplant on Aug. 26, 2020 and received his organs the very next day.

“Most double lung patients are in the hospital at least three weeks post-surgery. Mr. Medellin was released less than two weeks after surgery,” Jyothula said. “He will spend two to four weeks in inpatient rehab to regain his strength, and then he will get to go home to his family.”

Before his transplant, Medellin was the primary caregiver for his wife. He has nine children and 32 grandchildren, and he said he cannot wait to be with them again.

“To think that I was only a few days away from dying and now I have a second chance at life is truly a miracle,” Medellin said. “I’m extremely grateful to the team who saved me and gave me the chance to get back to my family.”