A 33-year-old man survived for 48 hours without his lungs, after a medical team replaced the organs with an external artificial-lung systemthat it developed to keep him alive until he could receive a double lung transplant.
There have been cases in which people have had their lungs removed and been connected to an external device to maintain oxygen levels. However, the devices used in these cases do not count as artificial lungs because they do not maintain blood flow across the heart, meaning it cannot function normally, says Ankit Bharat, a Thoracic Surgeon at Northwestern University Feinberg School of Medicine in Chicago, Illinois, who helped to develop the artificial system.
Bharat says his team’s design is unique because it maintains a balanced and continuous flow of blood to the heart, reducing the risk of blood clots that could trigger a heart attack. The findings were published today in the journal Med.
The engineering behind the artificial-lung system is remarkable, says Natasha Rogers, a Transplant Clinician at Westmead Hospital in Sydney, Australia. It is difficult to maintain normal heart function in the absence of lungs, she says. “They were really very brave.”
The team’s artificial-lung system could be used in other critically unwell people while they become healthy enough to receive lung transplants, she adds.
Life-Threatening Condition
Before being placed on the artificial-lung system, the man had developed acute respiratory distress syndrome — an often-life-threatening condition in which the lungs cannot absorb enough oxygen — triggered by the influenza virus. He was then placed on a ventilator; however, developed a drug-resistant Pseudomonas aeruginosa infection. The infection caused parts of his lungs to fill with pus, and he went into septic shock, at which point his heart and kidneys began to fail. “He was so sick, he had a cardiac arrest and he was actively dying,” says Bharat. Because the man was too unwell to receive a lung transplant, the team decided to remove his lungs — the source of the infection.
Surprisingly, the man began to improve quickly. “Within 48 hours, he was off all the medication to support his blood pressure, his kidney function was completely restored and his heart was working normally,” says Bharat. At that point, the man received a double lung transplant and has showed no signs of organ rejection or impaired lung function years later. “We are now approaching almost three years since we did this, and the patient is doing really great,” says Bharat.
Pandemic Invention
When they were introduced to the man, Bharat and his team had been working on an artificial-lung system to support people who were critically ill with COVID-19. The system was designed to get them healthy enough to be eligible for a lung transplant.
Although there is a technology that can take over the work that the lungs do — to oxygenate blood and remove carbon dioxide — called Extracorporeal Membrane Oxygenation (ECMO), the person’s lungs are kept in their body, which keeps the heart stable. Rogers says the new system is connected to the heart and is a modified version of ECMO that maintains the right pressure for blood to flow to and from the heart.
Rogers says the study reveals that the lungs can be temporarily removed from the body for long periods of time. “A theoretical possibility is that you could take the lungs out, maintain the person on this type of modified extracorporeal system, treat the lungs and theoretically put the lungs back,” she says. However, using the system requires multiple, specialist teams, meaning that only large hospitals would be able to use it.
Bharat is hoping that the system will be commercialized in the future for use in any hospital. “Right now, we’re going to offer it to patients at Northwestern who are about to die, and we’re going to keep a registry to keep track of these patients and their outcomes.”
REFERENCE: Nature; 29 JAN 2026; Rachel Fieldhouse