A double lung transplant forced a team of surgeons at an American university to resort to a technological innovation that could be used in the future. Surgeons managed to keep a man alive for 48 hours who had his lungs removed with an extraordinary solution.
A team of surgeons from Northwestern University (USA) managed the impossible: to keep a patient alive for 48 hours, without him having lungs.
The patient was waiting for a pair of lungs for a double transplant – a radical approach, writes Med magazine, which published a report on this case, writes Mediafax.
How was this possible? Surgeons used a total artificial lung system that oxygenates the blood as the lungs do, while managing blood flow and protecting the heart.
The patient had developed an infection that could not be treated with antibiotics
This artificial system proved crucial in stabilizing the patient and preparing him for transplant.
The patient has made a full recovery and his lungs are functioning at full capacity.
His story begins in the spring of 2023, when the man had developed flu-related lung failure.
This rapidly progressed to pneumonia, sepsis and then acute respiratory distress syndrome.
“She had developed a lung infection that just couldn’t be treated with any antibiotics because it was resistant to everything,” says surgeon Ankit Bharat.
“This infection caused his lungs to liquefy and then continued to progress throughout the rest of his body.”
The standard approach would have been to place the patient on life support and give the lungs time to recover.
The team solution
Here, however, the lungs were the main problem and source of infection: the man seemed certain to die if his lungs were not removed.
Removal of both lungs – a bilateral pneumonectomy – usually leads to heart failure due to disturbances in blood flow.
To avoid this and overcome the limits of previous attempts, the medical team behind the artificial breathing system added dual blood flow channels and a flow-adaptive shunt, allowing variations in blood flow to be smoothed out.
After the organs were harvested, signs of recovery began
The machine was enough to keep the patient alive long enough for his body to recover enough to make a lung transplant viable.
Once the organs were harvested, signs of recovery from the infection began.
Bharat and his team performed a molecular analysis of the lungs after they were removed, confirming that there was no chance that the lungs could recover on their own after acute respiratory distress syndrome.
A transplant was absolutely necessary
The scarring and damage to the immune system meant that, in this case, a lung transplant was absolutely necessary.
“Conventionally, lung transplantation is reserved for patients who have chronic conditions such as interstitial lung disease or cystic fibrosis,” says Bharat.
“Nowadays people think that if you do severe Acute Respiratory Distress Syndrome, you keep supporting them and eventually the lungs will get better.”
An innovation that could be used in the future
This is an approach that could be used again to save more lives.
But building an artificial breathing system is possible, at the moment, only in specialized centers.
Bharat hopes that the innovations applied here could be incorporated into standard devices in the future.
When the impossible becomes possible
While a two-lung transplant may previously have been considered impossible in this scenario, we now know that it can be achieved and successful – and may be an option in future cases, although it still depends on timely access to donor lungs.
“In my practice, young patients die almost every week because no one realized transplant was an option”says Bharat.
“For severe lung damage from respiratory infections, even in acute situations, a lung transplant can save lives.”
