Michelle Ankele-Yamashita’s yearlong medical ordeal began last September with a bad case of the flu. The 58-year-old Maui resident had not gotten her flu shot, but did not think much of the illness – she was the kind of person for whom a few days of rest would be all she’d need to get back on her feet.
Almost a week had passed, and Ankele-Yamashita wasn’t feeling any better. That’s when her husband gave her an ultimatum: “If you don't get dressed and let me take you to the ER tonight, I'm going to call the ambulance,” she recalled him saying.
After she arrived at the emergency room, doctors quickly admitted Ankele-Yamashita to the intensive care unit. Eventually, she was diagnosed with pneumonia and acute respiratory distress syndrome, a life-threatening injury to the lungs. About 200,000 people in the United States develop the condition each year as a complication of infections or trauma.
Ankele-Yamashita’s doctors moved her to Straub Benioff Medical Center in Honolulu, where she was placed on a machine that stood in for her lungs, since they were too damaged to give her body oxygen. The treatment is called extra-corporeal membrane oxygenation, or ECMO, and it is a way to bypass damaged lungs to let them recover from injury. Her lungs, however, suffered irreparable damage.
Ankele-Yamashita stayed on ECMO for over 100 days. Over weeks and months, she said it became clear that a lung transplant was her only chance of survival.
Still, performing a transplant would be no easy feat. The Queen’s Medical Center operates the only organ transplant center in Hawaiʻi and the Pacific region, but it exclusively performs liver and kidney transplants.
Honolulu is thousands of miles away from transplant centers in the continental United States, and with the network of tubes and medical equipment keeping her alive, Ankele-Yamashita could not simply hop on a flight. At that point, her prolonged stay on ECMO had increased the risk for major bleeding during surgery.
Dozens of transplant centers turned her case down. Only one program in Nashville, Tennessee, gave Ankele-Yamashita’s doctors the green light to transport her to the Volunteer State for further testing.
“It's understandable why some centers wouldn't want to take that risk and want to take a chance — but at the end of the day, this is a young woman with a beautiful family, and we really wanted to see if we could help her,” said Dr. Anil Trindade, associate medical director for the Vanderbilt Lung Transplant Program.
What followed was a 4,300-mile, 11-hour air ambulance flight from Honolulu to Nashville. Transplant doctors detailed Ankele-Yamashita’s story in a case report recently published in the journal JTCVS Techniques. The physicians wrote in the study that there are few cases of successful transplants after long-term ECMO – and to their knowledge, none that combined these factors with a long-distance transport of a patient on ECMO.
“The whole team was very excited when she finally arrived and it was really an enormous team approach,” Vanderbilt Lung Transplant Program Surgical Director Dr. Konrad Hoetzenecker said. “A lot of people invested a lot of time and muscle power to get her to a state where she was actually transplantable."
Ankele-Yamashita received a lung transplant in February. She had been on ECMO for about 150 days.
“When I came out of the transplant surgery, just not seeing the ECMO machine was just — I can't even explain how that felt. Like freedom,” Ankele-Yamashita said. Her doctors recently cleared her to move back to Maui, where she has prioritized spending quality time with her family and dogs.
“I have to be honest, I didn't get my flu shot before, because I hardly got sick,” she said. Now, she encourages others to learn from her story and protect themselves and their families by getting a flu shot.
Kaiser Permanente is offering no-cost flu shots to members at medical offices and at Saturday flu clinics beginning Sept. 20. HMSA and Longs Drugs are also hosting drive-thru flu shot clinics around the islands on Saturdays.
"Now I have a chance to really fight and get my life back," Ankele-Yamashita said. "I'm so grateful."
A version of this story first aired on The Conversation on Sept. 11, 2025. The Conversation airs weekdays at 11 a.m.
