X-rays show a 33-year old patients’ new lungs (left) and old lungs (right).Credit: Northwestern Medicine
A 33-year-old man survived for 48 hours without his lungs, after a medical team replaced the organs with an external artificial-lung system1 that it developed to keep him alive until he could receive a double lung transplant.
There have been cases in which people have had their lungs removed and been connected to an external device to maintain oxygen levels. But, the devices used in these cases don’t count as artificial lungs because they do not maintain blood flow across the heart, meaning it cannot function normally, says Ankit Bharat, a thoracic surgeon at Northwestern University Feinberg School of Medicine in Chicago, Illinois, who helped to develop the artificial system.
Bharat says his team’s design is unique because it maintains a balanced and continuous flow of blood to the heart, reducing the risk of blood clots that could trigger a heart attack. The findings were published today in the journal Med.
The engineering behind the artificial-lung system is remarkable, says Natasha Rogers, a transplant clinician at Westmead Hospital in Sydney, Australia. It is difficult to maintain normal heart function in the absence of lungs, she says. “They were really very brave.”
The team’s artificial-lung system could be used in other critically unwell people while they become healthy enough to receive lung transplants, she adds.
Life-threatening condition
Before being placed on the artificial-lung system, the man had developed acute respiratory distress syndrome — an often-life-threatening condition in which the lungs cannot absorb enough oxygen — triggered by the influenza virus. He was then placed on a ventilator but developed a drug-resistant Pseudomonas aeruginosa infection. The infection caused parts of his lungs to fill with pus, and he went into septic shock, at which point his heart and kidneys began to fail.
“He was so sick, he had a cardiac arrest and he was actively dying,” says Bharat. Because the man was too unwell to receive a lung transplant, the team decided to remove his lungs — the source of the infection.
Surgeons removed a patient’s infected lungs. An artificial lung system kept him alive.Credit: Northwestern Medicine
Surprisingly, the man began to improve quickly. “Within 48 hours, he was off all the medication to support his blood pressure, his kidney function was completely restored and his heart was working normally,” says Bharat. At that point, the man received a double lung transplant and has showed no signs of organ rejection or impaired lung function years later. “We are now approaching almost three years since we did this, and the patient is doing really great,” says Bharat.
