Artificial lung system keeps patient alive without lungs until transplant

(Press-News.org) Humans can’t live without lungs. But Ankit Bharat’s patient did for 48 hours. 

Reporting January 29 in the Cell Press journal Med, surgeons describe how they removed a patient’s infected lungs and built “artificial lungs” to keep him alive until a double lung transplantation was available. The work shows how the approach may serve as a life-saving bridge to transplantation. 

“He was critically ill. His heart stopped as soon as he arrived. We had to perform CPR,” recalls Bharat, the lead author and a thoracic surgeon at Northwestern University. “When the infection is so severe that the lungs are melting, they’re irrecoverably damaged. That’s when patients die.” 

The patient, a 33-year-old man, developed acute respiratory distress syndrome (ARDS), a life-threatening condition in which inflammation and infection overwhelm the lungs. Triggered by the flu, his lungs deteriorated rapidly and were further compromised by bacterial pneumonia. Eventually, his lungs, heart, and kidneys started to fail. A double lung transplant became his only chance of survival. 

The lungs were damaged beyond repair and were fueling infection. But the patient’s body was too sick to accept new lungs; it needed time to heal.  

“The heart and lungs are intrinsically connected,” says Bharat. “When there are no lungs, how do you keep the patient alive?” 

To solve the problem, Bharat’s team engineered an artificial lung system that temporarily replaced the lungs’ functions. The system oxygenated the blood, removed carbon dioxide, and helped maintain a stable blood flow through the heart and body while the patient had no lungs at all. 

Once the infected lungs were removed, the patient’s condition improved. His blood pressure stabilized, organ function recovered, and the infection subsided. Two days later, donor lungs became available, and the surgeons performed a double lung transplant. More than two years later, the patient has returned to daily life with good lung function. 

“Conventionally, lung transplant is reserved for patients who have chronic conditions like interstitial lung disease or cystic fibrosis,” says Bharat. “Currently, people think if you get severe ARDS, you keep supporting them and ultimately the lungs will get better.” 

But the lungs, when removed from the patient, told a different story. By analyzing them at the molecular level, the researchers found widespread scarring and immune damage. These are signs that the tissue had reached an irreversible stage and could not recover on its own.  

“For the first time, biologically, we are giving molecular proof that some patients will need a double lung transplant, otherwise they will not survive,” says Bharat. 

For now, the approach remains limited to highly specialized centers with the expertise and resources to carry it out. Bharat hopes that over time, the concept will 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,” Bharat says. “For severe lung damage caused by respiratory viruses or infections, even in acute settings, a lung transplant can be lifesaving.” 

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Med, Yan, Y., et al., “Bridge to transplant using aflow-adaptive extracorporeal total artificial lung system following bilateral pneumonectomy” https://www.cell.com/med/fulltext/S2666-6340(25)00412-X 

Med (@MedCellPress), Cell Press' flagship medical journal, publishes transformative, evidence-based science across the clinical and translational research continuum—from large-scale clinical trials to translational studies with demonstrable functional impact, offering novel insights in disease understanding. Visit https://www.cell.com/med. To receive Cell Press media alerts, please contact press@cell.com.

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