Laguna Hills Woman Receives Heart-Lung Transplant in S. Diego : Medicine: Nurse in critical condition after five-hour surgical procedure. Operation adds new dimension to UC San Diego Medical Center’s transplant program.

A desperately ill nurse from Laguna Hills was reported in critical but stable condition on Wednesday after surgeons at UC San Diego Medical Center completed the first combination heart-lung transplant ever attempted in San Diego County.

Catherine Renee Williams, 34, a registered nurse at Saddleback Memorial Medical Center in Laguna Hills, “should be able to lead a normal life” if her recovery continues smoothly, Dr. Paul Jagger, a medical center spokesman, said Wednesday.

Williams was hospitalized in January for treatment of a relatively rare, congenital heart defect that had caused severe and irreversible damage to her lungs. “It’s safe to say that she had less than a year to live,” Jagger said.

“We’re very pleased with her progress,” Jagger said. “Things went very smoothly for the first procedure (of this type) here. . . . Oxygenation (of the lungs) is excellent as . . . (are) cardiac functions.”

Doctors began the complex, five-hour operation late Tuesday night and completed it early Wednesday morning, Jagger said.

Williams on Wednesday “regained consciousness for a time and she was aware that she’d had the operation,” according to a family friend. “Her doctors were ecstatic.”

Williams, who was scheduled to remain in the recovery room for about 24 hours, will stay in an intensive care ward for at least a week, and be hospitalized for several more weeks, Jagger said. She will remain on a “continuous medication program” that is designed to keep her body’s immune system from rejecting the transplanted organs, Jagger said.

Nationally, 31 hospitals are conducting heart-lung transplants. More than 800 of the operations have been conducted worldwide. Medical centers at UCSD, Stanford and UCLA are the only California institutions to have completed heart-lung transplants. Cedar-Sinai Hospital and St. Vincent Medical Center in Los Angeles area have completed lung transplants but have not done combination heart-lung transplants.

UCSD’s surgery team was led by Dr. Stuart W. Jamieson, who has directed or performed more than 50 heart-lung transplants while working at other facilities, Jagger said. Jamieson and his transplant team moved to UCSD last July from the Minnesota Heart and Lung Institute. The transplant team includes Drs. Michael P. Kaye, Jolene M. Kriett and Riyad Y. Tarazi, and clinical nurse specialists Ann Hayden and Rebecca Robert.

Nationally, survival rates for patients who have undergone heart-lung transplants average about 60%, Jagger said. Jamieson’s patients at the Minnesota facility have a 75% survival rate, Jagger said.

Williams was one of three patients awaiting heart-lung transplants at San Diego hospitals. Both UCSD and Sharp Hospital recently created teams capable of performing heart-lung and lung transplants. UCSD also has several patients awaiting lung transplants.

Williams was placed on the heart-lung transplant list in January. Last October she was diagnosed as having Eisenmenger’s syndrome, a rare, congenital heart defect that ruins the lungs. A hole between the two chambers of her heart caused it to pump harder than usual, creating pressure that was gradually destroying her lungs.

Jagger said Eisenmenger’s syndrome is “almost always” diagnosed in infancy or early childhood. At that point it is possible to repair the heart and avoid irreversible damage to the patient’s lungs.

Because combination heart-lung donors are extremely rare, Williams’ physicians were ready to perform a complex operation involving the repair of Williams’ heart and the transplantation of a single lung, which is easier to obtain.

“We were hoping that we could get (at least) one lung, (but) we had the opportunity to get two lungs and a heart to go with it,” Jagger said. “If only one lung had become available we would have tried to repair the congenital defect in the heart.”

UCSD officials on Wednesday declined to divulge details about the donor.

The operation, which cost about $150,000, was not covered by Williams’ medical insurance policy, according to Michael Stringer, director of UCSD’s hospitals and clinics. However, Williams’ family, friends and co-workers are sponsoring a fund-raising campaign that, with matching funds from Saddleback Memorial, has collected $118,000. The medical center is “committed to cover any difference that remains,” Jagger said.

By coincidence, Gary Troxel, who just weeks earlier became UCSD’s first heart transplant patient, was released on Wednesday morning. Troxel, a 25-year-old construction worker from Riverside County, is in good condition following the Feb. 26 operation, Jagger said.

“This was an important day for San Diego and the region,” Stringer said. “It represents the availability of an important new medical program for critically ill patients.”

UCSD’s transplant program now includes hearts, heart-lung combinations, lungs, corneas and bone marrow, Stringer said.