“I’m not done living yet and have a lot of good to share with the world."
This was what a 65-year-old Filipino-American said after becoming the first known successful "COVID-to-COVID" double lung transplant recipient in the United States. He is now on his way to recovery.
Renato Aquino, who immigrated to Illinois from the Philippines to pursue a career in medicine 30 years ago, worked as a phlebotomist on the front lines during the pandemic.
“I spent the last year in and out of hospitals, struggling to breathe – not knowing if I’d live or die... I was a healthy guy with no underlying health conditions, but my symptoms started with a fever and quickly got worse," Aquino said in a statement from Northwestern Medicine.
On May 14, 2020, he drove himself to the emergency department because he was suffering shortness of breath from the coronavirus.
Aquino was placed on a ventilator before he was transferred to another hospital for extracorporeal membrane oxygenation (ECMO), a life support machine to help support the heart and lungs.
He remained on the ECMO for two months and then was placed back on a ventilator as his lungs struggled to recover.
On multiple occasions, the doctors told Aquino’s family to say their “final goodbyes” and start making funeral arrangements. “His doctors told us there was nothing more they could do for him,” explains Aquino’s niece, Tasha Sundstrom.
After seeing a news story about lung transplants being performed on COVID-19 patients at Northwestern Medicine, her niece mentioned it to Aquino's doctors and was then transferred to Northwestern Memorial Hospital in February.
Aquino was placed on a lung donor list since COVID-19 had caused permanent damage to his lungs.
Ankit Bharat, MD, chief of thoracic surgery and surgical director of the Northwestern Medicine Lung Transplant Program, who performed the procedure, said that when the team got the call that lungs were available from a donor who previously had the virus, they knew a "COVID to COVID" lung transplant was Renato's best shot at survival.
A week later, Bharat received the good news that a donor was found.
"After spending one week on the transplant wait-list, Renato received beautiful, healthy lungs – marking a new milestone for lung transplantation. There’s no evidence of any reactivation of COVID-19 in Renato’s lungs and he’s on track for a full recovery," the doctor said.
The lung transplant team had performed multiple tests that examined the donor’s lung fluid to ensure the donor had cleared the virus from the body, according to Dr. Rafael Garza-Castillon, another thoracic surgeon at Northwestern Medicine.
A lung biopsy was also performed to make sure there is no permanent damage to the donor lung.
The donor's history was reviewed to ensure that the COVID-19 infection was not a severe case.
“Once we arrived at the donor hospital, we directly inspected the lungs and took blood oxygen measurements from the pulmonary veins to ensure good lung function. By carefully assessing the donors and when specific criteria are met, we think lungs can be used from those with a history of non-severe forms of COVID-19," said Castillon, who also assisted with the donor retrieval and transplant.
Exactly one year later, Aquino is now on the road to recovery.
“I love taking care of people and making them happy. I’m ready to get back to being the "fun uncle" who makes silly faces and jokes with my nieces and nephews. I’ve missed out on so much this past year – but thanks to my medical team and organ donor, I have a lot more to gain," said Aquino.