Surgeons Keep Man Alive 48 Hours Without Lungs

When a Missouri man's lungs literally began to liquefy from an untreatable infection, surgeons faced an impossible choice: remove both lungs and risk instant death, or let the infection spread through his entire body.

They chose a third option nobody had successfully tried before.

In spring 2023, the 33-year-old patient arrived at Northwestern Memorial Hospital in Chicago with flu-related lung failure that quickly spiraled into severe pneumonia and sepsis. His heart stopped, requiring CPR to bring him back.

Dr. Ankit Bharat, chief of thoracic surgery at Northwestern Medicine, explained the dire situation. "He had developed an infection of his lungs that just could not be treated with any antibiotics because it was resistant to everything," he said. "That infection caused his lungs to liquify and then continued to progress to the rest of his body."

The team faced a dangerous problem. Lungs act as shock absorbers for the right side of the heart, and removing them typically causes the heart to fail instantly. Without blood flowing from the lungs to the left heart, chambers can collapse or form deadly clots.

While the patient remained on life support, the medical team designed something never successfully used before: a total artificial lung system that could handle oxygen exchange and maintain blood flow to keep the heart pumping normally.

The innovation lay in mimicking nature. "A key innovation here is that we maintained the heart's natural physiology," Bharat explained. "By using a 'flow-adaptive' design, we allowed the patient's own heart to regulate blood flow, rather than forcing it with a machine."

The gamble worked. Surgeons removed both diseased lungs, and the artificial system kept the man alive while his body began healing from the infection.

"Just one day after we took out the lungs, his body started to get better because the infection was gone," Bharat said.

After 48 hours on the artificial system, the patient was stable enough for a double-lung transplant. The procedure worked perfectly.

The Ripple Effect

Two years later, the Missouri man is back to his regular routine with excellent lung function and a fully preserved heart. But the impact reaches far beyond one patient.

The technology could transform outcomes for people with severe acute respiratory distress syndrome, necrotizing pneumonia, or septic shock. These patients currently face mortality rates exceeding 80 percent and are often denied transplants because their infections make surgery too risky.

"This technology allows us to 'clean the slate' by removing the infection, stabilizing the patient and bridging them to a successful transplant," Bharat said.

The team published their findings in the journal Med, including molecular analysis showing the extensive scarring and damage in the removed lungs. The research supports the idea that for some severe cases, transplantation may be the only viable option.

Looking ahead, researchers hope to develop durable, implantable artificial lungs that patients could live with long-term, not just as a bridge to transplant.

What started as one man's fight against a deadly infection has opened a new path to survival for thousands of others who previously had no options left.