A Teenager’s Journey from Bulgaria to Miami for a Life-Saving Lung Transplant

By: Ruelle Champion

At 17 years old, Albena Angelova of Bulgaria had already spent most of her life fighting a disease doctors couldn’t explain. She was diagnosed with progressive idiopathic pulmonary fibrosis, a rare lung disease.

“The word ‘idiopathic’ is very sad,” said Natalia Gabrovska, MD, Angelova’s lead pulmonologist in Bulgaria. “We use it when we don’t know the exact cause or development of a given disease.”

At 10 years old, Angelova’s disease started progressing. Occasional hospitalizations became more frequent, happening as much as once or twice a week.

“At one point, I realized we were wasting time trying to get the diagnosis and that we should consider a lung transplant,” Dr. Gabrovska said. “Albena was breathing with about 6 percent of her lung capacity.”

Dr. Gabrovska and her team tried to find a hospital in Europe that could give the teenager a lung transplant; an option that doesn’t exist in Bulgaria. After several rejections in Europe, they were recommended to Miami Transplant Institute (MTI)—a partnership with Jackson Health System and UHealth – University of Miami Health System.

“I wrote to the hospital, and within a few months, Albena received approval for treatment,” Dr. Gabrovska said.

Angelova and her father arrived in Miami on March 26, 2026. Not only had they never left Europe before, it was Albena’s first time on a plane. The pair said the idea of leaving Bulgaria and traveling more than 5,000 miles for medical treatment was overwhelming.

“It’s very difficult being so far from home with no family or friends,” Angelova said.

Once they arrived, Jackson’s hospitality team made sure an unfamiliar place felt a little more like home.

Emilia Ritzert, hospitality patient coordinator for Holtz Children’s Hospital, met Angelova and her dad on day one.

Ritzert and the team checked on the family multiple times each day, helping them navigate the hospital throughout their stay. With help from social workers, Ritzert was able to get Angelova’s dad to stay at the Ronald McDonald House, where he was able to prepare home cooked Bulgarian foods for his daughter.

“The only worry they had was the language,” Ritzert said. “Through their translator, they would ask, how they were going to understand and speak with the doctors.”

Jackson’s translation technology helped bridge the gap between Angelova, her father, and the various medical teams.

“She ended up telling me, ‘I don’t need to know everything. I know in my heart you’re here to take care of me,’” Ritzert recalled.

Angelova’s care before the lung transplant surgery required close collaboration between her doctors in Bulgaria and Juan Fernandez Castillo, MD, medical director of the lung transplant program at MTI.

“They were always available,” Dr. Fernandez Castillo said. “Despite the difference in hours, we were calling Dr. Gabrovska at midnight or 1 a.m. Her team was really outstanding and is just as dedicated as we are to give Albena her life back.”

When donor lungs became available, the team carefully evaluated whether they were a strong match. For a teenage patient, the goal was to select the best possible lungs while recognizing the risk of waiting too long.

“We make sure that we assess donor lungs with extreme detail and in doing that, we chose very good lungs for her,” said Mariana Gil Barturen, MD, a lung transplant surgeon at MTI. “Any lung transplant is a highly complex operation that requires a lot of coordination.”

On April 30, Angelova had a successful transplant. However, after about 10 days, she experienced complications.

“She had a brief rejection episode that she saw as a step back,” Dr. Gil Barturen said. “We put her on ECMO for a few days and monitored her, but she recovered well.”

The next step for Angelova was transferring to Christine E. Lynn Rehabilitation Center for The Miami Project to Cure Paralysis at UHealth/Jackson Memorial.

“Her condition limited her ability to participate fully in life, so the chance to help her return to function was truly a privilege,” said Unoma Akamagwuna, MD, chief of pediatric physical medicine and rehabilitation at Holtz Children’s and Lynn Rehabilitation Center. “Everyone came together around a shared goal to rebuild the foundation she needs to keep growing.”

Joslyn Gober, DO, medical director of pediatric rehabilitation at Lynn Rehabilitation Center, and Dr. Akamagwuna led Angelova’s team, which included physical, occupational, and speech therapies.

“As she recovered, I had her try things that were normal in America like pancakes and she loved it,” Ritzert said. “The rehab team then brought her over to teach her how to make her own and it meant so much to her.”

After her discharge to the Ronald McDonald House, she returned to Holtz Children’s to visit the care teams and even made them a traditional Bulgarian dish.

“I was really happy to see her fighting to walk, stand, and shower with no help,” Ritzert said. “We knew once we heard her guitar again in Holtz Children’s that she was well and happy.”

The family is expected to go back to Bulgaria this year. It took oxygen tanks, anesthesiologists, and complex plans to reach Miami. Once there, Angelova will be followed by her local care team and will have virtual follow-ups with Dr. Fernandez Castillo’s team at MTI.

“She’s already living a much more normal life,” Dr. Fernandez Castillo said. “She’s a very smart girl who’s walking independently, off of oxygen support, and every time we see her, she’s always smiling.”

“Albena is now 17 years old with the maturity of an adult,” Dr. Gil Barturen added. “Her future is bright.”

After overcoming years of medical uncertainty, thousands of miles traveled, months isolated from home, and a language barrier complicating it all; Angelova has everything she needs to embrace a fresh breath of air back home in Bulgaria.