discoveries magazine

Fearless—and No Longer Breathless

Despite an incurable lung condition, Shalini Waran is thriving following treatment including stem cell therapy.

Illustration: David Mahoney

Despite an incurable lung condition, Shalini Waran is thriving following treatment including stem cell therapy. 

Shalini Waran describes her doctor as "a very calm person who answers all my questions truthfully."

Sixteen years ago, she asked Michael Lewis, MD, director of Respiratory Care Services at Cedars-Sinai, "Is this something I can die from?"

That "something" is idiopathic pulmonary arterial hypertension (IPAH), a progressive lung condition for which there is no cure. But Lewis’ answer was full of hope. "Every patient is an individual and people can do very well on the right therapy," he told her.

IPAH occurs when tiny blood vessels in the lungs become thick and narrow, reducing oxygen flow and forcing the heart to work harder to pump blood through the lungs. Survival in untreated patients averages only two to three years from diagnosis. But IPAH medications can give patients more time and better quality of life.

Waran’s symptoms included fainting (she thought it was the heat) as well as fluid retention and shortness of breath. "I couldn’t walk five steps without needing to rest," she recalls. 

Born in India and raised in England, Waran came to the United States at age 32 to work as a freelance line producer in the film industry. Something her grandfather said to her when she was 5 years old helped her cope with the uncertainty about the future that came with her diagnosis.

"He told me that fear is like a huge wall in front of you, and you have to reduce it to six inches high so you can step over it," she recalls. 

Waran embraced hope, and the medications worked, enabling her to lead an active life. At 70, she is still going strong. For the most part, she has retired from the film industry but works part time as a bookkeeper. She does yoga, knits, reads and watches "all kinds of movies."

In 2018, life got even better after she participated in a clinical trial led by Lewis. The ALPHA Phase Ia study—an extension of pioneering cardiac stem cell research at Cedars-Sinai—focused on restoring function to the small vessels of the lung through an infusion of specialized stem cells manufactured from donor heart tissue. 

Waran was among the first six patients to receive the experimental treatment. Lewis says the results were "very encouraging." A second phase of the trial is underway, enrolling a larger number of patients. 

"The improvement from the stem cell infusion wasn’t miraculous, but it definitely made everything easier," Waran says. 

Thanks to the experimental therapy and her medication regimen, she can walk farther and go up and down stairs without being out of breath. 

"I was more than happy to take part in the clinical trial because Cedars-Sinai has done a lot for me," she says. "I’m grateful to be alive."