In the United States, a 33-year-old man stayed alive for two days after having his damaged lungs removed. He survived until a transplant by connecting an artificial lung system that supplied oxygen to the heart. Machinery and equipment had previously substituted for lungs in emergencies, but this is the first time it worked with no lungs at all. If commercialized, doctors could remove damaged lungs in advance so they do not affect other organs and buy more time until healthy donor lungs arrive.
A research team led by Professor Ankit Bharat at Northwestern University Feinberg School of Medicine said in the international journal Med on Jan. 29 (local time) that they had successfully kept alive for 48 hours with an artificial lung a 33-year-old male patient with acute respiratory distress syndrome (ARDS) after removing his lungs until he could receive a transplant.
◇Patient in septic shock kept alive with artificial lung
At the time of surgery, the patient was infected with the influenza (flu) virus. Acute respiratory distress syndrome, a life-threatening condition in which the lungs fail to properly absorb oxygen, had developed. The patient was on a ventilator but was also infected with bacteria resistant to antibiotics. As pus filled the lungs, the patient developed sepsis.
Sepsis is a disease in which infection of the blood by bacteria or viruses damages organs, and it is so deadly that the mortality rate reaches 50%. The patient fell into a severe condition in which, following the lungs, the heart and kidneys also failed to function properly. The remaining hope was to completely remove the damaged lungs and transplant healthy ones.
The researchers said, "We explanted the lungs and replaced them with a custom-developed external artificial lung system," adding, "This device is a unique artificial lung in that it is connected directly to the heart to maintain blood flow and prevent cardiac arrest." If blood does not flow, it clots. Such thrombi can block blood vessels and trigger cardiac arrest.
There is already extracorporeal membrane oxygenation (ECMO), a technology that replaces lung function with machinery and equipment. It draws blood from a patient's vein, supplies oxygen in an external device, and removes carbon dioxide. But the researchers said the new system differs in that ECMO is generally used while the lungs remain in the body.
The patient's condition improved after the infected lungs were removed and the artificial lung was connected. Blood pressure stabilized and other organ functions recovered. The infection subsided. Two days later, the medical team received a donated lung and performed the transplant. The researchers said the patient is still maintaining lung function and living normally nearly three years after the surgery.
◇Buys time to recover health until transplant surgery
The newly developed artificial lung could expand eligibility for lung transplants. Bharat said, "Until now, lung transplants were only performed for patients with chronic diseases such as interstitial lung disease or cystic fibrosis," adding, "We found evidence that patients with severe acute respiratory distress syndrome should also receive transplants."
Until now, the medical community thought that even for patients with acute respiratory distress syndrome, their lung function would recover if supported by machinery and equipment. But analysis of the explanted lungs showed severe inflammation from bacterial infection and extensive tissue damage, indicating an irreversible stage. Bharat said, "This shows they can no longer recover on their own," adding, "We present for the first time molecular evidence that some patients with respiratory distress syndrome must receive bilateral lung transplants to survive."
Natasha Rogers, a transplant specialist at Westmead Hospital in Australia, told Nature, "It's a striking result given how difficult it is to maintain normal cardiac function without lungs," adding, "Going forward, we may be able to use an artificial lung system until critically ill patients become healthy enough to undergo transplant surgery." Rogers added that, in theory, with the newly developed system, it would be possible to sustain a patient's life, remove the damaged lungs from the body for treatment, and then reimplant them.
References
Med (2026), DOI: https://doi.org/10.1016/j.medj.2025.100985