Our lungs are crucial for every breath of life we take. But a research team has found a way for technology to step in and completely replicate the complex functions of a person’s lungs, at least for a brief while.
Surgeons at Northwestern University detailed the impressive medical feat in a study out today. They developed a novel artificial lung system to replace the patient’s severely diseased lungs for two straight days—long enough to ensure a successful double lung transplant. The man survived his ordeal and is doing well with his new organs two years later.
“This strategy may offer a lifesaving bridge to transplantation for selected patients who would otherwise have no treatment option,” they wrote in their paper, published in the journal Med.
The importance of TAL
There are already devices and systems that can keep people alive by replacing some of an organ’s functions. These include extracorporeal membrane oxygenation (ECMO) machines that can sub in for both the heart and lungs at once. These devices are often used to take the load off the affected organ so it can more quickly recover from injury or illness.
In this case, though, there was no opportunity for such a grace period. The patient, a 33-year-old man, contracted a severe bout of flu that caused him to develop acute respiratory distress syndrome (ARDS), a life-threatening condition characterized by fluid leaking into the lungs. He also caught bacterial pneumonia, and his lungs, along with his kidneys and heart, began to fail. His only hope for recovery was a double lung transplant. But the doctors feared his body would simply be too weak to endure the procedure, while trying to keep his lungs intact could threaten the survival of any transplanted organs.
The doctors made the decision to entirely remove the man’s lungs and to engineer a temporary system that could stabilize him until a transplant was medically viable. Compared to devices like ECMO, however, their total artificial lung system—called TAL for short—was designed to completely take over for the lungs’ functioning. Importantly, it also kept cardiac function stable even in the midst of the man’s ongoing sepsis.
“We drained blood from the right side of the heart and routed it to an external pump and oxygenator, which removes carbon dioxide and adds oxygen. The oxygenated blood is then returned directly into the left atrium through two separate conduits, ensuring the left heart stays filled and can pump blood to the body,” lead researcher Ankit Bharat, a thoracic surgeon at Northwestern University, told Gizmodo.
TAL bought the doctors and the man’s body enough time. Within hours, the man’s condition began to improve. Two days after he was placed on TAL, the doctors performed a double lung transplantation, which went off without any serious hitch. Seven days after the surgery, he was removed from intubation. Eight weeks later, he was discharged from the hospital, and two years later, his transplanted lungs are continuing to function well.
Tests also confirmed that the man’s original lungs were so damaged and infected that he wouldn’t have survived much longer without a transplant.
The future of artificial lung technology
The doctors note that their work is intended as a proof of concept for now. And only a few specialized medical centers currently have the resources and expertise on hand to engineer similar TAL systems. But they’re hopeful their approach can be standardized and that it can someday be widely used to prolong the lives of people who otherwise wouldn’t have been eligible for transplantation.
“The next steps involve establishing multicenter registries and collaborative frameworks. These larger studies will be essential to refine protocols—such as anticoagulation strategies—and to validate criteria for patient selection and the timing of the intervention,” Bharat said. “We also aim to use the molecular data gathered from this study to better identify which patients have irreversible lung injury and would benefit most from this technology.”
