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Only a herculean effort by nearly 50 UW Health doctors and their teams of nurses, therapists and coordinators could have saved the life of 24-year-old Daniel Milburn when he was suddenly transported by Med Flight from Gundersen Health in La Crosse, Wis. to University Hospital in late March 2021. His incredible story – which culminated in an extraordinarily rare heart-and-double-lung transplant on Easter Sunday – is nothing short of a miracle.
A native of Louisiana, Daniel moved to Wisconsin in 2019 to work for the Ashley Furniture assembly plant in Arcadia, Wis., not far from La Crosse. Other than a lifelong asthma condition and some fainting episodes after becoming lightheaded, Daniel was a seemingly healthy young man who almost instantly found himself hanging on for life. It wasn’t immediately clear that he would need a new heart and lungs, but once all other medical options were exhausted, the race was on to save Daniel. Thankfully, he was in the right place, given the stellar reputation of the UW Health Transplant Center – known across the nation for both shorter-than-average wait times for new organs and excellent outcomes.
Dr. Jason Lai, the UW Med Flight physician whose crew transported Daniel to Madison, remembers hoping for the best but fearing the worst.
“When we picked up Daniel in La Crosse, he was in critical condition with blood clots in his lungs,” he says. “As Med Flight physicians, we usually don’t find out what happens with our patients once we drop them off. It was quite a miracle that Daniel pulled through.”
When he arrived at University Hospital, several UW Health teams -- including heart transplant, lung transplant, heart failure and critical care -- began attending to Daniel. After hours of tests, they discovered yet more pulmonary blood clots that had caused irreversible damage.
Blood clots in lungs put Daniel in great danger
“The clots in Daniel’s lungs put tremendous pressure on his heart, causing right-sided heart failure,” says UW Health’s Dr. Malcom DeCamp, Chair of Cardiothoracic Surgery, who took the initial call from Gundersen and arranged for Daniel’s transfer.
All of the medical teams spent hours consulting not only with each other, but with colleagues around the nation determining whether any form of treatment short of a multi-organ transplant was feasible. His unusually grave condition, known as chronic thromboembolic pulmonary hypertension, often goes undiagnosed for years before the body sounds its emergency alarms.
“Our hypothesis is that Daniel’s blood was genetically predisposed to clot where it normally shouldn’t, namely inside the blood vessels in his lungs,” says Dr. Daniel McCarthy, Surgical Director of Lung Transplant at UW Health. “Once we saw how much clotting there was, we had no choice but to put Daniel on ECMO in hopes of stabilizing him.”
ECMO, which stands for extracorporeal membrane oxygenation, is a last-resort artificial heart-and-lung machine to keep critically ill patients alive. It was used frequently to sustain many very sick COVID-19 patients, but otherwise is used only when other measures are exhausted.
Fortunately, ECMO settled Daniel’s situation and helped restore consciousness so he could speak with his care providers and his mother, Ronda Miller, who had just flown in from California, where she was working.
“The last thing I remember,” says Daniel, “was lying in the hospital in La Crosse. After a three-day coma, I woke up on Good Friday and saw my mom in the room. Thinking she was still in California, I knew something was severely wrong.”
Daniel thought doctors had to be talking about another patient
Daniel’s hunch was confirmed when doctors told him he needed to be placed on the wait list for a heart-and-lung transplant.
“When I heard them say ‘transplant,’” Daniel says. “I thought they were talking to the wrong patient.”
His mother also was astounded beyond words.
“I had just spoken to Daniel on the phone the day before he went to the hospital in La Crosse,” Ronda says. “It was inconceivable to hear that he might not live. Thankfully, everyone at UW Health was so comforting and said they would do whatever it took for him. There were so many nurses, transplant coordinators and therapists who spent hours with us and they had an answer for every question, which gave me total confidence.”
As the magnitude of Daniel’s illness became clear, only one path to survival emerged -- a new heart and lungs. Only 40 heart/lung transplants are done in the U.S. each year and even if new organs became available quickly, there was no guarantee of survival. Daniel’s situation was indeed dire enough to move him near the top of the wait list, but nobody could predict how soon matching organs would become available. Solid organs are almost always in short supply because more patients need organs than there are people who have chosen to become organ donors.
New heart and lungs arrived in one day
Patients in need of a new organ can wait days, weeks or even months, but as if scripted in Hollywood, Daniel’s prayers were answered the very next day -- Easter Sunday. He calls it a blessing, not a coincidence to be offered a heart and two lungs from the same donor who made the gift of life. The successful 8-hour surgery was performed by five UW Health cardiothoracic surgeons, including Dr. Jason Smith, Director of Cardiothoracic Transplant, who recovered the organ block from the donor.
“The new heart and lungs worked well right away,” says Dr. Amy Fiedler, one of the heart transplant surgeons who cared for Daniel. “It was all hands on deck for Daniel and there was great teamwork across the board.”
After spending just 2½ weeks in the hospital following the surgery, Daniel moved into a Madison apartment so he can be close to his care team. He works in the hospitality field and continues to get stronger over time while adhering to an exercise regimen.
“Daniel is recovering wonderfully,” says Dr. Erin Lowery, a UW Health transplant pulmonologist and medical director of the Lung Transplant Program. “When you consider how little time he had to prepare for this ordeal, it’s really extraordinary. Having his mom there for him has been an enormous source of support and strength. His prognosis for a fairly normal life is quite good.”
Daniel and Ronda cannot express how grateful they are not only for the quality of care at UW Health, but for the organ donor and their family who gave Daniel a second chance at life.
Becoming a donor could save another life like Daniel’s
“I will treat these gifts with the greatest possible respect and love,” Daniel says.” He also encourages those who have not become an organ donor to reconsider.
“You or your loved one could be in the same place I was,” he says. “You will want someone to donate for you the way somebody did for me.” Anyone can register to become a donor by visiting organdonor.gov.
Dr. Lowery says Daniel’s case beautifully illustrates how a multitude of physicians, nurses, therapists, coordinators and other caregivers were unshakably united on Daniel’s behalf.
“Daniel’s survival is a great testament to the breadth and depth of UW Health broadly and our Transplant Programs specifically,” says Lowery. “We are incredibly proud to see our heart transplant, lung transplant, heart failure, ECMO and critical care teams come together on behalf of this young man who had some bad luck but whose gratitude cannot be overstated.”