‘Lung in a box’ gives new life to isle patient

Lung transplants aren’t that common, and the way Estelle Ellington received hers was even less so.

The lungs arrived at the operating room "breathing" with oxygen and a solution that included red blood cells pumping through them.

" ‘Lung in a box,’ they call it," said the 53-year-old Mililani Mauka resident, who is recovering in Scottsdale, Ariz.

"It was a really hard recovery, but I’m getting better every day," Ellington said three months after her surgery at St. Joseph’s Hospital and Medical Center in Phoenix.

The experimental organ-preservation device, called the Organ Care System, is offered only at five sites in the nation and is still in the clinical trial stage, the hospital said.

The system allows lungs to continue to "breathe" and circulate with blood while in transit from the donor’s body to the recipient. The donor lungs actually expand and contract during transport.

"Any time an organ can be placed in an environment which is similar to the body, there is likely a benefit," said Dr. Michael Smith, who leads St. Joseph’s breathing lung transplant trial. "The traditional standard of care calls for the organ to remain ‘on ice’ without blood flow while in transit."

The hospital says the Organ Care System could revolutionize the field of lung transplantation.

Smith said the technology may allow for more extended periods of time that lungs can be considered viable, allowing a surgeon to travel farther to retrieve donated lungs and perhaps increasing the donor population.

Ellington, a mother of two, said she was diagnosed with lupus, an inflammatory disease that occurs when the immune system attacks tissue and organs, and severe pulmonary fibrosis, which causes lung tissue to become damaged and scarred.

About 10 years ago Ellington started getting extra winded on hikes, said her husband, Henry.

"It just kept getting worse," Estelle Ellington said.

For the past two years, she said, she was on oxygen 24 hours a day.

Dr. Eric Crawley, a pulmonologist at Tripler Army Medical Center, referred Estelle Ellington to St. Joseph’s.

Henry Ellington served 25 years in the Army before retiring as a physician’s assistant and is now at Waianae Coast Comprehensive Health Center’s emergency department.

"Everything just fell into place as it was meant to happen," Estelle Ellington said.

Lung transplants are not that common because of the small number of donor organs available, according to the National Heart, Lung and Blood Institute. About 1,800 of the procedures were done in the United States in 2010.

Risks also continue years after even a single-lung transplant. About 78 percent of patients survive the first year, according to the institute. About 63 percent survive three years, and 51 percent survive five years.

The organization said survival rates for double-lung transplants are actually better. The median survival for single-lung recipients is 4.6 years, while the median survival for double-lung recipients is 6.6 years.

The major complications of lung transplant are rejection and infection, the institute said.

Estelle Ellington doesn’t have all her former breathing ability back, but she said it’s already a big improvement.

"I am feeling OK now, but sometimes I have to remind myself that it’s me breathing and not a machine," said Ellington, who has lived with her family on Oahu for nearly 20 years. "We hope the people of Hawaii will become aware of medical advances for the treatment of severe lung disorders."

And she has another goal: "Get back to hiking," she said.