Artificial Lungs: A New Hope for Lung Transplantation Waitlists

Northwestern Medicine used a total artificial lung system to sustain a patient for 48 hours after bilateral lung removal, enabling a successful double‑lung transplant. The extracorporeal device provided both gas exchange and circulatory support, stabilizing the patient until donor lungs were available and demonstrating a practicable bridge‑to‑transplant option in select, extreme cases.

The planned operative strategy used a controlled bilateral pneumonectomy with immediate connection to a dual‑pathway extracorporeal circuit that drained systemic venous return and returned oxygenated blood to the left heart. Customized drainage and return configurations — including a flow‑adaptive shunt — preserved hemodynamic balance while the device supported oxygenation and CO2 removal.

Institutional safeguards included predefined protocol approvals, strict patient‑selection criteria emphasizing irreversible pulmonary source control and transplant candidacy, enhanced informed consent detailing experimental risks and escalation pathways, and protocolized monitoring of gas exchange, hemodynamics, bleeding, and infection markers to guide clinical decision‑making.

Outcomes in this case were concrete: 48 hours of device support with sustained gas exchange and circulation, survival to double‑lung transplantation, and durable recovery at follow‑up. The result is promising but early; systematic evaluation is required before broader clinical adoption of this technique.

Key takeaways:

• Northwestern Medicine demonstrated a 48‑hour bridge‑to‑transplant using a total artificial lung approach that supported gas exchange and circulation.
• Successful use required coordinated surgical, perfusion, and critical‑care teams and strict institutional protocols for selection and monitoring.
• Evidence is limited to an early report; multicenter protocols and systematic data collection are needed before wider clinical adoption.