A Kentucky elementary school teacher survived two double-lung transplants after a series of respiratory infections destroyed her lungs and hospitalized her for over a year, according to a news release from Northwestern Medicine in Chicago.

Emily Presley, a 47-year-old elementary school teacher from Lexington, Ky, is grateful to be alive this Thanksgiving after returning home from Northwestern Medicine with new lungs. In October 2022, surgeons at the Northwestern Medicine Canning Thoracic Institute performed a successful double-lung transplant on Presley, whose lungs were destroyed by a series of viral and bacterial infections that had compounded into acute respiratory distress syndrome (ARDS). The life-threatening condition allows fluid to leak into the lungs, causing breathing to become difficult and depriving the organs of oxygen. On Oct. 30, 2023, Presley returned to Lexington, where she will spend her first Thanksgiving at home with her husband and children since 2021.

“Being able to see her go through everything that she’s gone through, and actually get her back to Kentucky is really bittersweet, because I’m going to miss her and Jeff, but that’s the goal,” said Catherine Myers, MD, pulmonologist with the Canning Thoracic Institute. “Patients like her are the reason I went into medicine. I’m grateful to be part of a team that tries to do the impossible and save people’s lives, even when it seems like it would take miracle.”

In May 2022, Presley was wrapping up a year of teaching STEM – science, technology, engineering and math – at Wellington Elementary School in Lexington when she came down with a severe cold. The illness surprised Presley’s husband, Jeff, who said his wife was a “model of health” and rarely got sick.

“I walked in the house, and I couldn’t believe how Emily looked and sounded,” said Jeff Presley. “I could hear her breathing from across the room.”

He brought his wife to a hospital in Lexington where she tested positive for rhinovirus (the common cold) and parainfluenza (a respiratory virus), which made her susceptible to a bacterial staph infection that ravaged her lungs. Within an hour of arriving at the emergency room, Presley was put on a ventilator and placed into a medically induced coma.

“Staph pneumonias are one of the most common pneumonias to occur after viral infections,” said Dr. Myers. “Because staph lives on our bodies, these pneumonias are often the result of people’s immune systems not working properly after getting a virus. Someone as healthy as Emily could usually fight this type of infection, but in rare instances it can be deadly.”

“I knew it was bad because I had the mask on for oxygen and there were probably like 15 people in my room,” said Emily Presley. “I remember thinking, ‘This is bad.’ And then I was out after that for a while.”

For five months, Presley was attached to ECMO, an advanced form of life support that does the work of the heart and lungs, but showed no signs of recovery. Additional infections compromised her lungs and other organs, and ARDS continued to cause inflammation throughout her body. On Oct. 8, 2022, Presley was transferred to Northwestern Memorial Hospital in Chicago.

“When we got a call from Emily’s medical team in Lexington, I knew we could get her strong enough to list her for transplant,” said Ankit Bharat, MD, chief of thoracic surgery and director of the Canning Thoracic Institute. “We did that transplant on Oct. 25, but soon after, her immune system reacted negatively to proteins in the newly transplanted lungs, possibly some residue from COVID-19 proteins that may have been present from a prior infection in the donor.”

Dr. Bharat and other members of Presley’s medical team approached her family and shared that the best chance for Presley’s survival would be to remove the lungs, relist her for transplantation, and transplant her again.

“I told the medical team that Emily and I love our life together. We love our friends. We love our community. So if there’s a chance that she can survive and have good quality of life, then the answer to a second transplant is ‘yes,’” said Jeff Presley.

Within 24 hours, the team received an offer for new organs, and surgeons successfully transplanted the second set of lungs on Oct. 27, 2022. Over the following year, Presley focused on her recovery, relearning to walk and swallow. She also worked diligently on improving speech, handwriting, and other daily functions through rigorous physical and occupational therapies.

“I don’t know how somebody would go through this without community,” said Emily Presley. “I have so much to be thankful for this Thanksgiving and I’m so glad my Northwestern Medicine lung transplant team could get me home to share that gratitude with my family, my friends, and the Lexington community.”