A patient who developed a life-threatening condition managed to live without lungs for two days – thanks to surgeons who built him an artificial one.
The 33-year-old man developed acute respiratory distress syndrome (ARDS), causing inflammation and an infection in the lungs. It was triggered by the flu, his lungs deteriorated rapidly until they were damaged beyond repair, and he developed bacterial pneumonia.
Eventually, his lungs, heart, and kidneys started to fail and a double lung transplant became his only chance of survival.
Surgeons involved in the operation, at Northwestern University in Illinois, have described how they removed the patient’s infected lungs and built an “artificial lung” to keep him alive until a double lung transplantation was available.
“He was critically ill. His heart stopped as soon as he arrived. We had to perform CPR,” recalled Ankit Bharat, the lead author and a thoracic surgeon at Northwestern University. “When the infection is so severe that the lungs are melting, they’re irrecoverably damaged. That’s when patients die.”
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The patient’s body was too weak to accept new lungs and needed more time to heal from the infection, according to the report published in the Cell Press journal Med.
To save the man’s life, surgeons engineered an artificial lung system that temporarily replaced the organs’ functions. It oxygenated the blood, removed carbon dioxide, and helped maintain a stable blood flow through the heart and body.
Once surgeons removed the infected lungs, the patient’s organs and blood pressure started to recover.
After two days breathing through an artificial lung, donor lungs became available and a double lung transplant was performed.
More than two years later, the patient has returned to daily life with good lung function, surgeons have said.
Only about 150 to 200 lung transplants are carried out in the UK each year. However, there are not enough suitable donor lungs available in the UK and it can be hard to find the right match for an individual, lung charity Action for Pulmonary Fibrosis explains.
“Conventionally, lung transplant is reserved for patients who have chronic conditions like interstitial lung disease or cystic fibrosis,” Dr Bharat said. “Currently, people think if you get severe ARDS, you keep supporting them and ultimately the lungs will get better.”
But the damaged lungs, when removed from the patient and analysed, revealed there was widespread scarring and immune damage. These are signs that the tissue had reached an irreversible stage and could not recover on its own, surgeons explained.
“For the first time, biologically, we are giving molecular proof that some patients will need a double lung transplant, otherwise they will not survive,” Dr Bharat explained.
Using an artificial lung is currently a rare operation and is limited to highly specialised centres with the expertise and resources to carry it out.
But surgeons involved in this case hope the method will be adopted into more standardised devices that can keep patients alive while awaiting new lungs.
“In my practice, young patients die almost every week because no one realised that transplantation was an option,” Dr Bharat added. “For severe lung damage caused by respiratory viruses or infections, even in acute settings, a lung transplant can be lifesaving.”
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