In a unique medical procedure, a surgical team managed to keep a patient alive for 48 hours with no lungs at all, using a temporary artificial lung system, in preparation for a successful lung transplant.
Details of this achievement were published in the medical journal Med, where the procedure highlights the potential for this technique to be used as a life-saving bridge for patients whose lungs have suffered irreversible damage.
Professor Ankit Bharat, a thoracic surgeon at Northwestern University and lead author of the report, says: "The patient was in a very critical condition. His heart stopped immediately upon arrival and we had to perform CPR. When the infection reaches the point of 'melting' the lungs and causing irreversible damage, this is the path that often leads to the patient's death."
The patient, a 33-year-old man, was suffering from severe acute respiratory distress syndrome (ARDS) triggered by an influenza infection followed by bacterial pneumonia. His condition deteriorated rapidly until he developed simultaneous lung, heart, and kidney failure, and a lung transplant became his only option for survival.
The problem was that the severe infection and inflammation rendered the patient's body unfit at that moment to receive two new lungs.
Bharat explains: "The heart and lungs are closely linked. The central question was: how do we maintain the stability of the body and the circulation of blood without lungs?"
To solve this dilemma, the team designed an alternative lung system that temporarily performs its vital functions: supplying oxygen to the blood and removing carbon dioxide, while maintaining stable blood circulation.
After the complete removal of the diseased lungs, the patient's condition began to improve significantly. His blood pressure stabilized, the infection subsided, and his other organs began to function better. Just two days later, lungs became available from a donor, and the transplant was successfully performed. Now, more than two years later, the patient is living a normal life with good lung function.
Bharat points out that molecular analysis of the removed lungs revealed extensive scarring and immune system damage, biologically proving they had reached a point of no return. He says, "For the first time, we are providing molecular evidence that some patients with severe acute respiratory failure require transplantation as their only option for survival, not just support until their lungs recover."
This procedure is currently limited to highly specialized centers, but Bharat hopes it will lead to the development of standardized devices that could save the lives of more patients, especially young people, while they await transplantation. He concludes, "In my practice, I see young patients die almost every week because no one considered the transplant option for them. The message is: even in severe and critical cases caused by viruses or infections, a lung transplant can be a lifesaver."
