November 2023

PULMONARY

NORTHWESTERN MEDICINE SURGEONS UTILIZE BREAST IMPLANTS IN DOUBLE-LUNG TRANSPLANT

Featuring: Ankit Bharat, MD, ​Rade Tomic, MD

In a groundbreaking medical procedure conducted at Northwestern Medicine, surgeons successfully employed innovative techniques to address the critical condition of a patient who required a double-lung transplant. The patient, Davey Bauer, had a history of prolonged vaping, contracted influenza A, and developed a severe lung infection.

Executed in late May at Northwestern Medicine Canning Thoracic Institute, the procedure involved the removal of the patient's infected lungs. Subsequently, an artificial lung was constructed to sustain vital functions. Notably, breast implants (DD size) were strategically positioned within the chest cavity to provide structural support to the heart, preventing its collapse during the absence of natural lungs. The patient was promptly listed for a double-lung transplant, and a suitable donor match was secured within 24 hours.

“Davey’s case is remarkable because it shows that we can keep patients alive after removing their lungs through new technology, which can be transformative for many critically ill patients,” said Ankit Bharat, MD, chief of thoracic surgery and director of the Canning Thoracic Institute. “With this new approach that we’ve developed, many patients who get to the point of needing a lung transplant – but their damaged lungs are making them too sick to get one – can now potentially get transplanted. I think it’s going to open a lot of doors for many patients who have no other options.”

The patient, whose interests include snowboarding, skateboarding, gaming, and golfing, initially turned to vaping as a perceived healthier alternative to smoking. However, the progression of respiratory issues led to a critical health situation. Diagnosed with influenza A and a resilient lung infection, the patient's lungs deteriorated to a liquified state, necessitating the use of ECMO for circulatory and respiratory support.

“Davey’s lungs were so heavily infected that they started to liquify. If you looked at his X-ray, there was nothing left – the lungs were completely filled with puss,” said Rade Tomic, MD, pulmonologist and medical director of the Northwestern Medicine Canning Thoracic Institute Lung Transplant Program. “When we received a call from Davey’s medical team in St. Louis, we thought we could help him, but it was also very clear he wouldn’t survive the transplant in his current condition. He needed to clear the infection before we could list him for transplant, but the only way to do that was to remove both lungs. This was unchartered territory for us, but our team knew if we couldn’t help Davey, no one else could.”
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To maintain blood circulation, an artificial lung was engineered and temporarily attached, allowing the patient's body to clear the infection. Notably, DD breast implants were introduced to support the heart within the chest cavity. Once the infected lungs were successfully removed, the patient was listed for a double-lung transplant, which took place promptly.

“One of our plastic surgeons was very gracious to give us a rapid-fire course on the different types, shapes and sizes of breast implants, so we picked out a couple options and some of them were easier than others to mold inside Davey’s chest, with the DD option being the best fit,” explained Dr. Bharat. “I never imagined we’d be using DD breast implants to help bridge a patient to lung transplantation, but our team is known for taking on the most difficult cases and thinking outside the box to save lives.”

While the patient expressed gratitude for the support received and the medical team's perseverance, the focus remains on the medical breakthrough itself. This pioneering procedure sets a precedent for future interventions in critically ill patients requiring lung transplants, showcasing the adaptability and ingenuity of modern medical practices.
Ankit Bharat, MD, is the chief of Thoracic Surgery in the Department of Surgery, Harold L. and Margaret N. Method Research Professor of Surgery and associate professor of Surgery (Thoracic Surgery) and Medicine (Pulmonary and Critical Care). ​
Rade Tomic, MD, medical director of Northwestern Medicine Canning Thoracic Institute Lung Transplant Program and​ professor of Pulmonary and Critical Care in the department of Medicine.

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