Lungs of teen who had transplant like 'nothing that I have ever seen,' doctor says

Neal Rubin
The Detroit News

The surgeon who transplanted two lungs into a teenage boy who was going to die from vaping used the word "evil."

Another doctor at Henry Ford Hospital in Detroit on Tuesday afternoon openly begged anyone who vapes to stop.

Dr. Hassan Nemeh, the surgical director of Thoracic Organ Transplant, said the inflammation and scarring in the 17-year-old's lungs were "nothing that I have ever seen" across 20 years of similar surgeries.

In this photo provided by Henry Ford Hospital with the patient's face digitally blurred, the unidentified double-lung transplant patient is leaving Children's Hospital on his way to Henry Ford in Detroit. It is believed to be the first double lung transplant operation due to injuries from vaping.

"It was an evil," he said, "that I hadn't faced before."

Alongside him, discussing what's believed to be the first vaping-related double lung transplant in the United States, critical care anesthesiologist Nicholas Yeldo issued a plea: If you vape, "We beg of you to get help. We don't want to be taking care of you next."

Information about the anonymous patient was limited. He tuned 17 in the hospital. He's an athlete, a sailor, a typical young man who likes goofing around with his friends and playing video games.

Like 28% of high schoolers and 11% of middle schoolers in the most recent National Youth Tobacco Survey, he smoked e-cigarettes. And now his family members are determined to find value in his experience.

"We asked Henry Ford doctors to share that the horrific life-threatening effects of vaping are very real," they said in a prepared statement that thanked the donor, the donor's family and medical teams at three hospitals. "Our family could never have imagined being at the center of the largest adolescent health crisis to face our country in decades."

E-cigarettes have been tied to 39 fatalities and more than 2,000 lung injuries in the U.S., according to the Centers for Disease Control. One of the deaths came in Michigan, where Gov. Gretchen Whitmer has asked the courts to reinstate her ban on flavored vaping products.

The Whitmer administration began enforcing the ban in early October, contending that an increase in young people using e-cigarettes constituted a health emergency. Responding to a lawsuit by vape shop owners, a Court of Claims judge ordered a halt to the restriction.

Thoracic surgeon Dr. Hassan Nemeh goes over the differences between the original lungs and the transplanted ones during a press conference at Henry Ford Hospital in Detroit on Tuesday.

At that point, the young man's condition was perilous.

He was admitted to Ascension St. John Hospital on Detroit's east side on Sept. 5, suffering from what appeared to be pneumonia. Struggling to breathe, he was intubated a week later, then transferred to Children's Hospital of Michigan on Sept. 17 and hooked up to a long-term heart-lung machine known as an ECMO device.

Children's Hospital reached out to Henry Ford's transplant department on Oct. 3. With Henry Ford's specialized transport team busy elsewhere, Nemeh and Yeldo loaded a portable ECMO machine into the back of Nemeh's SUV, drove it to Children's, attached it and had the boy loaded into an ambulance.

By Oct. 8, he was on the national organ transplant waiting list. By Oct. 15, with ECMO losing effect and only days to live, he'd shot to the top, and he was undergoing six hours of surgery.

Lung transplants are relatively uncommon, with about 2,000 performed annually in the United States compared to some 18,000 kidney transplants. The National Heart, Lung and Blood Institute reports survival rates of nearly 80% after one year and more than 50% after five years, with slightly more success for double lung transplant patients: a median survival rate of 6.6 years, compared to 4.6 years for single lung recipients.

Pulmonologist Lisa Allenspach, who directs Henry Ford's lung transplant program, said that given his youth and improvements in the transplant process, he could far outlive the norm. He is breathing on his own, and scheduled to be transferred soon to a rehabilitation facility.

"Hopefully," she said, "he will be an advocate against vaping."

Henry Ford declined to give specifics about how long the teenager had smoked or what vaping products he preferred.

The CDC said last week that it had identified a ‘’potential toxin of concern’’ in the vaping-related cases, a gummy syrup called vitamin E acetate that is sometimes added to vaping products containing THC, the chemical responsible for most of marijuana’s psychological effects.

Vitamin E acetate is not outlawed under Michigan’s medical marijuana program. Cannabis industry representatives have told The Detroit News they would support its prohibition.

Studies have shown that young vapers prefer flavored e-cigarettes. Michigan was the first state to take action against flavorings, and New York and Rhode Island have taken similar steps.

President Donald Trump has said he is considering a ban on flavored vaping, and that the White House will issue a ‘’big paper’’ on the subject this week. He tweeted Monday that he’ll be ‘’meeting with representatives of the Vaping industry, together with medical professionals and individual state representatives, to come up with an acceptable solution to the Vaping and e-cigarette dilemma.’’

At Henry Ford, doctors said the solution is simple: Don't do it.

"A senseless disease process," Nemeh said. "Somehow, it's being portrayed as a benign habit."

"The general public has some idea of this being better than cigarettes," Allenspach said.

"That's absolutely a fallacy."

On the left is a CT scan of a patient who required a double lung transplant due to injury from vaping. On the right is a current X-ray taken after the operation. The reason why there’s no X-ray from before the operation is that the lung was so damaged the X-ray had no detail.

Twitter: @nealrubin_dn