In spring 2023, a Missouri resident was flown to\u00a0Northwestern Memorial Hospital<\/a>\u00a0on extracorporeal membrane oxygenation (ECMO), a form of advanced life support used when the heart and\/or lungs cannot provide enough oxygen to the body. What began as influenza-associated lung failure escalated into a rapidly progressive, necrotizing pneumonia and overwhelming sepsis despite maximal therapy. His condition continued to deteriorate, including an episode in which his heart stopped and the team performed CPR.<\/p>\n \u201cHe had developed an infection of his lungs that just could not be treated with any antibiotics because it was resistant to everything,\u201d said\u00a0Ankit Bharat, MD<\/a>, chief of thoracic surgery and executive director of the\u00a0Northwestern Medicine Canning Thoracic Institute<\/a>. \u201cThat infection caused his lungs to liquify and then continued to progress to the rest of his body.\u201d<\/p>\n For the sickest acute respiratory distress syndrome (ARDS) patients, clinicians often rely on prolonged life support and time, hoping the lungs can recover. But in some cases, the lungs themselves become the source of relentless infection and inflammation, driving organ failure and leaving no path forward unless the diseased lungs can be removed and replaced. But in these scenarios the patients are also too unstable to go through removal and transplant in the same setting. That created a dilemma: taking out both lungs can stop the infectious source, but without lungs, the body also loses critical gas exchange and the normal circulatory buffering the lungs provide, placing the heart at risk of collapse or catastrophic instability.<\/p>\n To solve this problem, Dr. Bharat\u2019s team designed a total artificial lung system intended to do more than oxygenate blood. The system was engineered to support circulation in the absence of lungs by helping maintain balanced blood flow through the heart, an essential requirement for survival after bilateral pneumonectomy (removal of both lungs). The design incorporated a flow-adaptive shunt that compensated for the loss of the lung\u2019s blood vessel network, dual pathways to drain blood from the body and return oxygenated blood back to the heart.<\/p>\n Because an empty chest cavity can allow the heart to shift, the team used temporary internal supports, including saline-filled tissue expanders (breast implants) commonly used in reconstructive surgery, to help stabilize the heart\u2019s position until transplantation.<\/p>\n \u201cJust one day after we took out the lungs, his body started to get better because the infection was gone,\u201d said Dr. Bharat.<\/p>\n Over the next 48 hours, the patient\u2019s condition improved enough to proceed with transplantation. When donor lungs became available, the Northwestern Medicine team performed a double-lung transplant. More than two years later, the patient has returned to daily life with excellent lung function.<\/p>\n Molecular Evidence of Irreversible Lung Injury<\/p>\n Beyond the surgical and critical care advance, this new report includes a detailed molecular analysis of the removed lungs, data that may help physicians better understand when severe viral and infectious lung injury has crossed a threshold from \u201cpotentially recoverable\u201d to \u201cirreversible.\u201d<\/p>\n The research team used advanced techniques,\u00a0such as single-cell and spatial transcriptomic approaches,\u00a0to study different parts of the removed lungs and discovered extensive scarring and damage caused by the immune system, similar to severe, irreversible lung disease. They found that the cells needed to repair the lungs were almost gone, cells that form scars were everywhere, and the normal structure of the lungs was completely gone. These results explain why just providing support wouldn\u2019t have helped the lungs heal in this situation.<\/p>\n \u201cWith severe ARDS, the conventional strategy is to keep supporting the patient and hope the lungs improve,\u201d said Dr. Bharat. \u201cUsing our approaches and data, we can show at the molecular level that some patients won\u2019t recover unless they receive a double-lung transplant.\u201d<\/p>\n The Canning Thoracic Institute researchers say these kinds of molecular maps may ultimately support the development of biomarkers and decision tools to identify, earlier and more confidently, when transplantation should be considered, particularly in acute settings where time is limited and patients can deteriorate rapidly.<\/p>\n A Highly Specialized Approach, and a Path Toward Broader Options<\/p>\n This strategy requires extensive expertise in transplantation, extracorporeal support, and round-the-clock multidisciplinary critical care. Northwestern Medicine investigators hope the principles described in the study will accelerate the development of more standardized devices and protocols that can safely bridge selected patients to transplant.<\/p>\n \u201cFor severe lung damage caused by respiratory infections, even in acute settings, lung transplant can be lifesaving. Patients and families should know to ask about all available options,\u201d said Dr. Bharat.\u00a0<\/p>\n The pulmonology and lung surgery program at\u00a0Northwestern Memorial Hospital<\/a>\u00a0is proud to be the\u00a0highest-ranked<\/a>\u00a0in Illinois for 14 straight years and No. 7 in the U.S.\u00a0For more information, visit\u00a0nm.org\/pulmonary<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"A case study documents how a \u201ctotal artificial lung\u201d (TAL) system temporarily supported a critically ill patient for…\n","protected":false},"author":2,"featured_media":270675,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[10],"tags":[132604,103,61,60,132605,132606,132607],"class_list":["post-270674","post","type-post","status-publish","format-standard","has-post-thumbnail","category-health","tag-ecmo-extracorporeal-life-support","tag-health","tag-ie","tag-ireland","tag-northwestern-medicine","tag-surgery-and-postsurgical-care","tag-thoracic-surgery-and-lung-transplant"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/posts\/270674","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/comments?post=270674"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/posts\/270674\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/media\/270675"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/media?parent=270674"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/categories?post=270674"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/tags?post=270674"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}![\"total](\"https:\/\/www.newsbeep.com\/ie\/wp-content\/uploads\/2026\/01\/total-artificial-lung-transplant-NorthwesternMed-2026-Artificial-lung3-2k.jpg\"\/)
Credit: Northwestern Medicine<\/p>\n![\"total](\"https:\/\/www.newsbeep.com\/ie\/wp-content\/uploads\/2026\/01\/total-artificial-lung-transplant-NorthwesternMed-2026-AnkitBharat-2k.jpg\"\/)
Credit: Northwestern Medicine<\/p>\n![\"total](\"https:\/\/www.newsbeep.com\/ie\/wp-content\/uploads\/2026\/01\/total-artificial-lung-transplant-NorthwesternMed-2026-Kurihara-Bharat-2k.jpg\"\/)
Credit: Northwestern Medicine<\/p>\n