A life-saving lung transplant at UCLA for patient who was turned away by more than 20 hospitals
Miriam Merianos was a healthy mom of three living in Texas when she got the flu in November 2018.
Before long, the virus worsened, fluid built up in her lungs and Merianos was struggling to breathe. She was taken to a local hospital and placed on an ECMO machine, a device that puts oxygen into the blood, bypassing the heart and lungs.
Merianos remained on the ECMO machine for 10 months — significantly longer than the typical treatment — and she was told her only chance for survival was a double lung transplant. But her doctors also told Merianos that surgery would be too risky for her. All of the antibodies her immune system had produced to fight the flu would be too likely to attack a transplanted organ and cause her body to reject the new lungs.
Her family was not willing to take no for an answer.
"We knew we had to find a hospital that was willing to take my mom's complicated case, because she wanted to live and be there for her three children," said Elaine Kramer, one of Miriam's daughters. "Knowing that made our voice stronger for her."
By early 2019, Merianos had been rejected for transplant surgery by more than 20 hospitals across the U.S. In April 2019, her family turned to Ronald Reagan UCLA Medical Center, where Dr. Abbas Ardehali, surgical director of the UCLA Heart and Lung Transplant program, reviewed Miriam's case and accepted her as a patient.
"It was a relief," Merianos said. "All we heard before was, 'Sorry we can't help you,' and that was heartbreaking. It was a blessing to be able to get a second chance at life."
Ardehali and his team knew what the challenges would be, but they were determined to take them on and help Merianos. "She was a young woman with an unexpected condition that could happen to anyone, and we felt we should give her a chance," said Ardehali, "She had been on ECMO life support longer than any patient I know of. She fought to make it to surgery and we needed to give her the best chance to survive."
Merianos still had a long way to go to beat the odds. Before she could undergo surgery, a team of specialists at UCLA worked to reduce the high level of antibodies in her system to limit the chances that her body would reject the transplanted lungs.
In July 2019, a donor match was found, and a surgical team led by Ardehali performed a successful double lung transplant.
"The surgery required a multidisciplinary approach, involving team members from the lung and infectious disease specialists to people who specialize in immunogenetics," Ardehali said.
Less than a day after the surgery, Merianos was awake and breathing on her own. Now, 11 months later, she is continuing toward a full recovery — and she is taking extra precautions to stay healthy during the COVID-19 pandemic.
Merianos' family credits the UCLA Health team with saving her life and giving her a chance to make new memories with them.
"They put life back into my mom," said her daughter Eliza Merianos. "She recently welcomed her first grandchild and is back to her old self. That's a place we weren’t sure we;d ever get to again."
Ardehali said performing complicated surgeries like Miriam's proves that high-risk patients can have successful outcomes. It also allows their team to share what they've learned with other transplant programs so more institutions are prepared to treat high-risk patients in the future.
"Miriam has beaten the odds," Ardehali said. "A lot of credit has to go to her and her family for their courage, their commitment and their determination to persevere."