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Vol. LIX, No. 18
September 7, 2007

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Organ Transplant Brings Hope, Gratitude To CC Physician

  Dr. Cathy Cantilena of the Clinical Center's department of transfusion medicine  
  Dr. Cathy Cantilena of the Clinical Center's department of transfusion medicine  
Dr. Cathy Cantilena, staff physician in the Clinical Center's department of transfusion medicine and an NIH employee since 1989, doesn't wear an iPod when she exercises outside. She doesn't want anything to block out the sound of birds singing. For her, listening to them is part of appreciating the gift of life; their songs bring her hope for another day. When she's inside at her office, a statue of an angel with a bird perched on its arm lifts her spirits. It's saying, "Hope is like a little bird that sings."

Cantilena began her tenure at NIH in NHLBI, working with patients diagnosed with rare or new diseases. Later, she worked under the mentorship of Dr. Harvey Alter, chief of DTM's infectious disease section, when he and his colleagues first identified the hepatitis C virus. But Cantilena didn't suspect that she would be diagnosed with a rare disease-lymphangioleiomyomatosis (LAM). In this disease an unusual type of muscle cell invades the tissue of the lungs, including the airways, blood and lymph vessels. Over time, these muscle cells grow into the structures' walls, causing them to become obstructed. Eventually, the muscle cells block circulation to and from the lungs, preventing them from providing oxygen to the rest of the body.

Unique to women of child-bearing age, LAM has no known treatment aside from transplantation; only about 800-900 women in the U.S. have it. In the past, physicians often gave LAM patients antihormonal agents, which didn't work. NHLBI's LAM protocol involves observing the disease processes to identify the proteins and genes that contribute to lung destruction and then to develop more effective therapies.

  Cantilena talks with Scott Kaufman, who recently made his 100th donation to the NIH blood bank. Cantilena tells donors, “You’re the celebrity here because you’re giving people like me life.” Kaufman and his brother, Lloyd—who is about to make his 100th donation—contribute regularly in memory of two family
  Cantilena talks with Scott Kaufman, who recently made his 100th donation to the NIH blood bank. Cantilena tells donors, "You're the celebrity here because you're giving people like me life." Kaufman and his brother, Lloyd-who is about to make his 100th donation-contribute regularly in memory of two family members who died of cancer.

Cantilena admits she was adept at ignoring symptoms that something might be wrong. One day, while playing with her children in the ocean, she could no longer breathe and couldn't jump the waves. She couldn't walk and get enough air to have a conversation at the same time. She also started to lose weight rapidly.

NHLBI physicians diagnosed her LAM in 2000 but she didn't begin her search for a lung transplant program until 2005. According to United Network for Organ Sharing guidelines, patients who receive lung transplants at programs performing more than 21 procedures annually have the best chance of surviving. Cantilena selected the Duke Lung Transplant Center and passed the pre-operative evaluation in January 2006. She soon knew she had made a good choice: Duke places transplant patients in small groups so they can journey together through the process. "The camaraderie was wonderful," Cantilena said.

In early March, her condition deteriorated rapidly after she caught a virus that weakened her lungs. She experienced a code blue lasting 6-8 minutes-long enough for physicians to worry about brain death-and went into a coma for 4 days. Though still on a ventilator, she awoke from the coma and found that her name had been moved to the top of the UNOS waiting list for lungs.

She received her transplant on Mar. 8, 2006, and the next day was awake and breathing the air in her hospital room. Although she had a long road ahead of her, Cantilena returned home and to work at NIH by early June, less than 3 months after her transplant.

DTM chief Dr. Harvey Klein remarked on Cantilena's "amazing ability to contribute to the CC clinical care effort right up to the time of transplant, as well as her remarkable return. This is a physician who carried her oxygen tank to work and to the clinic up until days before she left for Durham for her lung transplant. We considered it a miracle that she recovered so quickly and a blessing that she returned so quickly to our hospital. She is an inspiration to the physicians whom she trains in transfusion medicine and an example of the difference that organ and blood donors can make."

"It's a miracle I'm here," Cantilena said. "I'm alive. The sky is blue. I attended my daughter's first Holy Communion, watched my middle schooler's soccer games and saw my son graduate from high school. I am here to contribute to their lives. That's the ripple effect of organ donations. You get life back."

At the 1-year anniversary of her transplant, Cantilena is proud to have survived and knows that she will need to stay vigilant for infections that could compromise her ability to reach the 5-year mark. Her immunosuppressed state requires some lifestyle changes such as avoiding classrooms, large crowds and uncooked vegetables-all of which could harbor bacteria and viruses. "But you can't live in fear of setbacks," she said. "I just like to listen to the birds singing and smell the fresh air. It's so nice not to have to worry about every breath!"

Cantilena has an enormous sense of gratitude, especially to her family, friends and colleagues. She wants to spread awareness of the importance of organ and blood donation. Because she needed 15 blood donors, including three platelet donors, she encourages everyone who is healthy to donate blood regularly, to consider becoming an organ donor and to discuss those decisions with family members. "Make that contribution and live life to the fullest every day," she said. NIH Record Icon

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