Surgeons removed a man’s irreparably damaged lungs and kept him alive for 48 hours with artificial lungs until he could get a transplant.
Doctors crafted shunts,tubes and pumps into a system that oxygenated blood and supported blood flow through the heart, the team reports January 29 in Med. It is proof that a true artificial lung can keep a patient alive until donor organs are available, says Ankit Bharat, chief of thoracic surgery at Northwestern University Feinberg School of Medicine in Chicago.
In 2023, a 33-year-old man from St. Louis caught influenza B and his lungs began to deteriorate. He was hospitalized and got a second infection with Pseudomonas aeruginosa bacteria that were resistant to antibiotics. The infection spread to his blood. The dual infections and damage from overzealous immune reactions caused his lungs to fail.
“He was not getting better,” bharat says. “He was actively dying.”
Molecular tests showed that the man’s lungs would not have recovered.
Bharat and colleagues specialize in doing lung transplants for patients with COVID-19 or other infections. But the man couldn’t get a transplant while actively infected with bacteria. And he couldn’t live with such damaged lungs.
So Bharat and colleagues removed the diseased lungs and hooked the man to the artificial lung the team devised. The system takes blood from the right side of heart, puts it through a pump to add oxygen and take out carbon dioxide as the lungs would, than shunts the blood to the left side of the heart to be pumped through the body. That system maintains normal heart function as well as providing oxygen.
At least three times previously, doctors have used a type of external ventilation system called extracorporeal membrane oxygenation, or ECMO, to oxygenate blood and keep patients alive without lungs until they could get transplants. But ECMO is not a true artificial lung because it doesn’t provide proper blood flow support for the heart, Bharat says.
Doctors thought it could take weeks for the infection to clear and were prepared to sustain the man on the artificial lung for many days or weeks, Bharat says.But “we realized that once we took out the source of the bacteria, aka the lungs, the infection started to very rapidly get better.”
As soon as the man’s infection cleared his doctors put him on a transplant list. An organ was available immediately. Now, more than two years later, Bharat says, the “patient’s doing amazing. His heart is normal. Lung is normal.”