Washington veterinarian forced to travel across border for lung transplant

SEATTLE — A U.S. Marine Corps veteran from Washington state was diagnosed with a type of cancer after returning from a deployment in Iraq that doctors say was caused by toxic chemicals he was exposed to overseas.

Unfortunately, 44-year-old Andrew Stevens later suffered from chemotherapy that caused his lungs to fail. This year, his medical team placed him on a life support machine called extracorporeal membrane oxygenation (ECMO). It's “like an extracorporeal lung for your body,” said his wife, Stephanie Rudat. However, ECMO is not a long-term sustainable option.

Months later, Rudat said her husband's ICU doctors at Swedish Hospital told her that Stevens would need new lungs if she was to survive and recover.

“My lungs became stiff,” Rudat said. “They couldn't move.”

However, Rudat told KING 5 that the local team at VA Healthcare did not assist with the life-saving transplant here.

“This decision was made by the Lung Transplant Program, a joint program between the VA Puget Sound Healthcare System and UW Medicine where the transplant surgery will be performed,” UW Medicine said in a statement.

“Doctors contacted us, but they refused,” Rudat said.

As a result, Stevens will be rushed to Northwestern University's transplant center in Illinois on Friday, where she and her three sons will also have to be moved. Rudat said this has already caused further turmoil and instability for his three sons, who have already had a difficult year.

“Andrew fought an honorable war,” Rudat said. “Now he's not just fighting for a transplant; Andrew is fighting a system that claims to support him.”

The VA is paying for his treatment, but UW Medicine is the only affiliated transplant center in Washington. The transplant program denied Stevens eligibility for a transplant, citing outdated medical guidelines, Rudat said. It was once considered best practice to require patients to spend five years in remission before transplantation.

“This is a well-intentioned policy,” Rudat said. He explained that this general rule was created out of concern that cancer could come back during immunosuppression during transplant surgery.

Stevens has been in remission since February. However, as of 2021, the Journal of Heart and Lung Transplantation has relaxed its guidance, saying, “If the risk of recurrence is considered very low, transplantation may be an option.”

“I hope they don't just give people a firm 'no,'” Rudat said.

He said Stevens' oncologist doesn't think his cancer should be an obstacle to a transplant because the chance of recurrence is low and it is highly treatable.

“Here at Swedish Hospital, no one agrees to give up a transplant,” Dr. Rudat said.

But when Stevens' wife asked the Department of Veterans Affairs patient advocate to challenge that denial, she said she was told they would not reconsider Stevens' case “regardless of his progress.” she stated.

“She ended the conversation apologetically by saying that we should start looking into a long-term acute care facility for Andrew to live out his life,” Rudat said.

But Rudat did not give up. Instead, she got a second opinion. After reviewing Stevens' case, a prominent transplant doctor in California told Stevens' medical team: “I don't know if this theoretical risk would stop me from getting a transplant.”

In addition to the California doctors, Northwestern University's transplant team also said they were open to evaluating Stevens' transplant. Ultimately, Northwestern was able to acquire him before anyone else.

“We don't need more disruption than we're already facing this year because we know we have one of the nation's leading lung transplant centers right on our doorstep, but the Veterans Administration doesn't.” This partnership It's even more painful because we're not asking for any policy changes regarding this,” Rudat said.

KING 5 asked the team at VA Puget Sound Healthcare to come on camera and explain, but instead they responded with a statement that read in part:

“Veterans who may need lung transplants are some of the highest-risk patients we care for, which is why we are committed to helping pulmonologists and surgeons at Puget Sound, Virginia and the University of Wisconsin Medical Transplant Center. Our team of doctors, nurses, and social workers carefully evaluate each patient to determine if a lung transplant is the right treatment…

“Determining the best treatment for veterans with complex conditions requires the integration of several considerations, and we take this seriously and approach this with great care. .”

Now, Stevens' sons have just started the school year in Washington and are in the midst of uprooting their lives to move across the country to help their father fight for his life.

“When you're in the military, you don't leave anyone behind. You don't leave anyone behind,” Rudat said. “And he doesn't want to leave his family behind.”

Stevens' family faces significant new housing, living and travel costs as he will likely need to stay in Illinois for at least a year during the transplant and recovery process. If you would like to help, you can visit our verified site and join the hundreds of others who have donated. Fundraising activities A web page created in their name.

The University of Wisconsin Medicine's media relations team also declined to respond to KING 5's interview requests, instead emailing the following statement in part:

“A multidisciplinary team evaluates each patient to determine whether a lung transplant is the appropriate treatment. Each lung transplant center uses the latest technology to give patients the best chance of transplant success. Determine eligibility criteria based on medical guidance, research, and standards.”