Liesbeth Stoeffler's doctors had to make a courageous decision in 2009. Ms. Stoeffler was on a ventilator and deeply sedated after cystic fibrosis destroyed the lungs that had once given her the ability to run and hike.
She needed a double lung transplant, but doctors feared that prolonged ventilatory time could make her too weak or malnourished to be eligible for a transplant.
Doctors at Columbia University's Irving Medical Center took her off the ventilator in about a day and hooked her to an extracorporeal membrane oxygenation machine (ECMO) that pumped blood out of her body, removed carbon dioxide, and flowed oxygen-rich blood back into her. In fact, it looked like an artificial lung.
It was a rarely known and risky use of the machine, which not only enabled Ms. Stoeffler to wake up from the calm. She was also able to eat, talk on her smartphone, exercise in bed, and walk in place while connected – an unusually long 18 days for the transplant to take place.
"The ECMO was the bridge between my respiratory failure and the transplant," Ms. Stoeffler told USA Today in 2009.
ECMO – a treatment for lung-damaging viruses – has proven extremely helpful in the past in cases of H1N1 flu (or swine flu) and is used, according to Columbia and other ECMO centers around the world. A study published in the medical journal The Lancet last September showed that 62.6 percent of 1,035 seriously ill Covid-19 patients survived after ECMO treatment.
Ms. Stoeffler's transplanted lungs worked well for almost a decade, allowing her to hike in the mountains near her parents' home in Austria and complete two New York marathons, half marathons, an Ironman bike course, and a sprint triathlon.
But her body eventually refused the transplanted lungs, and she underwent another transplant in 2019. It didn't work that well or lasted so long. Ms. Stoeffler died of cystic fibrosis at Irving Medical Center on March 4, said her brother Ewald Stoffler. She was 61 years old.
Liesbeth Stoeffler was born on June 18, 1959 in Hermagor, Austria, a town at the foot of the Carnic Alps. Her father Johann was a truck driver; Her mother, Margarethe (Strempfl) Stoeffler, was a housewife.
After graduating from business school, she left Austria in 1977 for an au pair job in Manhattan, where she had hoped to move since her youth, her brother said in an email.
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"During the first three years that Liesbeth spent in New York, she refused to speak a single word of German," wrote Stoeffler, "so that she could learn English as quickly and as well as possible."
She took courses in computers and graphic design and was hired by Deutsche Bank, Blackstone Group, and eventually investment management firm Sanford C. Bernstein (now AllianceBernstein). She worked there for nearly 20 years, rising to vice president and presentation specialist, creating graphics for marketing and sales documents.
During her time at Bernstein, she developed breathing problems and learned in 1995 that she had cystic fibrosis. But she kept it largely to herself.
"She always coughed and got her staff to ask her to check it out," said Christina Restivo, a close friend she met in Bernstein and who headed a support team of friends who looked after her. "She kept it private until she got to the point where the only way to live was a double transplant."
In June 2009, after a routine blood test in the hospital, Ms. Stoeffler felt too exhausted to return home. One of her doctors, David Lederer, a pulmonologist, admitted it.
"She was on a ventilator in the I.C.U. within 48 hours," he said in a video of her case created by Irving Medical Center. He added, "She didn't really improve the vent support we provided for her so we knew we had to do something for her."
Using the ECMO helped her remain eligible for the transplant. "About five days later she told me it was the best thing she'd felt in years," said Dr. Matthew Bacchetta, who also treated Ms. Stoeffler, an online publication by Columbia.
In less than two years, Ms. Stoeffler started running seriously. Starting with the Fred Lebow Classic, a five-mile race in Central Park in January 2011 (named after the founder of the New York City Marathon), she finished 47 different races hosted by the New York Road Runners Club. Their last was an 8-kilometer event in August 2017.
Ms. Restivo said her friend's running likely extended the life of her transplanted lungs.
"Because your immune system is so suppressed by a transplant, she was told not to work out in a gym where she could pick up bacteria," she said. "She used nature to exercise her lungs."
In addition to her brother Ewald, three sisters, Gabriele and Birgit Stoeffler and Waltraud Wildpanner, Mrs. Stoeffler survive. and another brother, Hannes.
Ms. Restivo, who is Ms. Stoeffler's executor, said Ms. Stoeffler would sometimes write to the doctors with instructions. Another text arrived on their last day.
"I got a call to go to the hospital at 3:30 am," she said. “Liesbeth was still vigilant with her oxygen mask, texting me as usual, telling me what to do and keeping me informed of her status. Fully aware at all times. "