Surgeons Kept a Man With No Lungs Alive For 48 Hours While Waiting For a Transplant

By using a custom-built artificial system, they bought enough time to save his life.

In the spring of 2023, a 33-year-old man arrived at Northwestern Memorial Hospital in Chicago with lungs that were rapidly shutting down. What started as a bout of influenza had spiraled into acute respiratory distress syndrome (ARDS). Then, a drug-resistant bacterial infection took hold.

“He was so sick, he had a cardiac arrest and he was actively dying,” said Ankit Bharat, a thoracic surgeon at Northwestern University Feinberg School of Medicine, in comments reported by Nature.

What happened next sounds like medical science fiction. Surgeons removed both of the man’s lungs and kept him alive for 48 hours with no lungs at all. It was just enough time for his body to clear the infection and for donor organs to arrive.

The feat, described in a case report published in the journal Med, depended on a custom-built device the team calls a total artificial lung system .

Critical Situation

Doctors usually treat ARDS with patience. They place patients on ventilators or extracorporeal membrane oxygenation (ECMO) and hope damaged lungs will heal. In many cases, they do.

But this patient was different. His lungs had become the source of a runaway infection, and antibiotics were no longer working. The infection eventually spilled into his bloodstream, triggering septic shock.

Nothing seemed to be working.

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The medical team faced a grim paradox: Leaving the lungs in place would likely kill him, but removing them is usually fatal, too.

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That is because lungs do more than move oxygen. They help regulate blood flow through the heart. When both lungs are removed, blood returning from the body can overwhelm the heart, causing it to fail.

Rewiring the Flow

Bharat and his colleagues decided to attempt something unprecedented. They performed a bilateral pneumonectomy—removing both lungs—and immediately connected the man to their custom-built artificial lung system.

The system worked by diverting blood from the right side of the heart, passing it through an oxygenator to scrub carbon dioxide and add oxygen, and then returning it to the left side of the heart. Crucially, the device balanced blood pressure so the heart could continue to beat normally.

“The engineering behind the artificial-lung system is remarkable,” Natasha Rogers, a transplant clinician at Westmead Hospital in Sydney, told Nature. “It is difficult to maintain normal heart function in the absence of lungs.”

Within hours, the man’s blood pressure stabilized. “Within 48 hours, he was off all the medication to support his blood pressure,” Bharat said.

Buying Time

But the patient wasn’t out of the woods by any means.

Once the lungs were out, the doctors could finally examine the damage in detail. Using molecular and cellular analyses, the research team found evidence that the injury was irreversible.

The tissue showed widespread scarring and immune cell invasion. The cells that usually help regenerate lung tissue were largely absent. Instead, the lungs bore the molecular signatures of end-stage fibrotic disease.

For years, doctors have viewed ARDS as a condition from which lungs can recover if patients are supported long enough. This case offers biological evidence that, for some patients, recovery may never come.

“People think if you get severe ARDS, you keep supporting them and ultimately the lungs will get better,” Bharat said in a statement. “For the first time, biologically, we are giving molecular proof that some patients will need a double lung transplant, otherwise they will not survive.”

The only hope was a transplant. Then, finally the man got lucky.

Alive After Two Years

It would have been a cruel twist of fate if, after all this, there was no transplant available for the man.

But after 48 hours on the artificial system, donor lungs became available. Surgeons performed a double lung transplant. Over two years later, the patient has normal heart function and healthy transplanted lungs, according to the team.

This approach isn’t ready for widespread use yet. It requires multiple specialist teams and the massive resources of a major medical center. Still, the implications are striking.

For decades, artificial lungs have been a long-term dream of bioengineering. Here, a temporary version served as a bridge—buying time when biology had run out of options.

Bharat hopes to offer the system to other critically ill patients at Northwestern and to track outcomes in a registry.

This courageous, science-based gambit paid off for one patient. Perhaps it could save more lives in the future.