Doctors took a revolutionary and radical step to save the life of a woman losing a battle against a severe infection. In what is thought to be a world first, they kept her alive for six days with no lungs until she received a transplant.
Melissa Benoit was born with cystic fibrosis, a genetic disorder that causes a buildup of phlegm in the lungs. In April last year, the 32-year-old mother arrived at Toronto General Hospital with a severe lung infection. She had suffered from regular lung infections since her early twenties due to her cystic fibrosis. However, the doctors eventually found that this bacteria had developed resistance to most antibiotics.
She was left gasping for air and suffering coughing fits so hard she fractured her own ribs. As the hospital graphically described it: “Her inflamed lungs began to fill with blood, pus, and mucus, decreasing the amount of air entering her lungs, similar to a person drowning.”
Despite their best efforts, the situation became even more grave as she fell into septic shock, her oxygen levels dropping so low even a ventilation system was insufficient, and other organs began to fail. Along with this, she was put on kidney dialysis while being dosed up on numerous blood pressure medications and a last-resort string of strong antibiotics. Her only hope, the doctors decided, was to urgently remove her lungs, the source of deep bacterial infection.
“She got into a spiral from which her lungs were not going to recover. Her only hope of recovery was a lung transplant," Dr Niall Ferguson, Head of Critical Care Medicine at UHN and Mount Sinai Hospital, explained in a statement.
The doctors took the brave but risky decision to carry out an operation that had only previously been theorized: To remove both lungs, despite no donor lungs being immediately available.
A team of 13 undertook the nine-hour surgery on Melissa. Her lungs had become so filled with mucous and pus they were “as hard as footballs,” according to Dr Shaf Keshavjee, Surgeon-in-Chief. "Technically, it was difficult to get them out of her chest."
Within hours of the lungs being removed, her condition improved remarkably well. The state of her major organs also dramatically improved and she no longer required blood pressure medication.
Her body was hooked up to two external life support circuits that she lived on for six days. One was a small portable artificial lung connected by arteries and veins to her heart, which added oxygen to her blood and removed carbon dioxide. The other was an external pump to help with the gaseous exchange and circulate the blood.
Six days later, once stabilized and a pair of donor's lungs became available, she received the transplant.
"The transplant procedure was not complicated because half of it was done already," said Dr Marcelo Cypel, another member of the team. "Her new lungs functioned beautifully and inflated easily. Perfect."
Melissa is still recovering and receiving kidney dialysis. However, her progress since April is outstanding. She's back at home, her hair is growing back, she's able to walk unaided, and she can play for hours with her daughter without getting worn out.
"It's the simple things I missed the most," she said, "I want to be there for Chris and Olivia, even through her temper tantrums! I want to hear Olivia's voice, play with her and read her stories."
Thanks to this ground-breaking surgery and some very daring doctors, she can.