Second Breath: UCSD Health Completes First Double Lung Transplant for COVID-19 Patient

After more than 50 days on advanced life support, a multi-disciplinary team at UC San Diego Health helped one Escondido man become a candidate for a successful lung transplant

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Federico Gomez Gil, 56, is recovering from a double lung transplant at UC San Diego Health after a severe case of COVID-19 which resulted in pneumonia that permanently impaired his ability to breathe, UCSD announced Tuesday.

“What was eye-opening was that besides the COVID-19 virus, Mr. Gomez Gil was an otherwise healthy man,” said Eugene Golts, MD, the cardiothoracic surgeon at UCSD Health who performed the nearly eight-hour double lung transplant surgery. 

Gomez Gil was first diagnosed with COVID-19 in February before he was eligible for the vaccine.

"For Mr. Gomez Gil, he was not afforded the opportunity to get the vaccine and from that, you know, it could have been prevented," said Kamyar Afshar, MD, the director of lung transplant program at UCSD Health.

When he first arrived at UCSD's Sulpizio Cardiovascular Center, Gomez Gil was placed on a ventilator to assist with breathing, but it quickly became evident that a higher level of care was needed. 

Gomez Gil was then placed on extra-corporeal membrane oxygenation, or ECMO.

ECMO is used when a ventilator alone is insufficient. It works outside the body, pumping and oxygenating a patient's blood. The patient is connected to an ECMO machine via tubes, typically inserted into large arteries or veins in the neck and groin. With their workload reduced, the patient’s heart and lungs are able to rest and heal. 

Gomez Gil was on ECMO for more than 50 days. Prior to the pandemic, the standard time for a patient to be on ECMO was 9 to 12 days, according to UCSD Health.

ECMO is not a permanent remedy and, as the days passed, it became clear to his doctors that Gomez Gil would require some form of ventilation for the rest of his life.

Their solution was a double lung transplant. A multi-disciplinary team of physical therapists, respiratory therapists, pulmonologists and surgeons began working around-the-clock to get Gomez Gil strong enough to be a viable candidate for the transplant surgery, which remains relatively rare... COVID-19 added a new and unknown factor.  

“A requirement for transplant is that patients have a degree of mobility, even if on life support. We slowly wake patients up for periods of time and work with them to undergo a degree of physical therapy. It’s a marker for how well the patient will do following the surgery,” said Travis Pollema, DO, a cardiothoracic surgeon at UCSD who assisted Golts.

While on ECMO, Gomez Gil did physical therapy for approximately nine weeks before his transplant surgery. 

On June 14, Gomez Gil received his new lungs. 

“The surgery went well and he has a good prognosis,” said Golts, “He has a long road to recovery, longer than most lung transplant patients because he needs to learn how to breathe again on his own after having mechanical lungs do it for him for so long.”

Approximately three months after surgery, Gomez Gil was discharged. 

Afshar said, "It's not an easy journey by all means, not only for the patients, but also for their loved ones."

“This has been a rollercoaster of emotions,” said Guadalupe Gomez, Federico’s eldest daughter, “It has been amazing to see his progress. One day he had all these tubes in, and then eventually, they were removed and he was communicating with us. Now, he is back home. It’s been surreal.” 

“I feel so much better today. I am most looking forward to spending time with my four grandkids,” said Gomez Gil, “I am so grateful to the donor and the entire medical team. I am so blessed to be a success story. I want people to know this virus is real and serious. It’s so important for everyone to protect themselves, follow all the safety precautions and get vaccinated.”

Post-transplant care for Gomez Gil includes strict monitoring from his medical team, daily anti-rejection and anti-infection medications, exercise and physical rehabilitation.  

UC San Diego Health is the only hospital system in San Diego that performs lung transplants. The program is ranked #1 in the nation for one-year patient survival rates among programs with a volume of 50 to 75 lung transplants performed, and #3 among all lung transplant programs.

Recently, the ECMO program at UC San Diego Health received the Extracorporeal Life Support Organization (ELSO) Gold Level Center of Excellence award.

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