September 29, 2022

Patient journeys from South Africa for lung transplant

Mervyn Joseph, who searched the world over for the best place to be considered for lung transplant, is thankful he found Vanderbilt University Medical Center.

Mervyn Joseph traveled from South Africa to receive his lung transplant at Vanderbilt.
Mervyn Joseph traveled from South Africa to receive his lung transplant at Vanderbilt. (photo by Erin O. Smith)

Mervyn Joseph knew in March when his health was rapidly deteriorating despite being treated with medication, to quickly seek lung transplant or he would die. He had been diagnosed with interstitial lung disease in October 2021 — a disease to which his father, brother and sister had succumbed.

Prior to his diagnosis, Joseph, an attorney in Johannesburg, South Africa, had always been active, going to the gym five days a week before the COVID-19 pandemic and working a demanding schedule. As with everyone else, his life changed significantly from 2020. Then in 2021, his breathing pattern altered, leading to the diagnosis of interstitial lung disease.

Joseph searched the world over for the best place to be considered for lung transplant. He was laboring to breathe, even during short walks. He didn’t have much time.

“I told my team back home that one of the places that I had identified was Vanderbilt University Medical Center because it has got a very good reputation,” he said. “And I immediately received a very positive response that, without a shadow of a doubt, they would recommend that I should approach Vanderbilt.”

Joseph reached out to David Erasmus, MD, medical director of the Lung Transplant Program at the Vanderbilt Transplant Center, who guided him through the process of coming to Vanderbilt. With little time to spare because of his declining health, he boarded a plane to Nashville in April. His situation turned more urgent when, on the first leg of his flight to the U.S, his supplemental oxygen started running out because the plane was unable to recharge the batteries.

“I immediately communicated with Vanderbilt to say this was a crisis,” he said. “On our arrival in Nashville, arrangements had already been made for cylinders of supplementary oxygen with all the support gear, etc., available for me at our hotel. And it was from that moment onwards that I realized what an efficient system I had bought into. Nothing is left to chance. It is a highly coordinated, professional and precision-driven organization.”

Once in Nashville, Joseph went through a battery of tests that all potential transplant patients go through to ensure they are a good candidate for a transplant.

“When we first saw him for consultation, his lung function was declining rapidly,” Erasmus said. “It was clear that medical therapy was failing.”

Through the evaluation process, doctors discovered that Joseph had a previously undetected cardiac issue, and a stent was placed. This delayed his placement on the transplant list by a month. Shortly thereafter, the oxygen he was using in his rental apartment in Nashville was inadequate, and he was placed on high flow oxygen at Vanderbilt University Hospital until he could undergo a transplant.

“Patients with certain interstitial lung diseases such as idiopathic pulmonary fibrosis may have a very unpredictable course,” Erasmus said. “We encourage early referral for transplant for this disease because of the unpredictable risk of rapid decline.”

On June 24, Joseph received a double-lung transplant performed by Matthew Bacchetta, MD, MBA, MA, professor of Surgery and Surgical Director of the Vanderbilt Lung Institute. About three months after his transplant, Joseph is undergoing rehabilitation with regular monitoring and follow up as an outpatient at Vanderbilt. This includes thrice weekly physical therapy at Dayani Center, where he and the attentive team strive to return him to his pre-physically disabled status. He has enthusiastically followed the program and says that he is feeling incredibly well.

“I’m a new person,” he said. “I’ve in fact changed my birth date because I feel that I was reborn … on the 24th of June this year.”

If he hadn’t boarded that flight to Nashville, he would not be alive, he said. “I was a dead man walking.”

He credits his organ donor and the medical team at Vanderbilt, from the attentive pulmonologists, anesthetists and the cardio-thoracic units, and fondly remembers the nurses and therapists who walked him around his unit at 9:30 at night, attached to oxygen and monitoring equipment. They helped keep him healthy enough for transplant, saw him through the transplant and the follow-up and recovery afterward.

“One of the things that Vanderbilt should also be credited with is compassion, because a patient in that kind of situation goes through ups and downs, good days and bad days,” he said. “They read you, they help you, they encourage you, they feel sad with you, they feel happy with you, and patients need to feel that and feel that they are part of a family. And I can tell you it was incredible. My experience was astounding because when, for example … I walked very soon after surgery, everyone at the nurse’s station rose as one — they stood in unison, applauded and encouraged.”

Joseph and his spouse, Michael Hogan, who was carefully guided and assisted through this journey by the Vanderbilt support team, are now looking forward to returning to South Africa.

“We’re having a celebration of life lunch party at home,” he said. “The theme is ‘America,’ in recognition of this fabulous country that has given me new life. So, we’re doing an American theme. We’ve bought caps and shirts (including scarves for our twin dachshunds Rembrandt and Lautrec) and flags and bunting and will play the music for which hospitable Nashville is renowned, and we’re going to be serving hamburgers and hot dogs in the traditional style. We will skip the mac n’ cheese though!”