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By Maria Azzurra Volpe
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A patient with double lung failure survived for two days without both organs after surgeons used an artificial system to replace their function until a transplant became possible.
In a report published in the journal Med, thoracic surgeon Ankit Bharat detailed how his team at Northwestern University removed a man’s lungs and replaced their functions with an artificial system.
This approach allowed the patient to survive long enough to receive a double transplant, offering a potential new life saving option for people with catastrophic lung failure.
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“He was critically ill. His heart stopped as soon as he arrived. We had to perform CPR,” Bharat said. “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 was a 33-year-old man who developed acute respiratory distress syndrome (ARDS)—a severe and often fatal condition where infection and inflammation overwhelm the lungs—that was triggered by the flu and worsened by bacterial pneumonia.
As the damage escalated his organs—including the heart and kidneys—quickly began to fail. By the time he arrived at the hospital, his conditions were critical.
According to Bharat, a double transplant was the only possible option for the patient, but his body was too weak to receive donor lung immediately and needed to recover for a successful transplant.
“The heart and lungs are intrinsically connected,” says Bharat. “When there are no lungs, how do you keep the patient alive?”
To solve the issue, Bharat’s team engineered an artificial lung system to temporarily take over the functions of the lungs to keep the patient alive. After both of the patient’s lungs were removed, the system oxygenated his blood, cleared carbon dioxide and helped maintain stable blood flow.
With the source of infection gone, the man’s blood pressure soon stabilized, failing organs began to recover and the overwhelming infection subsided.
Two days later, once a suitable donor’s lungs became available, surgeons performed the transplant.
Now, more than two years after the procedure, the patient has resumed his daily life and has good lung function.
Bharat explained that lung transplantation is reserved for patients who have chronic conditions like interstitial lung disease or cystic fibrosis, and people with severe ARDS, are typically supported under the belief that their lungs will get better.
But analysis of the removed lungs at a molecular level found extensive scarring and immune damage, indicating that the damage had become irreversible.
“For the first time, biologically, we are giving molecular proof that some patients will need a double lung transplant, otherwise they will not survive,” said Bharat.
While for now this approach remains limited to highly specialized centers with skills and resources to carry it out, Bharat hopes this concept will eventually be adopted into more standardized devices that can keep patients alive while awaiting new lungs.
“In my practice, young patients die almost every week because no one realized that transplantation was an option,” he said.
“For severe lung damage caused by respiratory viruses or infections, even in acute settings, a lung transplant can be lifesaving.”
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Reference
Yan, Y., Chandrasekhar, A., Yang, H. C., Devarakonda, T., Reynolds, A., Yeldandi, A. V., Ambalavan, A., Kurihara, C., Budinger, G. R. S., & Bharat, A. (2026). Bridge to transplant using a flow-adaptive extracorporeal total artificial lung system following bilateral pneumonectomy. Med. https://doi.org/10.1016/j.medj.2025.100985
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