Surgeons at Northwestern Memorial Hospital have achieved a remarkable medical breakthrough by successfully employing a total artificial lung system to keep a patient alive for 48 hours without any lungs. This innovative procedure created a critical window for the patient to recover from a life-threatening infection prior to undergoing a double lung transplant.

The details of this case, published in the prestigious journal Med, represent significant advancements in transplant medicine and 'salvage therapy', especially for patients previously deemed beyond help.

The patient, a 33-year-old man with no prior health issues, was admitted to the hospital in early 2023 after contracting Influenza B. His condition rapidly progressed to acute respiratory distress syndrome (ARDS) and necrotizing pneumonia, leading to extensive lung damage.

Despite being placed on a ventilator and a heart-lung bypass machine (ECMO), the patient experienced severe septic shock, multiple cardiac arrests, and kidney failure. The entrenched infection rendered antibiotic treatments ineffective while his damaged lungs remained intact.

Faced with an overwhelming mortality risk exceeding 80 percent, Dr. Ankit Bharat and his surgical team made the critical decision to perform a bilateral pneumonectomy, surgically removing both lungs to eradicate the source of the infection.

The challenge of removing both lungs is the drastic impact on the circulatory system. To counteract this, the team engineered an extracorporeal Total Artificial Lung (TAL) system designed to perform vital functions akin to natural lungs while maintaining circulatory stability.

This custom TAL system not only oxygenated blood but also created dual return pathways that meticulously moderated blood flow to the heart, ensuring it continued to pump effectively despite the absence of lungs.

The results of this innovative approach were immediate. Following the lung removal, the source of sepsis was eliminated, and within 48 hours, the patient's blood pressure stabilized, kidney function normalized, and he became free from medication dependencies.

Researchers examining the removed lungs discovered irreversible damage characterized by scar tissue and inflammatory cells, confirming that a lung transplant was the patient's sole path to survival.

Two days later, the patient successfully underwent a double lung transplant and has since enjoyed excellent lung function, showing no signs of organ rejection over two years post-surgery.

As the advances in this engineering feat are widely recognized, some caution remains in its application. Dr. Natasha Rogers from Westmead Hospital has noted that this complex procedure necessitates a highly specialized team and is currently limited to elite medical centers. Nonetheless, Dr. Bharat remains hopeful that such technology could evolve into a standard lifesaving option for critically ill patients awaiting second chances.