CHICAGO — For many years, double lung transplants weren’t considered a viable option for treating lung cancer.
“It's been done before, but it's always been unsuccessful,” said Ankit Bharat, chief of thoracic surgery at Northwestern Medicine. “When you removed the lungs, the cancer cells spread throughout the rest of the body and came back within a few months of the transplant.”
But after developing a brand new technique to switch damaged lungs at the peak of the COVID-19 pandemic, Northwestern Medicine's Canning Thoracic Institute has now performed greater than 40 successful lung transplants on cancer patients in only two and a half years.
The success rate of the operation for lung cancer patients is now 100%, and in January the hospital performed the primary transplant on a patient whose lungs were affected by each COVID-19 and lung cancer.
Art Gillespie, a captain with the University of Chicago Police Department, contracted COVID-19 in March 2020 while visiting his uncle in a nursing home. While hospitalized with the virus, Gillespie learned he had stage 1 lung cancer.
Despite receiving treatment for Covid and chemotherapy, he developed pulmonary fibrosis, a disease that causes scarring within the lungs and makes respiration difficult. Gillespie ultimately had two-thirds of his right lung removed to treat the cancer, and despite the surgery, he required every day oxygen.
Gillespie was later given a life expectancy of 1 to 2 years.
“For me, 2022 was mostly about getting a lot sicker,” Gillespie said. “My quality of life was pretty compromised at that point. My ability to do anything, even speak, was very taxing.”
Bharat said Gillespie was a very good candidate for a double lung transplant, especially since the transplant treatment for lung cancer was developed directly from the technique for COVID-affected lungs.
While lung transplants have traditionally been performed by removing lungs one by one, first cutting the vein that carries blood from the center to the lungs after which the vein that carries it back, Bharat said surgeons had to search out a way to stop COVID bacteria from migrating from the lungs to the center.
Doctors developed a method to sever the veins concurrently and later discovered that the identical technique could stop the spread of cancer cells.
“With lung cancer, we had to make the same changes,” said Rade Tomic, a pulmonologist at Northwestern Medicine who also worked on the transplant treatment. “We had to make sure we didn't let the cancer spread or get into the bloodstream.”
Doctors also performed a second step to make sure cancer cells and COVID-19 bacteria were faraway from the remainder of the chest. After the lungs are removed, doctors flush the remaining airways and chest.
Gillespie said he was initially reluctant to undergo the double transplant. He had already had lung surgery and didn't wish to undergo one other major operation. But ultimately it gave the look of the one option.
Gillespie underwent surgery in January after being placed on the transplant list in September. He is on the road to full recovery, he said, and hopes to return to work within the near future.
“I'm a grandfather,” Gillespie said. “The first thing I thought about was spending more time with (my grandchildren) and watching them grow up. It's just an indescribable benefit.”
Tomic said these recent transplant techniques would have far-reaching and far-reaching implications. The treatment is already used for other conditions reminiscent of pulmonary fibrosis and is a life-saving intervention for patients with advanced lung cancer who may haven’t any other options, he said.
“The goal is to help the patient, to give them a chance at a new life and to give them the opportunity to get their life back,” Tomic said. “They will have a much, much longer survival time than they would have had without the lung transplant.”
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