While Melissa Benoit waited for double transplant at Toronto hospital, her terminal lung infection called for risky and unprecedented procedure.
Doctors in Canada have saved a young mother’s life by resorting to a radical solution –removing her lungs for six days while she waited for a transplant, in what is believed to be the first procedure of its kind in the world.
With a severe lung infection, Melissa Benoit had arrived at a Toronto hospital in April. The doctors there were led to consider the unprecedented approach as they realized that Benoit had just hours to live and she had been born with cystic fibrosis.
“It was a difficult discussion because when we’re talking about something that had never to our knowledge been done before, there were a lot of unknowns,” Dr Niall Ferguson of the University Health Network, the health authority responsible for the Toronto general hospital, told a news conference on Wednesday.
She was kept sedated and on a ventilator to help her breathe the the then 32-year-old had a bout with influenza and was left fighting off respiratory failure.
“She got into a spiral from which her lungs were not going to recover,” said Ferguson. “Her only hope of recovery was a lung transplant.”
But condition continued to deteriorate despite being put on a temporary life support device. Her body was sent to septic shock and her blood pressure dropped as the bacteria in her lungs became resistant to most antibiotics. Her organs began shutting down one by one.
And then the removal of both her lungs in hopes of eliminating the source of the bacterial infection was the bold solution the doctors had contemplated for years but never carried out as her team of doctors gathered together to weigh the options.
Once her lungs were removed, there were the risk of bleeding into the empty chest cavity and whether her blood pressure and oxygen levels could be sustained were the list of unknowns for the doctors.
“What helped us is the fact that we knew it was a matter of hours before she would die,” said Dr Shaf Keshavjee, one of three surgeons who operated on Benoit. “That gave us the courage to say, if we’re ever going to save this woman, we’re going to do it now.”
Thinking of their three-year-old daughter, Benoit’s husband, Chris, gave doctors the go-ahead. “We needed this chance,” he said. “Things were so bad for so long, we needed something to go right.”
A nine-hour surgery to remove Benoit’s lungs was carried out in mid-April by a team of 13 doctors. Keshavjee said that each lung was swollen and as hard as a football as they were filled with mucous. “Technically, it was difficult to get them out of her chest.”
Her condition began to dramatically improve hours later. “And literally within minutes – it was probably around 20 minutes after having taken those infected lungs out – her blood pressure normalised, and they could remove all the blood-pressure-supporting drugs and just leave her on the pumps that were providing the circulation,” Keshavjee told the Canadian Press.
While other devices oxygenated and circulated her blood, a small artificial lung was connected to Benoit’s heart. “We didn’t know if we’d get [them] in one day or one month,” said Keshavjee.
Benoit underwent a successful lung transplant six days later when a pair of donor lungs became available.
(Adapted from The Guardian)