Though Larrabee will never meet the donors, she easily recalls the information she learns about them, like the age of the youngest donor—11—and that a significant number died after drug overdoses.
“I really want the full picture. I want to remember each time that lungs are coming in here that they’re not just lungs, like, they’re from a person…somebody loved them. I don’t want that part to ever be lost on me,” she says. “What’s so neat about EVLP is that you’re kind of taking somebody’s very worst day and turning it into another family’s very best day.”
For Heather Leverington, that very best day came in 2016. Ten years earlier, at age 27, the track and field coach at Lock Haven University in central Pennsylvania was diagnosed with a rare inflammatory condition called polymyositis that sometimes impacts the lungs. By 2015, the five-time NCAA Division II shot put champion was wheelchair bound and using oxygen at home. In March 2016, Leverington’s physicians added her name to the transplant waiting list.
Twice, her medical team called to say that a set of lungs might be available for transplant. Doctors rejected the organs the first time; the second time, the donated lungs went to someone else. On Nov. 7, 2016, the team called again, telling her a set of lungs was available, but there was a catch: The lungs were coming from a company called Lung Bioengineering, and because the FDA had not yet approved EVLP conducted outside of a hospital, she would have to consent to being part of the clinical trial in order to receive them.
“I said yes with no hesitation,” says Leverington, who was told to go to the University of Pittsburgh Medical Center for the transplant operation. The next morning she had a new set of lungs. Later, she reached out to the donor’s family through the OPO, but never heard back.
Receiving the transplant transformed the daily lives of Leverington and her husband, allowing her to return to coaching and even travel to Newcastle, England, last summer to participate in the World Transplant Games, an Olympic-style competition for recipients of donated organs, where she won a silver medal in the shot put and a bronze in the discus in her age group. She also visited Lung Bioengineering and met some of the people who kept her new lungs artificially alive before they were flown to Pittsburgh and implanted in her chest.
“It kind of gave me chills,” she says of the visit. “It was really kind of surreal, seeing where everything happened, and thinking that a part of me had been there before.”
Larrabee was in the operating room at Lung Bioengineering when the lungs received by Leverington sat under the dome during EVLP. Meeting Leverington was a rare opportunity to see a recipient she had helped keep alive. Oh my God, I’ve seen what your lungs look like, Larrabee thought. “It was really surreal to think that she was so sick that she might not be standing here” if the lungs hadn’t been judged suitable for transplant after undergoing EVLP, Larrabee says.
Not all lungs that Larrabee works on end up transforming the life of a recipient. Even when a lung or set of lungs is rejected by a transplant team, Larrabee sees the case as a success. “At least if lungs are going to fail, they fail on our system, and not in a recipient,” she says. “Ex vivo lung perfusion allows the lungs to show their true colors.”
Michael S. Gerber is a consultant and writer in Washington, D.C.