Joshua Garza is spending a lot of time at Houston Methodist Hospital.
“I’ll go to the doctor any day of the week, because it means I'm still alive and I'm here to do it. That’s probably the worst thing you can hear in the world: 'We can't do anything else for you,'” Garza said.
That’s exactly what he was told earlier this year at another hospital.
“Late January, I started getting sick,” he said. “I couldn’t even walk anymore. My oxygen level had just gotten so low.”
His battle with COVID-19 got even worse.
“They said, 'You're going on a ventilator Monday and not many people survive that,'” he explained.
He decided, with the help of his family, to try treatment elsewhere. He was transferred to Houston Methodist.
“They said, 'Yup, your lungs are deteriorating, but you have an option,' and I said, 'Whatever you have to do,' so they put me on a machine called ECMO,” Garza said.
The ECMO machine, also known as extracorporeal membrane oxygenation, was able to stabilize Garga. He was then evaluated for a lung transplant, which took place on April 13.
“I think they told me I was either the 21st or 22nd to have the double lung transplant due to COVID,” he said.
One in 10 lung transplants in the U.S. have gone to patients with COVID-19-related lung damage in 2021, according to the United Network for Organ Sharing. In 2020, that number was 1 in 50.
“We do lung transplants for anyone who's basically in chronic failure for multiple reasons. The most common ones are scarring of the lungs, as well as emphysema,” said Dr. Erik Eddie Suarez, the program director for Heart Transplant, Lung Transplant and Mechanical Circulatory Support at Houston Methodist Hospital. “Now that COVID has entered the picture, COVID has become a significant portion of the transplants we’ve done in the last year.”
Suarez, a lung transplant surgery specialist, said these transplants are the hardest he’s ever done.
“At some point it became apparent that there was a chronically damaged lung that was never going to get better, so our first transplants we did, we didn't know what to expect. And still even now it is very variable what we find,” Dr. Suarez said.
He compares it to a bowl of spaghetti.
“When you first operate on someone, it’s very easy to pull apart the noodles in the bowl of spaghetti to get to what you need to. When someone's had a lot of scarring or a redo surgery, imagine it to be like pouring concrete into that bowl of spaghetti and having to take each of those little noodles out by chipping away the concrete and not injuring any of those noodles or else the patient will die. That's how severely difficult these first early COVID lung transplants were,” he said.
The transplants don’t come without controversy.
“The way that a lung transplantation works is that a lung offer goes to the most sick patient,” he said.
COVID patients on life support for months end up being the most sick patients on that wait list.
“That’s some of the controversy we’re going through now. Because there are people that have been waiting longer, who are not as sick as them but have been waiting a long time for transplantation, especially people who have things like emphysema, which is a very long chronic disease you need oxygen for and people suffer for it. But they’re not usually at imminent risk of death,” Dr. Suarez said.
“I do think it’s very new, and people are still trying to figure out what to do with that. There's a lot of discussion on it, and there are a lot of strong feelings on all sides,” he said.
As a medical professional, Suarez said he really has one goal.
“If I can save someone's life, I want to save someone's life,” he said.
Lives like Joshua’s.
“Almost four months in the hospital, basically dealing with the lungs and COVID at the same time, it’s been a long journey,” Garza said. “Somebody sacrificed their life for you to stay alive and I take that to heart.”
COVID lung transplants will continue as more people get sick.
“We’re still having a good load of people who are recovering, or if they’re not recovering, waiting for transplantation. So it'll still be with us for some time in the future. I don't see this going away in the next year,” Dr. Suarez said.