Words by Abby Haglage and Alexandra Thompson.
A teenager who underwent a double transplant after vaping “destroyed” his lungs was reportedly just “days from death”.
The unnamed 16-year-old went under the knife at a Detroit hospital in what doctors believe to be “the first double lung transplant in the world for a patient whose lungs where irreparably damaged from vaping”.
He was suffering from the newfound condition EVALI, e-cigarette or vaping product use associated lung injury.
His surgeon described the damage as “an evil he hasn’t faced before” in his 20 year career.
“Our teenage patient would have faced certain death if it weren’t for the lung transplant,” surgeon Dr Hassan Nemeh said at a press conference yesterday.
In a statement from the patient’s family, they described him as a “perfectly healthy” teenager who enjoyed sailing and playing video games.
Things took a dramatic turn for the worse when he was rushed to Henry Ford hospital in early September with suspected pneumonia.
He was later transferred to intensive care at Detroit Children’s Hospital, where he was put on life support.
The teenager’s condition was so severe, doctors put him on a list for a lung transplant, with a donor being found mid last month.
The medics claim the teenager was a “matter of days” away from death had it not been for the transplant.
“What I saw in his lungs was something I’ve never seen before and I’ve been doing lung transplants for 20 years,” Dr Nemeh said.
“There was an enormous amount of inflammation.
“The lung was so scarred we had to literally deliver it out of the chest.
“This is an evil I haven’t faced before.”
The family’s statement, read by Dr Lisa Allenspach - medical director of the Henry Ford Hospital Lung Transplant Program - said: “We ask Henry Ford doctors to share the horrific life-threatening effects of vaping are very real.
“Our family could never have imagined being at the center… of this crisis.
“Within a very short period of time, our lives have been forever changed.”
What is EVALI?
The teenager’s case comes as the US faces a “vaping crisis”.
As of November 5, the Center for Disease Control and Prevention (CDC) reported 2,051 cases of EVALI, including at least 40 deaths.
These have occurred in every state aside from Alaska.
“Unfortunately, many more people have been hospitalised with lung injury each week,” Dr Anne Schuchat, principal deputy director of the CDC, told Scientific America.
EVALI causes flu-like symptoms such as breathlessness and night sweats.
Once in hospital, tests may reveal low oxygen levels in the blood, as well as murky spots on an X-ray.
Overtime a build-up of fluid, known as “wet lung,” can lead to complete organ failure.
While a mystery for a while, the CDC identified Vitamin E acetate, a honey-like substance used to thicken vaping products, as one of the toxins fuelling the crisis.
“We have a strong culprit,” Dr Anne Schuchat, principal deputy director of the CDC, said last week.
The CDC claims it found vitamin E acetate in samples from 29 EVALI patients across 10 states, CNN reported.
Vitamin E acetate is “enormously sticky” and “does hang around”, according to Dr James Pirkle from Wake Forest Baptist Health.
“Vitamin E is illegal in vaping products sold in the UK,” Ciaran Osborne, director of policy at Action on Smoking and Health (ASH), told Yahoo UK.
THC, the psychoactive component of cannabis that makes users’ “high”, may also be to blame. This is also banned in the UK.
The CDC found THC in 23 out of the 28 patients they analysed.
Dr Pirkle added THC leaves the lungs faster than Vitamin E acetate and therefore may have been in more samples.
Most EVALI sufferers make a full recovery, however, some are left with limited lung function and find themselves back in hospital when their symptoms fail to clear up.
After analysing 60 EVALI patients across 24 hospitals, scientists from the Intermountain Medical Center in Utah concluded high doses of IV steroids “tapered slowly” should be the go-to treatment for critically ill patients.
Lung transplants are required if a person has “advanced lung disease that is not responding to other treatment” or if their life expectancy is expected to be less than two-to-three years without the procedure, according to the NHS.
A lack of donors means this is a relatively rare operation in the UK, with just 214 transplants taking place between 2017 and 2018 in England, NHS statistics show.
And in the US, around 2,000 people have a lung transplant each year, compared to almost 18,000 kidney transplants, according to the University of Michigan.
Donations usually come from the deceased, according to the NHS.
In rare cases, a section of the lung may be taken from a live donor.
“There is a tremendous scarcity of organs,” Dr Remzi Bag, medical director of the lung transplant program at the University of Michigan, told Yahoo Lifestyle.
“Lung transplant programs have to find a way to figure out whether this precious gift of donation would be taken good care of by the recipient.”
He added offering more lung transplants would be the “wrong way to prevent death from vaping” because it fails to fix the problem itself.
Dr Ilona Jaspers - deputy director of the Center for Environmental Medicine, Asthma, and Lung Biology at the University of North Carolina at Chapel Hill - added: “Lung transplant should be a last resort for EVALI patients.
“I would not think lung transplants are the procedure of choice for EVALI patients in the future,” she told Yahoo Lifestyle.
“More emphasis on prevention, early detection and treatment of the disease to reverse the lung damage should be placed rather than opting for a lung transplant.”