Breathing Freely: Lung Transplant Gives Patient Second Chance

For Kari Lusti, dealing with lung infections and bronchitis became a way of life for her in her early 20s. Once the infections began to develop into pneumonia and multiple hospitalizations, Lusti knew something much more serious was happening.

"Every time I would get pneumonia it would get worse, last longer and require more medication to treat," explained Lusti.

In 2017 and after years of illness, Lusti was diagnosed with bronchiectasis, a condition in the lungs that makes it harder to clear mucus, leading to multiple infections. Years later, her symptoms worsened and Lusti was also diagnosed with MAC lung disease, a long-term infection of the lungs caused by Mycobacterium abscessus complex (MAC), a type of bacteria that naturally lives in dust, soil and water. 

According to the U.S. Centers for Disease Control and Prevention, MAC bacteria typically do not cause harm for healthy individuals and most often affect the skin, but can result in health issues for people with other lung diseases, such as bronchiectasis, like Lusti. 

In January 2025, Lusti's health took a serious turn for the worse as she was hospitalized again for pneumonia.

"I was in the hospital for 45 days, and what scared me the most, was that none of the antibiotics I was given during that time was working to clear my pneumonia – the doctors there were beginning to discuss end-of-life care with me," explained Lusti. "At the time, my daughter was only 11 years old and I knew I had to do everything I could to be there for her."

Lusti was transferred to UC San Diego Health to be immediately assessed for lung transplant, the only hospital system in San Diego County with a lung transplant program. 

"Due to her MAC infection, Ms. Lusti underwent a comprehensive evaluation in partnership with our transplant infectious disease team at UC San Diego Health to confirm she was a safe candidate for surgery," said Kamyar Afshar, DO, medical director of the lung transplant program at UC San Diego Health. "Through our multidisciplinary approach, we were able to successfully perform a bilateral lung transplant for Ms. Lusti, who may have otherwise been denied surgery due to her high-risk case."

Using an advanced lung perfusion machine, Lusti's donor lungs were received from across the country and preserved through hypothermic preservation technology, which enables the lung transplant team at UC San Diego Health to safely utilize donor organs from geographically distant regions, including across North America and Hawaii. 

"This innovative approach to organ procurement significantly expands the availability of life-saving donations and facilitates timely transplantation in complex cases, such as Ms. Lusti's," Eugene Golts, MD, surgical director of lung transplant at UC San Diego Health, who performed the surgery. 

"The operation itself was technically demanding due to the presence of extensive and dense scar tissue, resulting from the patient's history of recurrent pulmonary infections, and enlarged lymph nodes that further complicated the surgery. Despite these challenges, the procedure was completed successfully and we are incredibly proud of the result."

According to Afshar and Golts, their team tested Lusti for MAC bacteria following lung transplantation and all her cultures came back negative. 

"We are now in the planning phase of discontinuing her antibiotic regimen, and it is wonderful to know the transplant has eliminated a condition that she lived with for so long," said Afshar. "Our team is continually humbled by the resilience of individuals like Ms. Lusti and we are fortunate to be able to provide such life-saving care for patients and witness their continued success in their transplant journey."

At UC San Diego Health, the region's only academic medical center, approximately 50 lung transplant surgeries are performed each year. The program is at the forefront of surgical approaches and treatment, including transplanting lungs from donors with Hepatitis C and HIV into recipients who do not have the infection and being one of the few in the nation to use bacteriophage therapy, viruses used to target multi-drug resistant bacteria, to control lung infections.

The freedom to breathe 

In March 2026, Lusti honored the one-year anniversary of her lung transplant surgery with friends and family by spending the morning visiting teams in the Intensive Care Unit and Pulmonary Care Unit at Jacobs Medical Center at UC San Diego Health to thank them for their life-saving care.

"For the first time in four years, I can finish a sentence without coughing. I can breathe on my own, with no tubes and no daily inhalers; the freedom to just breathe is such a gift we often take for granted," said Lusti. 

"It's incredible to be here one year later, healthy and with my daughter. She was my 'why' the entire time and I told my doctors that I needed to survive for my daughter. She needed her mom."