Idiopathic Pulmonary Fibrosis
For the Hsu’s, it’s the little things in life that matter most, such as time spent with family. Every year, Mr. Hsu and Jean look forward to taking international vacations with their two adult children, during which they explore local cultures through walking tours and other activities.
Yet during one of their most recent trips in spring 2018, when Mr. Hsu, Jean, and the couple’s two adult children were on a walking tour in Croatia, Mr. Hsu began experiencing unusual symptoms. He had shortness of breath while climbing stairs and walking long distances, and eventually developed a dry cough. He even had a difficult time breathing on the flight home.
After they returned, he saw a pulmonologist in his hometown in New Jersey, who diagnosed Mr. Hsu with idiopathic pulmonary fibrosis (IPF), a disease characterized by scarring of the lungs with no known cause. Over time, the scarring makes it difficult to breathe, as it did for Mr. Hsu, who was in his early 70s when he first noticed symptoms.
There is no cure for IPF, yet pulmonary rehabilitation, oxygen therapy, and other treatments may temporarily improve symptoms. In many cases, as in Mr. Hsu’s, referral for lung transplant is the only available long-term treatment.
The Road to the UPMC Lung Transplant Program
Following his diagnosis in 2018, Mr. Hsu’s pulmonologist prescribed supplemental oxygen for him to use while sleeping, in addition to medications that could potentially slow the progression of his condition. As time went on, he needed more and more oxygen therapy to the point that he was on it 24/7.
Mr. Hsu – along with Jean, his wife and dedicated caregiver throughout his lung transplant process – was actively looking for a lung transplant center that would accept his case prior to the onset of the COVID-19 pandemic. The center that they originally worked with did not approve Mr. Hsu for the transplant waiting list due to his age and the complexity of his case.
The Lung Transplant team at UPMC will evaluate every patient referred to our program. We have experience treating patients with complex conditions and older patients over the age of 70.
Therefore, when the couple reached out to several transplant centers recommended by their local doctors, UPMC was the first to respond. The team swiftly arranged a comprehensive lung transplant evaluation for Mr. Hsu that began in February 2021.
“From the beginning, we had a feeling that UPMC is quite experienced in the lung transplant area,” Jean said.
Comprehensive Care Every Step of the Way
First, the Lung Transplant team contacted the couple to explain the lung transplant process at UPMC and answer any questions they had.
The next step was for Jean and Mr. Hsu to travel to Pittsburgh for a pre-lung transplant evaluation in February.
The pre-lung transplant evaluation includes lab work and diagnostic tests to determine if someone is a candidate for lung transplant. Doctors perform these to determine the severity of your lung disease and to make sure the procedure is safe for you.
Mr. Hsu’s initial visit lasted a few days, and during that time, the couple was able to stay at Family House, an affordable housing option provided to UPMC patients who travel to Pittsburgh for their care. After the evaluation, the team helped the couple work out insurance details and connected with Mr. Hsu’s local doctors in New Jersey about preparing him for his lung transplant.
The couple returned to Pittsburgh for Mr. Hsu’s lung transplant in April, performed by Pablo Sanchez, MD, surgical director, UPMC Lung Transplant Program.
“Our lung transplant team was top notch,” Jean said. “Thanks to them, my husband was able to receive the care he needed.”
Following the transplant, Mr. Hsu remained under the care of Dr. Sanchez, who used state-of-the-art technology and therapies to help him heal properly. This included extra-corporeal membrane oxygenation (ECMO); a machine that supports the lungs by providing oxygen to the blood; and pulmonary rehabilitation. Mr. Hsu also had the opportunity to participate in the Lung Transplant Go (LTGO) study, a clinical trial exploring telerehabilitation behavioral exercise after lung transplantation.
“Dr. Sanchez made all the critical decisions, which included using the ECMO machine for a couple days after the procedure so that my husband’s new lungs could get some rest,” Jean said. “He made all the right decisions to carry him through the process.”
Since discharge from the hospital, Mr. Hsu has been under the care of Kaveh Moghbeli, MD. He and his family communicate with their UPMC care team through phone calls, telemedicine appointments, and the MyUPMC online patient portal. They also visit Pittsburgh for in-person clinical visits every three months.
“They are always responsive, patient, compassionate, and professional in addressing questions and concerns from our family,” Jean said.
From their initial contact with UPMC until Mr. Hsu’s discharge in June, the lung transplant team seamlessly guided him through the process, according to Jean.
“The whole thing was planned out so well – UPMC has a comprehensive program to carry you all the way through rehabilitation,” Jean said.
Experiencing Life’s Special Moments Together
After receiving his new lungs in April 2021, Mr. Hsu and Jean remained in Pittsburgh until that December, when they moved back to New Jersey. His recovery went smoothly other than an infection that the UPMC team diagnosed and treated in October.
Mr. Hsu was admitted to the hospital for several days while the lung transplant team collaborated with infectious disease partners on a treatment plan. The couple returned home to New Jersey after the infection completely cleared his system.
Now, they keep in regular contact with their care team, and come back to Pittsburgh every three months for a follow-up visit to UPMC. Overall, they are incredibly thankful for the care they’ve received throughout the entire lung transplant process, and for the meaningful life experiences they’ve shared together since.
“If it weren’t for the UPMC Lung Transplant Program, we wouldn’t have been able to see the birth of our two grandchildren,” Jean said. “And there will be more special moments in life that we’ll get to spend together.”
Mr. Hsu’s treatment and results may not be representative of similar cases.
