Ben Askren headed home from the hospital this week with a new set of lungs and a second chance at life. Or, depending on how you think about it, maybe it’s more like a fourth or fifth chance, since that’s about how many times he estimated he’d already died while in the hospital battling severe pneumonia linked to a staph infection.

“Amy, how close was I to dying?” Askren asked his wife in the car ride home while posting an update for his social-media followers.

“Too close,” she told him. “A few times.”

As recently as early June, Amy Askren had told those same social-media followers she was “praying for a miracle.” Her husband — a retired MMA fighter, two-time NCAA national champion wrestler and former Olympian — was unconscious and hooked up to machines, including a ventilator and an ECMO device (extracorporeal membrane oxygenation — essentially a form of life support).

The prognosis was dire. Askren needed a double lung transplant. If he didn’t get it, he’d die. All over those combat sports sections of the internet, the support came in the form of prayers and fundraisers. Former opponent Jake Paul and UFC CEO Dana White, among others, contributed financial support.

And then in late June, the miracle came. Amy Askren announced June 30 her husband had received a double lung transplant.

“We are forever thankful to the donor and his family,” she wrote on Facebook. “This is the beginning of a new lifestyle for Ben, but every new day he has is a gift. It still doesn’t feel real that he was walking around completely healthy just 5 weeks ago. So much can change so quickly.”

USA TODAY Sports / Reuters

But the challenges for Askren are still just beginning, according to Dr. Kirlos Haroun, a physician at Johns Hopkins Hospital in Baltimore. As both a fight fan and a doctor, Haroun followed Askren’s story closely. He’s seen similar cases in his work as an emergency room physician and Johns Hopkins faculty member, he said, so he knows the risks lung transplant patients face.

“I've dealt with a lot of really acute lung injury, and I've dealt with transplant patients. The double lung transplant is this really complex last resort for very, very severe lung injuries,” Haroun told Uncrowned. 

"It’s the only transplant that is exposed to the air with every breath, so it's exposed to the world at every moment. You combine that with pretty strong drugs, somebody who's immunocompromised, and your risk for infection every day is incredibly high.”

There are two main threats for any lung transplant patient, according to Haroun. The first is that, as with any transplant, the body may reject the new organ. Medication can lower this risk — and transplant patients will need to remain on that medication for their entire lives — but it does so by suppressing the body’s natural immune system. That leaves patients at higher risk of infection, but also vulnerable to diseases like cancer, Haroun said.

“Whenever I see a transplant patient in my ER, and they come in with a cough, the thought is always opportunistic infections. There are viruses, there are fungal infections, and then there's really bad drug-resistant bacteria,” Haroun said. “Ben's going to be taking some very heavy immunosuppressive drugs just to let the transplant work. I mean, people with transplants, they live their lives, but there is always this concern. Anyone you're around can expose you to something.

"I would be cautious about him even entering a gym, let alone rolling and wrestling just because of the infection risk. A skin abrasion can lead to a severe reinfection that can be life-threatening, and I think that's a really, really emotionally and mentally difficult thing beyond the physical risks he has.”

One person who understands both the physical and emotional challenges is Jeffrey Pinard, who underwent a double lung transplant a little less than two years ago. Pinard was diagnosed with cystic fibrosis as a child, he said, so medical risks and challenges have essentially always been a part of his life. After dealing with multiple infections that affected his lungs, he was finally placed on the lung transplant list while in his early 50s.

“I was on the wait list about eight months,” Pinard said. “I had to be taken off the wait list five different times because there was a question about going through with the transplant since I had such drug-resistant bugs in me.

"No one told me this beforehand, thankfully, but I only had a few weeks to live when I finally got my lungs. When the surgeon cut into my lungs to start taking them out, they exploded. That was something they had never seen before. There was just so much infection packed in there.”

Pinard knew more than most what to expect. As a college student, he’d studied genetics and microbiology at the University of Michigan. He was even an undergrad assistant on the research team led by geneticist Francis Collins who, in conjunction with Lap-Chee Tsui and his team at the Hospital for Sick Children in Toronto, first isolated the gene for cystic fibrosis.

Because of his experience with that disease, Pinard said, he was already well-accustomed to the sometimes drastic steps needed to avoid infection after the lung transplant.

“Everyone who has a cold is a threat to you,” Pinard said. “Like, a mortal threat. Big crowds, things like that, you have to change your behavior so that you minimize your risk as much as possible.

"The first year post-transplant is the hardest. That's when you’re going to have the highest levels of steroids, prednisone and some of the other anti-rejection drugs. As you improve and your body gets used to the new lungs, then they can start tapering those off and then there will be a little bit less risk. But of course, that never goes away and you really have to balance the threat of infections with the threat of rejection.”

But after reading about Askren, Pinard said, he does see reason for optimism. He was a relatively young man and healthy lifelong athlete with no major known comorbidities prior to the illness that necessitated the transplant. At the same time, there are more than just the physical adjustments to consider after such a dramatic life change.

“This transplant is so different for every single person,” Pinard said. “I know people who’ve had it and were doing great within a month. I’m close to two years and I’m still struggling. But it’s also about perspective. The year or so before my transplant, I was basically living on the couch, which isn’t much of a life. Even getting up to make myself a peanut butter and jelly sandwich felt like an enormous task that took so much effort. So now, when I can do something like empty the dishwasher and it doesn’t take every ounce of effort I have? It feels phenomenal. It makes me feel like a million dollars. But I don’t know how he’ll feel about that, having been an MMA fighter and an athlete. Being so strong and then having the rug pulled out from under you, it can be a shock.”

There’s also the looming question of mortality. Survival rates for lung transplant patients have steadily improved over the years, but Pinard noted the five-year survival rate for this procedure is still just a little over 50%. Recent statistics suggest slightly more than one-third of double lung transplant recipients are now making it past the 10-year mark. Some have lived 20 years or more after the procedure, but they are the exceptions.

Kansas City Star via Getty Images

“Psychologically, it is kind of a heavy burden. If you look at the statistics, 10% of double lung transplant patients die every year,” Pinard said. “You can't help but see that you've got an expiration date.”

Still, Pinard said, he sees more reason for optimism than pessimism in Askren’s situation. His support system, his experience pushing through physical and emotional challenges, all the same things that made him successful as an athlete, these should serve Askren well in his new life, Pinard said.

But make no mistake, he added, it is a new and different life awaiting the former fighter as he recovers from the transplant surgery.

“It will get better. That’s the thing I’d say to Ben right now, is it will get better,” Pinard said. “I wish I’d known that more. At first, every day can be very difficult to get through. You’re learning how to breathe again with new lungs. You’re learning how to get up and walk again. Some people are in a lot more pain than others after the surgery. But it will get better, so don’t set deadlines for yourself or get disappointed if it takes longer than you expect. If it takes a year to get back to a stable place, that’s fine.”

As Askren lay in the hospital awaiting his transplant, he noted in one social-media post it was difficult at times to ward off negative feelings. Here he was, a man who hadn’t smoked, had always tried to take care of his health, and now he needed new lungs just to have a chance at survival.

“I will not feel bad for myself,” Askren said at one point.

Earlier this week, as he headed home, his message was one of gratitude.

“I said this already in one of my videos, but the support you guys gave me, whether it was sending a GoFundMe, whether it was helping my kids and wife get through it — I had friends from all over the country come to visit and hang out for a couple of days — it meant so much,” Askren said in one video. “It was so great to just have all this support and all the love, and hopefully I'm not in this situation again for a really, really, really long time. I plan on living a while.”

MMA Mixed Martial Arts News, Photos, Stats, Scores, Schedule & Videos