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Theresa Victoria barely reached medical appointments that would save her life.
Victoria, who suffers from terminal pulmonary fibrosis, was on a flight to Chicago last December when the battery of her portable oxygen concentrator died. The flight attendant provided an urgent oxygen canister, but her need was so great that it ran out after 15 minutes.
“That's when I felt like I was going to die,” said Victoria, 68, a resident of Lakeland, Florida. “I couldn't breathe.”
However, Victoria consulted with Pablo Sanchez, MD, director of the Surgery of the Lung Transplant Program at the University of Chicago School of Medicine. She wanted something seemingly impossible. A double lung transplant that does not use blood transfusions to align with her religious beliefs.
“I don't think she expected us to say, 'Let's see what we can do,'” Sanchez said.
A catastrophic discovery
Forty years ago, Victoria was hospitalized with pneumonia. She later experienced a period of phe buildup and cough. Her doctor in Florida regularly prescribed drugs, including albuterol inhalers.
However, it wasn't until 2023 that Mexican doctors diagnosed her with stage 2 idiopathic pulmonary fibrosis. This is a condition characterized by scarring in the lung tissue. Scars damage lung tissue, including air sacs and small blood vessels, that help bring oxygen into the body.
“Your lungs aren't that flexible and resilient,” Sanchez said. “Oxygen does not move well as the lungs start to get stiffer and harder.”
Irreversible scars in both Victoria's lungs led to her being hospitalized every few months for breathing problems and constantly using a portable oxygen concentrator. Most of her days spent sitting and lying down.
“That was a bad thing,” her husband, Patala, shook her head. “It's really bad.”
When her condition deteriorated, Victoria was given about a year to live there. She was approved for a double lung transplant in 2024.
Nevertheless, some Florida surgeons were not active due to her decision to receive her age, frailty or not receive blood. Victoria is deeply committed to her faith as a Jehovah's Witness who does not support the use of blood transfusions.
“I didn't want blood, so I was more afraid of blood than transplants,” she said.
Minimize blood loss for better results
Sanchez was sure he and his team could help Victoria become one of Illinois' first bloodless double lung transplant recipients.
“Everyone else said to Theresa, “No,” but we didn't say yes because we were crazy,” Sanchez said.
“We said 'Yes.' Because we knew we could help her through all of this. ”
Bloodless transplantation surgery was developed to treat patients with specific religious beliefs, and the Uchicago Medicine transplant team adapted these techniques for lung transplantation. Rade Tomic, medical director of Uchicago Medicine's lung transplant program, said the method produces better results and has a lower risk of graft dysfunction, arrhythmia and stroke.
Nevertheless, few medical centers can take on the procedure if both lungs are implanted.
“No one in our area does that because it's a technically challenging procedure if we don't have the ability to transfusion patients,” Tomic said.
Bloodless pulmonary transplant surgery and successful recovery
Shortly after her arrival, Victoria was recognized to stabilize her health, accumulate iron and hemoglobin levels, and gain weight before surgery.
February 19 – After weeks of nervous predictions and meditation from Patala, one of the medical helicopters landing from his wife's hospital room may be carrying her donor's gift – Sanchez has begun surgery to replace Victoria's sick lungs.
He began by opening Victoria's chest and connecting the heart to the extracorporeal membrane oxygenation (ECMO) system to temporarily replace the work being done by the lungs. He first removed his left lung and confirmed that he had minimal blood loss.
“We paid a lot of attention because we didn't want this patient to bleed in the ICU later,” Sanchez said.
After carefully connecting the new lung pulmonary arteries and veins to Victoria's existing blood vessels, Sanchez confirmed that blood flows into the lungs and ventilate before repeating the same procedure in the right lung.
After 10 hours of work, the implant was completed. Sanchez asked Victoria to open her eyes.
“I opened my eyes and smiled,” Victoria said. “I was very happy.”
Easy breathing after double lung transplantation
With her breathing improving day by day, Victoria no longer needs a portable oxygen concentrator.
She still undergoes frequent medical checkups to fine-tune her medication and monitor her health, but the couple rents an apartment in Chicago for a year, making it easy to attend rehabilitation appointments.
Apart from being readmitted to hospital once due to weakness after the planned range of lungs, Victoria continues to make progress.
Patala keeps an iPad-sized pill organizer and dozens of pills that my wife photographs every day. Victoria looks forward to the decline in these drugs over time. And she is excited about future visits from her son and grandchildren.
“Before the transplant I could do anything anymore, and now I can do my daily activities in life,” she said. “It was worth it.”
