Ex Vivo Lung Perfusion
 
The number of lung transplants performed annually has increased significantly in recent years.  In fact, over 1,400 procedures were performed in the United States in 2007 compared to less than 1,000 procedures in 2000.  However, the number of lung transplants performed remains substantially smaller than most other solid organs.  For example, over 16,000 kidney transplants were performed in 2007 and over 10,000 of these were from deceased donors.  This is in part because two kidneys are usually retrieved from one deceased donor for two recipients, whereas two lungs are often retrieved for a single recipient.  Indeed, bilateral lung transplants are performed for approximately 60% of recipients in the United States.  Nonetheless, even after accounting for the number of bilateral procedures, the disparity between the number of lung and kidney transplants performed is still striking. Furthermore, in liver transplantation where a single organ is retrievable from each donor, over 5,500 liver transplants were performed from deceased donors in 2007.  The difference in the number of lung, liver, and kidney transplants performed is driven primarily by differences in donor organ utilization rates.  Approximately 75% of potentially recoverable kidneys and livers were transplanted in 2007 compared to less than 20% of lungs.  In other words, kidneys and livers can be retrieved and transplanted from approximately 75% of donors whereas lungs can only be transplanted from less than 20% of donors.  Lungs are most susceptible to injury after brain death, such as neurogenic pulmonary edema, aspiration, pneumonia, or ventilator induced lung injury, and this renders most organs unsuitable for transplantation.  Yet, the death rate on the waiting list is significantly higher for patients awaiting a lung transplant (125 deaths per 1,000 patient-years at risk) than for those awaiting a kidney transplant (65 deaths per 1,000 patient-years at risk).  Clearly, retrieving lungs from a greater proportion of deceased donors would increase the number of transplants performed and reduce the death rate on the waiting list. Ideally however, this should not compromise donor organ quality. 

Over the past several years, there has been growing research in the field of ex vivo lung perfusion, or perfusing the lungs outside of the body.  After retrieving lungs from the donor, a standard ventilator is used to inflate them using relatively low pressures and oxygen concentrations to avoid overdistention and further lung injury.  The lungs are then perfused with a mixture of a special preservation solution and red blood cells.  Using this system, lungs can be maintained for up to 12 hours, and this allows additional time to assess their suitability for transplantation.  More importantly, some interventions can be implemented to improve lung function and convert unsuitable organs into lungs suitable for transplantation.  For example, the tonicity of the preservation solution can be altered to remove edema fluid from the lungs via diffusion into the perfusion solution.  This would be beneficial in cases where lungs have been injured by neurogenic pulmonary edema, a common complication after brain death.  Furthermore, maintaining donor lungs at normal body temperatures would preserve the necessary cellular metabolism for endogenous reparative processes that are inhibited by hypothermic storage.  Theoretically, this would allow an injured lung to partially repair itself.  Most of this encouraging research has been performed in animal models.  However, a Swedish group reported their early clinical experience using this technique.  The group was able to successfully recondition six of nine pairs of lungs initially deemed unsuitable for transplantation, and these six pairs of lungs were transplanted into six patients.  All recipients survived three months after transplantation indicating adequate early pulmonary function, but two recipients died in the first year after transplantation of apparently unrelated causes.  This early experience with this technique is encouraging, and a multi-center clinical trial is planned in the United States.

 

The real impact of ex vivo lung perfusion on donor organ utilization, the number of transplants performed, and long-term outcomes after transplantation remains to be seen.  However, this technique offers the possibility of addressing the donor organ shortage that has limited a more wide spread use of lung transplantation.

 

 

 

          We are proud to introduce to you two new members of the St Louis Second Wind's Board of Directors; Marian Frentzel and Amanda Helderle. We have asked each of them to introduce themselves to the members of the organization.

 

          My name is Amanda Helderle. I am 33 years old and have had a roller

 coaster ride of a life so far. However, it is wonderful that my life has started to level out a bit. To begin, I was born with a genetic lung disease called Cystic Fibrosis (CF). At the time of diagnosis my life expectancy was 6 years and it gradually increased as I got older; I am now 33 and living a life that I never expected to live. My life began to change when I moved to Los Angeles to be listed on USC's lung transplant list. After being listed on the lung transplant list for a couple of years I received the call I had being waiting for...the call that would save my life. On May 12, 2004 I was called and told that I should arrive at USC's ICU as quickly as possible. Later that evening my two gorgeous pink lungs were placed inside me.

            Eventually, I affectionately named my lungs Mike 'n Ike for my favorite candy that I could no longer eat because of the development of steroid induced diabetes. Me, Mike 'n Ike and my beloved dog traveled all over Southern California hiking, running, surfing, skating, swimming and anything else that required deep breathing. I felt that since I received this gift of life I should enjoy everything possible. Additionally, I began taking classes at the local community college. From the first class I took (History of California), school just felt right.  I continued to take classes at the community college in Santa Monica until I began to miss my family.
 
            In August 2006, I left California to travel by car from the west coast to the midwest via Highway 44. The drive was an amazing 18 day road trip! From L.A. to San Francisco, south through Redwood National Forest, Yosemite, Arizona, New Mexico and more. It was truly an amazing trip. I arrived back in St Louis greeted by my family, and I have been living here and going to school since my arrival. I hit some bumps in the road in 2007 when my body began to reject Mike 'n Ike. Luckily, I was once again listed on the lung transplant list only this time at Barnes-Jewish Hospital. I was transplanted only three months later on February 14, 2008.  While I have had many ups and downs with being an organ recipient, my life has been quite interesting and challenging to say the least. I have managed to make it this far and do not plan on stopping now. Currently, I spend much of my time in school and volunteering for several different organizations. I have a wonderful support network of friends and family that encourage me to continue to fight no matter what happens. I feel truly thankful for every moment I am given!

 
Welcome Marian Frentzel

  
All About My Lungs
 
           St. Louis has been home to me all my life. I went to Beaumont High School, Washington University School of Fine Arts, University of Missouri St. Louis, married, raised my three children, my grandchildren were all born here, worked at Ralston Purina, and above all, received a double lung transplant at Barnes Jewish Hospital on July 6, 2006. All in St. Louis, Missouri. 
 
          I was diagnosed with chronic rheumatoid arthritis 20 years ago in my early 40's. I became less and less active due to the pain and deformity of my wrist, hands, knees and feet... Many medications (gold injections, methotrexate,  Naproxen, Cox-2 Inhibitors) were used all the way up to acupuncture, which gave me the most comfort.  My husband and I divorced after 24 years of marriage. I was a smoker, and successfully quit in 1999, after many failures.
 
          Dr. John Best, my pulmonologist from St. Luke's Hospital told me I was suffering due to the beginning of COPD in 2002. Along with taking rehab at St. Luke's Hospital and using acupuncture to ease the pain of rheumatoid arthritis everything was generally uncomplicated. But within 1 year I was hospitalized with a respiratory infection. After a virus recurring again and again I was put on oxygen 24/7 in 2004. As time went by, I required more and more oxygen and became weaker and very fragile.
 
          I was evaluated for a double lung transplant in Sept 2005 at Barnes Jewish Hospital and was listed March 1, 2006. I battled panic attacks, depression and fear of the unknown along with being sick. My daughter Karrie was a huge help being my significant caregiver of my family.
 
          Betty Wallace helped so much by introducing me to Second Wind of St. Louis, taking me with her to Barnes Support Group, and even taking me with her to church.
 
          On Thursday July 6, 2006 I got the call from Barnes to go pick up my new lungs. My surgery started at 9 PM and was in ICU by 2 am Friday morning. I was on a breathing tube and ventilator over night and by 7:30 am I was extubated (with ventilator and breathing tube removed). Before surgery my lung function was 12% and 7 weeks later it was 90%. I have continued to do well after almost 3.5 years. Immune depressive drugs I take for my transplanted lungs, has nearly ended discomfort and further damage from rheumatoid arthritis.
 
          Every day is a gift because of my donor family and the miracles of medical science. Each of these wonderful factors hasn't much value without each other.  I am enjoying and thankful for my remarkable life. I am probably the only 65 year old woman who feels happy about her age. I feel well and want to give back any way I can. 

 

Please join us as our guests for our Annual Second Wind Christmas Party on December 13, 2009 at Chris' Pancake and Dining which is located at the intersection of Watson and Southwest Ave, just a block west of  Hampton Ave.
 
We will begin at 2:00 PM with a 30 minute social and beverage time followed by dinner consisting of three entrees you can choose from, a salad, baked potato, mixed veggies, and cake & ice cream.

To make reservations please contact:
Tom Archer
3440 Halliday Ave.
St. Louis, MO 63118
314.664.6360
tea3440@sbcglobal.net
 
We will need the following information: Your name, number of reservations, and your telephone number. Reservations must be received by December 10, 2008.
 
We are looking forward to celebrating the holidays with you!
 
Second Wind Board Members: 
 
Annette Carr, Linda Nottestad, Gary Brandenburger, Josh Stegeman, Marian Frentzel, Amanda Helderle and Tom Archer 
 

 

Dear Sir,

 

 

 

Because of your generosity Second Wind provided $1,223.34 in assistance during November.  The payments were for lodging in St. Louis and insurance copays.
 
We Need Your Help to Reach Our Lung Walk Goal - We Are $5,500. Short
 
Our goal this year is to raise $40,000. in assistance funds for patients in need.  To date we have received $34,442.  This is our primary fundraiser for the year.  We know many of you were not able to participate physically in the Lung Walk, but, please consider making a donation to help us reach our goal.
 
Welcome New Members
 
(Fred) Sherrill and Shelia Lee from Mayfield, KY. Fred was transplanted 10/5/09.
 
Barbara and Joseph Kramer from Kimberling City, MO.  Barbara was transplanted 10/19/09
 
Memorials
 
In Loving Memory of June Feltz
 
James Graves
Mike Bendele
Amber and William Slade
Stan and Pat Zielinski
John and Bonita Parry
Billy Baker
Bob Johnson
Brad and Donna Maitland
Danny and Tammie Roth
Richard and Sharon Kidwell
Gerald and Garnett Rinehart
Frederick and Brenda Woodrell
Thomas and Karen Taylor
Denise and Frederick Johnson
Cindy Spears
Christina and Carl Hopkins
Patricia Foester
Kenneth and Dorothy Hylton
Debra LaFleur
Stephanie Duarte
Louis and Kathryn Francis
Tom Platnico
Michael Goldwasser
T.C. and Nancy Williams
Carole Tholborn

Tom Archer
 
In Loving Memory of Renee Haven
 
Michelle and Jerry Gillman - Message:  In honor of the second anniversary of her passing.  "We love you and miss you very much.  Love, Mom and Dad."
 
In Loving Memory of My Dear Friends of Second Wind Who I Came to Know through this Wonderful Organization.

 

Betty Wallace, Joy Warnecke, Debbie Ratliff, Annie Archer, Renee Haven, Sharon Miller, Jennifer Sutton, Laura Riggin Brandenburger, Jack Richie, Joe Dougherty and Mike Smith from Gary Porte
 
Psalm 103: 15-16
As of man, his days are like grass,
He flourishes like a flower of the field,
The wind blows over it and it is gone.

 

 

Darlene M. Daurelle, 73, of Maquoketa died Tuesday, November 10, 2009, at the Clarissa C. Cook Hospice House in Bettendorf, Iowa. Funeral services were held at 7 p.m. at Pape Funeral Home in Clinton.  Burial was held in St. Irenaeus Calvary Cemetery.

Darlene was born in Clinton, Iowa, on October 22, 1936, the daughter of Vincent and Magdalyn Determan Whalen. Darlene graduated from St. Mary's High School. She married Arthur Daurelle on October 6, 1956, in Clinton. Darlene had worked at Charlie's Supper Club, the Port Hole and Interstate Power Company. She was a member of Faith Community Church in Maquoketa.  Darlene enjoyed watching her grandchildren play sports, bowling, reading and watching movies.

 

Darlene was a member of St. Louis Second Wind Lung Transplant Association. She received a left lung transplant at Barnes-Jewish Hospital on October 12, 2002

Darlene is survived by two daughters, Vickie Logan, of Long Grove, Iowa, and Kathy (Kevin) Holle, of Bettendorf; two sons, Michael Daurelle, of Cape Coral, Fla., and Tom (Alison) Daurelle, of Maquoketa; nine grandchildren, Chris, Shaun, Kimi, Tyler, Shelby, Miranda, Shannon, Haleigh and Cassie; and her brother, James (Carol) Whalen, of Davenport. She was preceded in death by her parents. Memorials may be made to the St. Louis Second Wind Lung Transplant Association, Inc. Online condolences may be sent to www.papefh.com.
 

Memorials may be made to the St. Louis Second Wind Lung Transplant Association, Inc.

 

By Jan and Larry Kwasigroh