Lung :: Lung transplant with external, artificial lung Novalung

The lung transplant team at Toronto General Hospital, University Health Network used the Novalung, an external, artificial lung to keep the patient alive until a set of donor organs became available for transplantation.

The artificial lung functions like normal lungs, while avoiding or reducing lung injuries linked to the use of a breathing machine or ventilator.

The procedure was performed because there were no other options for the patient and the team raced against time to save the patient’s life. Subsequent procedures will be part of a clinical trial at TGH testing the artificial lung as a bridge-to-transplant for end-stage lung disease patients who are waiting for a lung transplant. The device has been used in the Balad Theatre Hospital in Iraq on soldiers who have been critically wounded and needed life-saving measures.

The three-hour procedure at TGH was performed on December 2, 2006 by a 20-member team headed by Dr. Shaf Keshavjee, Director of the Lung Transplant Program at Toronto General Hospital, Director of the Latner Thoracic Surgery Research Laboratories and Professor and Chair, Division of Thoracic Surgery, at the University of Toronto. The patient was on the artificial lung for one day until a pair of lungs and a heart became available for her on December 3, 2006. She remained on the artificial lung for one more day after the operation, allowing her newly transplanted lungs to recover from the procedure. Other key members of the team included: Drs. Tom Waddell, Marc De Perrot, Andrew Pierre, Stefan Fischer, Terry Yau, Stuart Reynolds, and cardiac perfusion manager Stephen Harwood along with a team of OR and intensive care nurses, anesthesiologists, and other health-care professionals.

“Without the artificial lung, our young patient would not be alive today to be a beloved daughter, wife and mother for her three children,” said Dr. Keshavjee. “This young woman came to TGH and was found to be so ill that she was admitted to our intensive care unit on the same day. She needed to have a lung transplant urgently and the wait for donor lungs can be between three to five months,” he said. The TGH lung transplant program performs between 80 to 90 transplants a year, making it one of the largest transplant centres in the world.

Yen Tran, 21, is the mother of four-year-old fraternal twins and a 14-month-old son. She had rarely been sick in her life, had played soccer in high school, but began to have difficulty breathing after she had her third child. At first she thought she was “just out of shape,” but grew alarmed when she eventually could not walk up and down the stairs in her home and her lips and nails turned a dark blue.

Yen was admitted to TGH with a condition known as primary or unexplained pulmonary hypertension, a rare lung disorder in which the blood pressure in the pulmonary artery rises far above normal levels, putting a strain on the heart. Yen began to realize how ill she was and wondered if she would survive.

“I hoped that I could get a pair of lungs, but I was not sure if I could wait that long,” she said, adding that after the transplant, she feels she was “brought back to life and given a second chance. I’m so grateful that I was able to benefit from the artificial lung and a generous donor for real ones. I’m so glad to be alive and I’m so glad that I can go home to my children.”

The Novalung or Interventional Lung Assist Device is about the size of a CD case and essentially does the work of the lungs. The blood leaving the device has the same amount of oxygen and carbon dioxide that exits the normal lung because the patient’s blood passes through a type of special filtering membrane in the device. A unique feature of this device is that it does not require a pump to run, thereby reducing damage to blood cells. It is attached to a patient via tubes through the femoral (thigh) blood vessels and is powered by the patient’s own heartbeat.


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