The Detroit surgeon who performed the lifesaving double lung transplant on a teenager whose lungs were damaged by vaping spoke with Local 4 about his thoughts on the dangerous trend.
Lung transplants are rarely done in the setting of acute lung damage. There’s usually an extensive evaluation and planning period. But the vaping injuries in Daniel Ament’s case were so rapid and ferocious that the only option was to find new lungs.
Dr. Hassan Nemeh is the director of the Heart and Lung Transplant Program at Henry Ford Hospital. He led the team that performed Daniel’s transplant.
“If you have scaling between 0 to 10 — 10 being the worst — he was a 10,” Nemeh said.
Nemeh said doctors got a phone call from Children’s Hospital about a young man with lung failure due to vaping.
“Time was not on our side,” Nemeh said. “It was precious, so we needed to move as soon as we could.”
Daniel had already been on extracorporeal membrane oxygenation — a special machine that takes blood out of the body, oxygenates it and returns it to the body, replacing the function of the lungs. But nobody can survive on ECMO long-term.
“If I recall correctly, he was on ECMO for 11 days when we got the call,” Nemeh said.
The clock was ticking for Daniel.
“Being on ECMO is a high-risk situation by itself, so complications do arise, and we see a patient’s picture go from relatively stable to completely unstable and progressing to multi-system organ failure.
Once the decision was made to do a lung transplant, Daniel was placed on the list, and to everyone’s relief, a pair of lungs became available.
During the six-hour surgery, Nemeh was shocked by the damage, he said.
“I would say, functionally, he was near 100% gone,” Nemeh said. “The lungs were terrible. They were destroyed. The lung destruction that I faced with this transplant was worse than anything else that I’ve seen.”
But the rest of Daniel’s body was healthy.
“In his case, it was lucky in the sense that his injury was solely to the lungs,” Nemeh said. “All his other organs were functioning beautifully — kidneys, liver, everything else was working just fine.”
That has helped Daniel successfully rehabilitate from the massive surgery. Even though the transplant saved his life, he’s not yet out of the woods, experts said.
“In terms of prognosis, lung transplant among the solid organ seems to carry the worst prognosis among all the solid transplants because it’s a very fragile organ and, again, it’s in touch with the outside world,” Nemeh said. “For lung transplant, 50% of the patients are expected to be alive and well for between seven to eight years. The other 50% don’t make it there.”
The experience put the vaping epidemic in a different perspective for Nemeh.
“This particular case was a life case,” Nemeh said. “I saw the agony of the parents. I saw the young, beautiful face of a young man dying in front of me because of the injury. I felt how senseless this is. Really, I mean, this is something that should not have happened and could have been completely avoidable.”
Nemeh said it made him a crusader against the dangers of vaping.
“This is the value in mind, and my mission, as I stated on a couple occasions before, is to prevent our kids from having access to this and prevent it from being promoted for the kids,” Nemeh said.
Daniel’s life was saved, but Nemeh said the vaping injury has changed the teen’s life forever.
Nemeh said while vitamin E acetate has been implicated and others are being investigated, he believes, based on the aggressive and widespread distribution of the inflammatory damage he saw, that the injury was a combination of a chemical injury and a cascade of other damaging processes in the lung. He said it seems unpredictable, so vaping is very much like playing Russian roulette with your lungs.
Frank McGeorge, MD & Derick Hutchinson/Click On Detroit