Chicago, IL – August 12, 2026 – In a new study published today in Science Advances, Northwestern Medicine researchers have uncovered a previously hidden immune environment in the thymus that may help drive myasthenia gravis (MG), a chronic autoimmune disease that causes muscle weakness and fatigue, mainly impacting women under age 40 and men over age 60. Using the largest known cellular and spatial map of the MG thymus ever assembled, researchers identified specialized immune cells and survival signals that may help sustain the disease, opening new avenues for future research and treatment.

Myasthenia gravis occurs when the body's immune system mistakenly attacks the communication point between nerves and muscles. The symptoms worsen with activity and improve with rest. Most often, the disease affects the muscles that control the eyes, facial expressions, talking, swallowing and chewing. In severe cases, breathing muscles can become dangerously weak.

While researchers have long known that harmful antibodies play a major role in MG, they do not fully explain why symptoms vary among patients or why some people continue to experience disease activity despite treatment, including the surgical removal of the thymus called a thymectomy.

“During childhood, the purpose of the thymus is to train the body’s immune cells, but in adulthood, the thymus shrivels up and starts to malfunction, which can lead to myasthenia gravis,” said Ankit Bharat, MD, senior author of the study, chief of thoracic surgery and executive director of the Northwestern Medicine Canning Thoracic Institute. "Our study suggests there's more to myasthenia gravis than antibodies alone. We found evidence that the thymus may create an abnormal immune environment that helps certain B cells survive and persist, even after the thymus is removed. Understanding that environment gives us an entirely new framework for studying and possibly treating the disease."

What this means for patients

For patients like 30-year-old Marissa Humayun of Chicago, the latest research gives her hope, especially after three years of ups and downs.

In early 2023, at the age of 26, Humayun went to the emergency department with stroke-like symptoms that came out of nowhere, including a droopy eyelid and double vision. When bloodwork came back negative for the main MG antibodies, Neena Cherayil, MD, a neuro-ophthalmologist at Northwestern Medicine, diagnosed Humayun with ocular myasthenia gravis (OMG) and seronegative myasthenia, a rare form of MG, where three of the known antibodies for MG don’t show up in standard blood tests, but patients still present symptoms.

Three months after her diagnosis, Humayun underwent robotic surgery with Dr. Bharat to have her thymus removed and donated the small gland to his research study. Even though the thymectomy was a success, Humayun’s symptoms returned, which can happen in some patients. Humayun now relies on infusion therapy at Northwestern Memorial Hospital to help control her symptoms and is treated by Arjun Seth, MD, a neuromuscular medicine specialist at Northwestern Medicine.

“When symptomatic, I have droopy eyelids, fatigue and double vision – especially if I’ve pushed myself too hard or didn’t rest enough. Myasthenia gravis is such a discouraging disease, but I must honor my body for what it can do today,” said Humayun. “Dr. Bharat is an inspiring surgeon and researcher, and Northwestern Medicine has truly taken care of me throughout my diagnosis and treatment. I’m optimistic for the future, knowing scientists right here in Chicago are working to find solutions for patients in the myasthenia gravis community.”

“Our hope is that we can now identify patients – like Marissa – who are at risk of having a recurrence after the thymectomy and after treatment,” said Dr. Bharat. “Also, this study gives us clues as to why some patients don’t respond to the conventional medical treatments. What we’re hoping to do is identify those patients who are at risk and then ultimately design clinical interventions that can kill those cells and then prevent the recurrences.”

A surprising discovery

To better understand what happens inside the thymus, Northwestern Medicine researchers analyzed 23 thymus samples from 16 patients and combined several advanced technologies, including single-cell RNA sequencing, immune receptor analysis and spatial transcriptomics. Together, these techniques allowed scientists to identify individual cell types and determine where those cells were located within the tissue.

After integrating their data with previously published datasets, the team created an atlas containing nearly 347,000 cells, making it the most comprehensive map of the MG thymus to date. Researchers expected to find evidence of a single rogue immune-cell population driving disease, but instead, they found something very different.

The study revealed a diverse population of class-switched B cells clustered within and around abnormal germinal centers in MG tissue. Rather than showing signs of traditional immune regulation, these cells appeared to rely on a separate survival pathway involving molecules known as BAFF and BCMA.

The researchers describe the finding as a potential "tolerance checkpoint swap" in which B cells move away from normal immune-control mechanisms and become supported by survival signals from the surrounding tissue environment.

"We did not find one dominant B-cell clone taking over," said Dr. Bharat. "Instead, we found a diverse population of B cells living within an abnormal immune neighborhood. The neighborhood itself may be helping these cells survive."

What happens next?

The findings may help explain several longstanding mysteries surrounding myasthenia gravis, including why antibody levels do not always match disease severity and why improvement after thymus-removal surgery can vary from patient to patient. However, the researchers caution that the current study did not directly test those questions.

“This study is not a treatment announcement and does not change current recommendations for patients with myasthenia gravis,” said Dr. Bharat. “Thymectomy remains an evidence-based treatment for appropriately selected patients, and additional research will be required to determine whether the newly identified pathways play a direct role in disease progression.”

Instead, the work provides a detailed roadmap for future investigation.

"This study gives us a map," said Dr. Bharat. "The next step is to determine whether these pathways actively drive disease and whether they can be targeted to restore immune tolerance. That's the promise of this research."

The pulmonology and lung surgery program at Northwestern Memorial Hospital is proud to be the highest-ranked in Illinois for 15 straight years and No. 4 in the U.S., according to U.S. News & World Report, 2026 – 2027. For more information, visit nm.org.

Chicago, IL – July 14, 2026 – Northwestern Medicine surgeons have performed the first known quadruple-organ transplant involving retransplanted lungs in the United States. Elizabeth Wehrle, a 36-year-old mother from Montezuma, Iowa, received two donor lungs for a second time, along with a liver and kidney, after complications from cystic fibrosis and chronic rejection of her first lung transplant left her critically ill. The groundbreaking surgery happened at Northwestern Memorial Hospital and involved a multidisciplinary transplant team uniquely equipped to manage one of the most complex surgical cases ever undertaken. 

KEY NOTES AT A GLANCE

• According to the Scientific Registry of Transplant Recipients (SRTR), Wehrle is the first patient in the United States to receive a quadruple-organ transplant involving retransplanted lungs.
• According to SRTR, Northwestern Medicine is the sixth transplant program in the U.S. to perform a quadruple-organ transplant, but the first to perform one with retransplanted lungs.
• To date, only seven quadruple-organ transplant procedures have been performed in the U.S. (one transplant center performed two).
• Redo lung transplantation is among the most technically challenging procedures in medicine. Previous surgeries create extensive scar tissue, obscuring normal anatomy and making operations significantly more complex.

“Retransplanting lungs is extraordinarily difficult because prior surgery can leave the chest densely scarred and the normal anatomy severely distorted,” said Ankit Bharat, MD, chief of thoracic surgery and executive director of the Northwestern Medicine Canning Thoracic Institute. “Adding a liver and kidney transplant placed Elizabeth’s case in a category few transplant programs ever encounter. Her outcome reflects not just surgical skill, but an entire system built to care for the most complex patients. Elizabeth’s initial double-lung transplant from 2017 left extensive scar tissue which severely distorted the normal anatomy of her chest. When you make an incision, the risk of bleeding and injury to nearby organs and blood vessels increases, and with four organs involved, there’s an even greater risk of organ rejection and serious infection.” 

“Every transplant case is unique, but Elizabeth’s case was extremely rare and difficult,” said Satish Nadig, MD, PhD, transplant surgeon and director of the Northwestern Medicine Comprehensive Transplant Center. “This operation worked because the thoracic, abdominal transplant, anesthesia, intensive care unit, perfusion and nursing teams functioned as one coordinated team. Because we all worked so well together, the surgical implantation was completed in approximately eight hours. It truly highlights why Northwestern Medicine’s expertise can take on some of the most complex transplant cases in the world.”

Rare lung rejection presents extraordinary challenge

 Wehrle, a patient with cystic fibrosis, previously underwent a double-lung transplant in 2017 at another health system and had regained her quality of life before getting sick in January and eventually being diagnosed with a severe form of chronic rejection in late February. While chronic rejection is common in lung transplant patients, Wehrle’s case was especially rare and life-threatening.

“Unfortunately, she developed a rare form of rejection called restrictive allograft syndrome (RAS) which is often fatal and so high-risk that many transplant centers wouldn’t consider repeat lung transplantation,” said Dr. Bharat. 

As physicians evaluated Wehrle’s condition, they discovered additional organ failure caused by cystic fibrosis complications – she would also need a liver and kidney transplant. By the time Wehrle’s medical team in Iowa referred her to Northwestern Medicine, she had progressive respiratory failure and required both a ventilator and life support machine known as extracorporeal membrane oxygenation (ECMO). 

“Even though a redo double-lung transplant plus a liver and kidney transplant had not been identified in U.S. registry data, we thought we could help Elizabeth because of our experience with some of the most challenging transplant cases and the multidisciplinary systems we’ve built at Northwestern Medicine to care for these patients,” said Dr. Bharat.    

Timing and coordination for transplantation 

On March 17, Wehrle was admitted to the Cardiothoracic Intensive Care Unit at Northwestern Memorial and was listed for a quadruple-organ transplant on March 19. Three days later, she received word that four organs were available. Thoracic surgeons started on the double-lung retransplant the evening of March 22, and abdominal surgeons followed in the early morning hours of March 23 with the liver and kidney transplant. 

To overcome the challenges associated with prolonged transplant surgeries, Northwestern Medicine used advanced machine perfusion technology to preserve donor organs outside the body, giving surgeons more time than traditional cold storage alone. This approach allowed the thoracic team to focus on the complex lung retransplantation while the liver and kidney remained safely supported. The surgery required extensive preparation and precise choreography.

“The liver and kidney were on a machine perfusion pump, which was fantastic because it allowed the lung team to take their time and make sure the lungs went in safely without being on the clock for the abdominal organs,” said Dr. Nadig. “When the abdominal organs went in and blood flow was restored, they began functioning straight away.”

"The whole operation had to be very closely coordinated, with so many team members and two different teams working in extremely close collaboration to make sure there was no single misstep," said Chitaru Kurihara, MD, a thoracic surgeon and surgical director of the Lung Transplant Program at the Canning Thoracic Institute. “If one surgeon had tried to do this as a single 20-hour operation, that would have been too much stress on a critically ill patient. By separating it out this way, we were able to achieve the outcome we hoped for in only eight hours.”

Life after a historic transplant 

For Wehrle, the historic surgery represented an opportunity to return to the life she had built with her family after her first transplant in 2017.

"Life was great after my first double-lung transplant," Wehrle said. "I was a stay-at-home mom, I homeschooled my son, and I was busy with all his activities. I had my life back. But as my health deteriorated, simple daily tasks became overwhelming. There were days that I couldn't get myself dressed because I just couldn't breathe.”

Following the transplant in March, Wehrle quickly recovered, with her new lungs, liver and kidney functioning well. In less than three weeks, she was discharged from Northwestern Memorial and began rebuilding her strength. She’s currently walking 3-4 miles per day and doing light weightlifting.

“Before surgery, there was so much tightness in my chest and I couldn’t breathe. Almost immediately after transplant, I felt like a new person,” said Wehrle. “Without my four new organs, I know I wouldn’t be here today.”

Wehrle will return home to Iowa on July 17 and be reunited with her 11-year-old son, Landen, who got to experience a Chicago summer when he visited his mom in June. The scars from Wehrle’s surgeries are a visible reminder of her journey and she doesn’t take them for granted. 

"I don't hide my scars," Wehrle said. “I’m looking forward to going to the swimming pool this summer and showing off my battle scars. I earned them. They saved my life.”

"I'm so proud of this case because of the way our teams came together to anticipate every challenge and be prepared for it," said Dr. Bharat. "There was a tremendous amount of passion to help Elizabeth. The thought of reuniting her with her child and giving her a new lease on life makes all of us incredibly happy."

The procedure was made possible by the generosity of an organ donor and donor family.

More information on lung transplantation 

Since Northwestern Medicine’s Lung Transplant Program first started in 2014, they’ve performed more than 700 lung transplant procedures for patients with end-stage lung diseases such as COVID, cancer, cystic fibrosis, chronic obstructive pulmonary disease (COPD) and more. Northwestern Medicine has one of the shortest wait times for a lung transplant in the U.S. with a median wait time of three days. 

Patients interested in being evaluated for a lung transplant can contact the 24-hour referral line at 312.695.5864 or 844.639.5864. For more information about organ transplantation at Northwestern Medicine, visit nm.org. 

Chicago, IL – July 8, 2026 – A landmark study from the Northwestern Medicine Canning Thoracic Institute, published today in JAMA, suggests lung transplantation can significantly extend survival in select patients with advanced lung cancer.

In a study of patients with medically refractory, lung-limited stage IV non-small cell lung cancer (patients with terminal lung cancer confined to the lungs who are out of treatment options), Northwestern Medicine physicians and scientists found that lung transplantation was associated with substantially better early survival than medical management (chemotherapy, radiation, immunotherapy, etc.) alone.

The study, titled “Lung Transplant for Refractory Lung-Limited Stage IV Non-Small Cell Lung Cancer,” evaluated outcomes from the Double Lung Transplant Registry for Lung-Limited Malignancies – known as the DREAM registry – a pioneering Northwestern Medicine program designed to test whether replacing lungs overtaken by treatment-resistant cancer can remove organ-confined disease and rescue patients dying of respiratory failure. Northwestern Medicine is currently the only known health system in the country with a dedicated lung transplant program (DREAM) for patients with advanced lung cancers who have failed all other treatment options.

“This work changes what we can imagine for a highly selected group of patients who were previously considered beyond the reach of curative-intent intervention,” said co-corresponding author Ankit Bharat, MD, who is chief of thoracic surgery and director of the Canning Thoracic Institute. “We are not saying lung transplant is appropriate for every patient with stage IV lung cancer. We are saying that when the cancer is rigorously proven to be confined to the lungs, when standard therapies have been exhausted, and when the lungs themselves have become the life-limiting organ, transplantation may offer a new path forward.”

KEY RESULTS AT A GLANCE

• Study population: 404 adults with end-stage pulmonary disease, including 98 with stage IV lung cancer; 17 underwent lung transplant and 81 received medical management alone after nonbiologic barriers prevented transplant.
• Comparison with patients who did not receive transplant: In the main study period (September 2021 through June 2025), every transplanted patient was alive, while fewer than half of similar patients treated with medical therapy alone were alive.
• Comparison with patients who received lung transplant for lung failure from non-cancer causes: One-year posttransplant survival among lung transplant patients was 100% for those transplanted for stage IV lung cancer vs 88% for patients transplanted without cancer.  

A devastating form of stage IV lung cancer

Cancers of the lung are the leading cause of cancer-related deaths in the United States with more people dying of lung cancer than colon, breast and prostate cancers.

Most patients with stage IV lung cancer have disease that has spread beyond the lungs. But a subset develops advanced non-small cell lung cancer that remains confined to the lungs, even as it progresses throughout both lungs and causes respiratory failure. These patients may exhaust targeted therapy, immunotherapy, chemotherapy and clinical trial options, yet still have no evidence of cancer outside the lungs. For these patients, the immediate cause of death is often not widespread systemic cancer, but progressive failure of cancer-filled lungs.

“This is a biologically distinct clinical scenario. These patients have stage IV cancer, but the disease remains anatomically limited to the lungs,” said co-corresponding author Young Kwang Chae, MD, MPH, who is a thoracic medical oncologist with the Robert H. Lurie Comprehensive Cancer Center of Northwestern University at Northwestern Memorial Hospital. “In these rare select group of patients, DREAM provides us a disciplined, scientifically rigorous way to ask whether removing the organ containing all visible disease can change the natural history of an otherwise fatal condition.”

What the study found

The JAMA study included 404 adults treated or evaluated at Northwestern Medicine from September 2021 through June 2025 for end-stage pulmonary disease.

Among 98 patients with stage IV lung cancer confined to the lungs, 17 underwent lung transplant and 81 met transplant eligibility criteria but didn’t undergo transplant because of nonbiologic barriers such as logistical, financial or geographic factors, and were treated with medical management alone.

The results showed 100% one-year survival among the 17 patients with stage IV lung cancer who received a lung transplant, compared to 41% one-year survival among the 81 patients with stage IV lung cancer who were treated with medical therapies alone.  

The investigators also compared the lung cancer transplant recipients with 306 patients without cancer who underwent lung transplant for end-stage pulmonary disease such as cystic fibrosis, COPD or pulmonary hypertension. Between those two groups of patients, one-year posttransplant survival was 100% among the patients transplanted for stage IV lung cancer, versus 88% among lung transplant recipients without cancer.   

“Any time we consider expanding the use or donor lungs, organ stewardship must be central. These results suggest that, in carefully selected patients and in the right multidisciplinary setting, lung transplantation for lung-limited malignancy can achieve early outcomes that are comparable to accepted noncancer transplant indications,” said Dr. Bharat.

Why this approach is different

Lung cancer has long been considered a relative contraindication to lung transplantation due to the concern that lung cancer would rapidly recur in the transplanted lung. The Northwestern Medicine team designed the DREAM trial to determine whether modern cancer detection methods could identify patients whose cancer was limited to the lung, limiting the chances of recurrence.

Patients underwent comprehensive contemporary staging to confirm that disease was confined to the lungs, including advanced imaging and systematic invasive mediastinal evaluation to reduce the risk of missing cancer spread outside the lungs. Transplant was considered only after patients had medically refractory disease despite available systemic therapies and consideration for clinical trials.

The surgical strategy was also redesigned to minimize the risk of cancer dissemination during the operation.

“This innovative technique involves putting the patient on heart and lung bypass, delicately taking both cancer-ridden lungs out at the same time along with the lymph nodes, washing the airways and the chest cavity to clear the cancer, and then putting new lungs in,” said Dr. Bharat. “These patients can have billions of cancer cells in the lungs, so we must be extremely meticulous to not let a single cell spill into the patient’s chest cavity or blood stream. We believe this technique can help reduce the risk of recurrence, which we learned through our experience with pioneering COVID-19 lung transplants in 2020.”

The team also used single-cell transcriptomic analyses to study tumor regions across the removed lungs and investigate mechanisms of treatment resistance.

“Using state-of-the-art single-cell analysis of individual cancer cells from multiple regions of both cancer-filled lungs, we saw tumors that were profoundly resistant, with different cancer-cell populations relying on different resistance pathways. That helps explain why chemotherapy, immunotherapy and other systemic therapies could no longer meaningfully control the disease and why replacing the diseased lungs may be the only realistic option to extend life for these carefully selected patients,” said Dr. Bharat.

“The paradigm shift is not simply that transplant was performed for lung cancer. The shift is that transplantation was embedded within a complete scientific framework – rigorous staging, proof of lung-limited disease, transplant-specific operative innovation, intensive surveillance and molecular analysis of the explanted tumors. That is what makes this a new model of transplant oncology,” said co-corresponding author G.R. Scott Budinger, MD, chief of pulmonary and critical care medicine at the Canning Thoracic Institute.

Recovery, recurrence and next steps

Postoperative outcomes among the transplant recipients with cancer were generally similar to those among transplant recipients without cancer. Median hospital length of stay was 14 days for patients transplanted for stage IV lung cancer and 16 days for transplant recipients without cancer.

During follow-up, four of the 17 transplant recipients saw their cancer return and they were treated with local and systemic therapies (ex: surgery, radiation, chemotherapy, immunotherapy, etc.) By the end of the study in January 2026, two of the 17 transplant recipients had died.

The authors emphasize that longer follow-up is needed to define the durability of disease control, the risk of late recurrence and long-term quality of life after transplant.

“This is not a claim that transplant restores normal life expectancy, and it’s not a blanket indication for stage IV lung cancer. It’s evidence that a carefully selected group of patients facing otherwise poor near-term survival may have an opportunity for meaningful additional life – that’s why this work matters,” said Dr. Bharat.

About the DREAM Program

To date, Northwestern Medicine surgeons have performed more than 50 lung transplants for patients with advanced lung cancers.

Since Northwestern Medicine’s Lung Transplant Program first started in 2014, they’ve performed more than 700 lung transplant procedures for patients with end-stage lung diseases such as COVID, lung cancer, cystic fibrosis, chronic obstructive pulmonary disease (COPD) and more. Northwestern Medicine has one of the shortest wait times for a lung transplant in the U.S. with a median wait time of three days.

Patients interested in being evaluated for a lung transplant can contact the 24-hour referral line at 312.695.5864 or 844.639.5864. For more information about the Lung Transplant Program or lung cancer screenings, visit nm.org. 

PATIENTS AVAILABLE FOR INTERVIEWS

David Peterson – Washington, DC

David Peterson is a freelance photographer who lives in Washington, DC. In early 2019, he developed a cough that wouldn’t go away, and after going to a local clinic, they discovered a dark spot on his lung. Peterson was diagnosed with lung cancer at a health system in Washington and started immunotherapy treatment, followed by surgery to remove a softball-sized tumor believed to have been developing on his left lung for more than a decade.

For nearly a year, Peterson’s recovery appeared promising, but a follow-up CT scan revealed his cancer had returned. Despite aggressive chemotherapy and multiple clinical trials, the disease continued to progress, and Peterson was running out of time.

In 2023, he discovered an online story about the DREAM Program at Northwestern Medicine, reached out to the lung transplant team and was fast-tracked for evaluation. Just weeks after being listed, and shortly after relocating to Chicago with the support of his wife and kids, Peterson received the call. On September 24, 2023, at the age of 57, Peterson underwent a double-lung transplant.

Now 60, he remains cancer-free and has had no signs of organ rejection. While managing a daily regimen of medications and ongoing physical rehabilitation, he’s embracing life again – reconnecting with his work as a freelance photographer, participating in lung transplant support groups and spending time with his family. His cancer, driven by a KRAS G12D gene mutation and unrelated to smoking, makes his case particularly noteworthy and he’s hopeful his story can raise awareness about emerging transplant options for patients with advanced lung cancer.

“When I first heard, ‘lung transplant,’ I thought it was too extreme to even consider, but it became my second chance at life. Today, I’m cancer-free, back with my family in DC, and picking up my camera again,” said Peterson. “I don’t take a single day for granted. This experience has taught me that even when options feel exhausted, there can still be hope – sometimes in places you never expected.”

Laura Rotunno – Deerfield, Illinois 

For Laura Rotunno of Deerfield, Illinois, a lung transplant was a second chance at life after being diagnosed with lung cancer four years ago. Initially, the cancer started on her left lung, but after two years of chemotherapy, the cancer spread to her right lung. Facing limited treatment options, Rotunno’s physician recommended she reach out to Northwestern Medicine to be considered for the DREAM Program.  

After an extensive transplant evaluation, and being hospitalized with pneumonia, Rotunno was placed on the lung transplant waiting list on May 20, 2025. Ten days later, at the age of 63, Rotunno underwent a successful double-lung transplant at Northwestern Memorial Hospital on May 30, 2025. Coincidentally, Rotunno’s transplant fell on the 11^th birthday of her beloved German Shepherd, Koda.

Married to her husband, Richard, for 35 years and together for 45, Rotunno cherishes time with her family, including their 29-year-old daughter, Jenna. As she approaches her 65^th birthday on July 31, Rotunno is back to working as a receptionist at a local health care system, and she reflects often on the anonymous donor who made her transplant possible.   

“When I got the call that donor lungs were available, everything changed,” said Rotunno. “Just a few months earlier, I was in the hospital on oxygen, wondering what the future would hold. Now I wake up every day thankful for the simple things – a walk with my dog, time with my husband and daughter, and the chance to celebrate another birthday. My transplant is proof that one incredible act of generosity can change someone else’s life forever.”

Jodi Graf – Houston, Texas 

For nearly three decades, Jodi Graf, a NASA engineer and mother of two, lived her life one breath at a time. In 1997, she began experiencing unexplained shortness of breath. Doctors in Houston, Texas, initially diagnosed her with asthma, prescribing an inhaler. But instead of improving, her condition worsened.

In 2005, after a bout of pneumonia, doctors identified a more serious condition – interstitial lung disease (ILD), which causes scarring of the lungs, making it difficult to breathe. For 10 to 15 years, Graf remained relatively stable until her health began to rapidly decline and she came to rely on supplemental oxygen.

In December 2023, Graf entered a formal lung transplant evaluation with doctors in Houston, but during the testing, they discovered a mass in her lungs. Despite not having a history of smoking, Graf was diagnosed with advanced lung cancer. At most transplant centers around the world, patients with active cancer are no longer eligible for lung transplants. Instead of being listed for a transplant in Houston, Graf underwent radiation treatment while her lung function dropped to 30 percent.

“Basic activities required constant supplemental oxygen – sometimes as much as 10 liters. Just walking from my car to my office at NASA was a feat,” said Graf. “I would Google ‘lung transplant’ constantly, searching for hope. That online search led me to news stories in Chicago about the DREAM Program and when I called Northwestern Medicine, I found my people.”

Last November, Graf arrived at Northwestern Memorial Hospital where she underwent a transplant evaluation and was listed for a double-lung transplant. Less than 24 hours after being placed on the wait list for new lungs, Graf received the call that a match was found, and her surgery took place on Thanksgiving Day – November 27, 2025.

After surgery, Graf walked on a treadmill – without oxygen – for the first time in years. She will reside in Chicago for one-year post transplant, and soon hopes to hike in Yellowstone, explore the Canadian Rockies, and travel with her husband, John, and their two sons, ages 22 and 26, without oxygen tanks for the first time in decades.

Tannaz Ameli – Minneapolis, Minnesota 

Tannaz Ameli, a retired nurse living in Minneapolis, Minnesota, built a life in the United States after immigrating from Iran in 1980.

In September 2021, Ameli developed a persistent cough that steadily worsened. Initial testing, including a chest X-ray, led doctors to diagnose her with pneumonia. However, as her symptoms changed from a dry cough to a productive one, further imaging still pointed to pneumonia.

By January 2022, with no improvement, Ameli sought care at a large health system in Minnesota where she received a life-changing diagnosis: stage IV lung cancer. She started chemotherapy, but it quickly became clear that standard treatment would not be sufficient and Ameli was running out of time. After learning about Northwestern Medicine’s lung transplant program through media coverage, her husband, Medhi, arranged for a second opinion.

During a consultation with Ankit Bharat, MD, chief of thoracic surgery, Ameli learned she was a strong candidate for a lung transplant because her cancer remained confined to the lungs and had not spread to the lymph nodes.

Ameli traveled to Chicago and was admitted to Northwestern Memorial Hospital on July 3, 2022, where she was listed for a double-lung transplant. Just 10 days later on July 13, a donor was identified and Ameli, then 64, underwent a successful double-lung transplant. Four years later at the age of 68, Ameli remains cancer-free.

“As a nurse, I spent my life caring for others, and I never imagined I’d be the one relying on such extraordinary care,” said Ameli. “When I came to Northwestern Medicine, the first thing Dr. Bharat told me was, ‘I think we can make you cancer-free,’ and he delivered on those words. If you or a loved one has lung cancer, Northwestern Medicine is the place to be. These days, I’m enjoying traveling, spending time with friends and family and living proof that there is hope even in the most difficult moments.”

Chicago, IL – May 10, 2026 – A NASA engineer and mother of two is the first known patient from Houston to receive an innovative double-lung transplant to treat terminal lung cancer. Jodi Graf traveled to Northwestern Medicine in Chicago to participate in a clinical trial known as DREAM, where select patients with advanced lung cancers receive double-lung transplants. Northwestern Medicine is currently the only health system in the country offering this cutting-edge approach for patients with advanced lung cancers who have failed all other treatment options.

“This innovative technique involves putting the patient on full heart and lung bypass, delicately taking both cancer-ridden lungs out at the same time along with the lymph nodes, washing the airways and the chest cavity to clear the cancer, and then putting new lungs in,” said Ankit Bharat, MD, chief of thoracic surgery and executive director of the Northwestern Medicine Canning Thoracic Institute. “These patients can have billions of cancer cells in the lungs, so we must be extremely meticulous to not let a single cell spill into the patient’s chest cavity or blood stream. We believe this technique can help reduce the risk of recurrence, which we learned through our experience with pioneering COVID-19 lung transplants in 2020.”

From breathless to boundless

For nearly three decades, 61-year-old Graf, who is a robotic software developer at NASA, lived her life one breath at a time. In 1997, she began experiencing unexplained shortness of breath. Doctors in Houston initially diagnosed her with asthma, prescribing an inhaler. But instead of improving, her condition worsened.

In 2005, after a bout of pneumonia, doctors identified a more serious condition – interstitial lung disease (ILD), which causes scarring of the lungs, making it difficult to breathe. For 10 to 15 years, Graf remained relatively stable until her health began to rapidly decline and she came to rely on supplemental oxygen.

In December 2023, Graf entered a formal lung transplant evaluation with doctors in Houston, but during the testing, they discovered a mass in her lungs. Despite not having a history of smoking, Graf was diagnosed with advanced lung cancer. At most transplant centers around the world, patients with active cancer are no longer eligible for lung transplants. Instead of being listed for a transplant in Houston, Graf underwent radiation treatment while her lung function dropped to 30 percent.

“Basic activities required constant supplemental oxygen – sometimes as much as 10 liters. Just walking from my car to my office at NASA was a feat,” said Graf. “I would Google ‘lung transplant’ constantly, searching for hope. That online search led me to news stories in Chicago about the DREAM Program and when I called Northwestern Medicine, I found my people.”

Last November, Graf arrived at Northwestern Memorial Hospital where she underwent a transplant evaluation and she was listed for a double-lung transplant. Less than 24 hours after being placed on the wait list for new lungs, Graf received the call that a match was found, and her surgery took place on Thanksgiving Day – November 27, 2025.

Breathing freely again

After surgery, Graf walked on a treadmill – without oxygen – for the first time in years. Now she’s walking and breathing freely.

Graf has always loved national parks, but before transplant, high altitudes made many destinations impossible. Now, she’s dreaming big again. She hopes to hike in Yellowstone, explore the Canadian Rockies, and travel with her husband, John, and their two sons, ages 22 and 26, without oxygen tanks for the first time in decades.

“As best we can tell, Jodi is now cancer free and we are hopeful that it stays that way. Her interstitial lung disease is also gone and there’s minimal chance it will reoccur,” said Catherine Myers, MD, who is Graf’s pulmonologist at the Canning Thoracic Institute. “Jodi is doing wonderfully and our hope is that she will be able to live with these new lungs for many years to come.”

“I’m 61 years old and I’m not ready to lose my own mother – let alone have my boys lose me. With my new lungs, I’m so glad that I’ll be there for them a while longer. They’re grown up, but they still need their mom,” said Graf.

“As a new mom myself, I understand that special connection,” said Dr. Myers. “So many patients don’t get a lung transplant for themselves – they get it for their loved ones, for their children, for their spouses. Having the opportunity to help Jodi stay longer with her children is what this is all about – it’s why I love what I do.”

Lung cancer cases on the rise in women and never-smokers

Cancers of the lung are the leading cause of cancer-related deaths in the United States with more people dying of lung cancer than colon, breast and prostate cancers combined, and doctors have noticed a startling new trend.

“On a daily basis, we’re seeing more women and never-smokers being diagnosed with lung cancer,” said Dr. Bharat. “Conventionally, lung cancer has been associated with smoking and older age. While smoking certainly increases your chances of developing lung cancer, we’re seeing an explosion of lung cancer cases in patients who have never smoked or had limited smoking exposure – like Jodi.”

In a study of nearly 1,000 consecutive patients treated for lung cancer at Northwestern Medicine, researchers discovered only 35% would have qualified for screening according to the U.S. Preventive Services Task Force (USPSTF) screening criteria. The two-thirds of patients who would have been excluded were disproportionately women and never-smokers. Currently, USPSTF recommends annual lung cancer screenings for adults ages 50-80 who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years – a narrow window that excludes many vulnerable individuals.  

Northwestern Medicine researchers recommend expanding the universal age-based screening to 40-85. They estimate this would detect 94% of lung cancers, preventing more than 26,000 extra deaths annually. In response to these findings, Northwestern Medicine has launched the Lung Health Center at the Canning Thoracic Institute to detect lung, heart and bone conditions earlier. For more information or to schedule a screening consultation, call 312.695.1800 and mention the Lung Health Center, or email lunghealthcenter@nm.org.

About the DREAM Program

To date, Northwestern Medicine surgeons have performed more than 50 lung transplants for patients with advanced lung cancers.

Since Northwestern Medicine’s Lung Transplant Program first started in 2014, they’ve performed more than 700 lung transplant procedures for patients with end-stage lung diseases such as COVID, lung cancer, cystic fibrosis, chronic obstructive pulmonary disease (COPD) and more. Northwestern Medicine has one of the shortest wait times for a lung transplant in the U.S. with a median wait time of three days.

Patients interested in being evaluated for a lung transplant can contact the 24-hour referral line at 312.695.5864 or 844.639.5864. For more information about the Lung Transplant Program or lung cancer screenings, visit nm.org. 

CHICAGO — January 29, 2026 — Surgeons and critical care specialists at Northwestern Medicine have successfully supported a critically ill patient for 48 hours after removing both lungs, an extraordinary step taken to eliminate a life-threatening infection and stabilize the patient for a successful double-lung transplant. The case, published today in Cell Press journal Med, describes a “total artificial lung” (TAL) system designed to temporarily replace key functions of the lungs while also helping maintain stable blood flow through the heart and body.

In spring 2023, a Missouri resident was flown to Northwestern Memorial Hospital on extracorporeal membrane oxygenation (ECMO), a form of advanced life support used when the heart and/or lungs cannot provide enough oxygen to the body. What began as influenza-associated lung failure escalated into a rapidly progressive, necrotizing pneumonia and overwhelming sepsis despite maximal therapy. His condition continued to deteriorate, including an episode in which his heart stopped and the team performed CPR.

“He had developed an infection of his lungs that just could not be treated with any antibiotics because it was resistant to everything,” said Ankit Bharat, MD, chief of thoracic surgery and executive director of the Northwestern Medicine Canning Thoracic Institute. “That infection caused his lungs to liquify and then continued to progress to the rest of his body.”

For the sickest acute respiratory distress syndrome (ARDS) patients, clinicians often rely on prolonged life support and time, hoping the lungs can recover. But in some cases, the lungs themselves become the source of relentless infection and inflammation, driving organ failure and leaving no path forward unless the diseased lungs can be removed and replaced. But in these scenarios the patients are also too unstable to go through removal and transplant in the same setting. That created a dilemma: taking out both lungs can stop the infectious source, but without lungs, the body also loses critical gas exchange and the normal circulatory buffering the lungs provide, placing the heart at risk of collapse or catastrophic instability.

To solve this problem, Dr. Bharat’s team designed a total artificial lung system intended to do more than oxygenate blood. The system was engineered to support circulation in the absence of lungs by helping maintain balanced blood flow through the heart, an essential requirement for survival after bilateral pneumonectomy (removal of both lungs). The design incorporated a flow-adaptive shunt that compensated for the loss of the lung’s blood vessel network, dual pathways to drain blood from the body and return oxygenated blood back to the heart.

Because an empty chest cavity can allow the heart to shift, the team used temporary internal supports, including saline-filled tissue expanders (breast implants) commonly used in reconstructive surgery, to help stabilize the heart’s position until transplantation.

“Just one day after we took out the lungs, his body started to get better because the infection was gone,” said Dr. Bharat.

Over the next 48 hours, the patient’s condition improved enough to proceed with transplantation. When donor lungs became available, the Northwestern Medicine team performed a double-lung transplant. More than two years later, the patient has returned to daily life with excellent lung function.

Molecular evidence of irreversible lung injury

Beyond the surgical and critical care advance, this new report includes a detailed molecular analysis of the removed lungs, data that may help physicians better understand when severe viral and infectious lung injury has crossed a threshold from “potentially recoverable” to “irreversible.”

The research team used advanced techniques, such as single-cell and spatial transcriptomic approaches, to study different parts of the removed lungs and discovered extensive scarring and damage caused by the immune system, similar to severe, irreversible lung disease. They found that the cells needed to repair the lungs were almost gone, cells that form scars were everywhere, and the normal structure of the lungs was completely gone. These results explain why just providing support wouldn’t have helped the lungs heal in this situation.

“With severe ARDS, the conventional strategy is to keep supporting the patient and hope the lungs improve,” said Dr. Bharat. “Using our approaches and data, we can show at the molecular level that some patients won’t recover unless they receive a double-lung transplant.”

The Canning Thoracic Institute researchers say these kinds of molecular maps may ultimately support the development of biomarkers and decision tools to identify, earlier and more confidently, when transplantation should be considered, particularly in acute settings where time is limited and patients can deteriorate rapidly.

A highly specialized approach, and a path toward broader options

This strategy requires extensive expertise in transplantation, extracorporeal support, and round-the-clock multidisciplinary critical care. Northwestern Medicine investigators hope the principles described in the study will accelerate the development of more standardized devices and protocols that can safely bridge selected patients to transplant.

“For severe lung damage caused by respiratory infections, even in acute settings, lung transplant can be lifesaving. Patients and families should know to ask about all available options,” said Dr. Bharat.

The pulmonology and lung surgery program at Northwestern Memorial Hospital is proud to be the highest-ranked in Illinois for 14 straight years and No. 7 in the U.S. For more information, visit nm.org/pulmonary.

DEKALB, IL — Northwestern Medicine Kishwaukee Hospital recently celebrated a milestone – its 100^th robotic-assisted bronchoscopy surgery. In the innovative procedure, a surgeon takes biopsies of the lung, and a pathologist is present in the room during the procedure. They can diagnose lung cancer in real time. 

Robotic-assisted bronchoscopy is a game-changer for patients in DeKalb and the surrounding communities. The high-tech option is less invasive for patients needing a lung biopsy. Physicians can access the harder-to-reach nodules in the peripheral lung more quickly and safely. Most lung nodules, about 70 percent, are in the peripheral lung, or outer regions of the lung.  

“It’s incredibly stressful for patients to wait for biopsy results. To be able to minimally acquire a tissue sample and analyze rapidly, we can not only ease some of that anxiety for patients, but we can also swiftly get them to treatment,” says Daniel Coomes, DO, an interventional pulmonologist at the Canning Thoracic Institute at Northwestern Medicine Kishwaukee Hospital.

For the procedure, 3D and specialized software is used to chart out a path to the area of concern in a patient's lung. During the bronchoscopy, Coomes uses a controller to navigate a 3.5 mm catheter, which can move 180 degrees in any direction, to the target. Computer-guided navigation and a camera probe provide the physician a real-time view of the lung.  When the nodule is reached, the catheter locks on. Sensors hold it in place as the lungs fill and deflate with each breath. Tissue samples are removed for biopsy. With the tools, an interventional pulmonologist can mark the nodule with a fluorescent dye. This can help a surgeon to remove as little lung tissue as possible in the future.

"Catching the cancer so early was a blessing”

For Nick Brenkus of Gilberts, Ill., the robotic-assisted bronchoscopy was a smooth procedure that helped him get his cancer diagnosis early - making it easier to fight. For three years, Dr. Coomes had monitored a small spot shown on CT imaging of Brenkus’s lung. When it began to grow, he recommended the robotic-assisted bronchoscopy. 

“Quite honestly, he doesn't really remember too much about [the procedure] because it was so easy and so painless,” Nick’s wife, Susan, recalled. “He went in that morning. Dr. Coomes did the bronchoscopy. He was there for maybe another hour in recovery in Kishwaukee. Dr. Coomes said, ‘You know, you might end up with a sore throat or a little achiness,’ but he came home and the next day was back to Nick.”

The biopsy taken during the procedure showed Brenkus had stage one adenocarcinoma, the most common subtype of lung cancer. With a family history of cancer, Nick knew that catching cancer in stage one meant the cancer is small and had not spread to other parts of the body, meaning it was more favorable to treat. 

Because they caught it so early, he was able to have the cancer surgically removed by Northwestern Medicine thoracic surgeon Andrew Arndt, MD. The 76-year-old was able to avoid chemo or radiation because of it. 

“Any of the follow-ups since the surgery have all been good,” Brenkus shared. 

“The fact that Dr. Coomes saw this early on and continued to keep an eye on it really helped with identifying the issue soon enough that we caught this so early. That is a blessing,” Brenkus’ wife Susan said. 

Expanding Access to Robotic Procedures in Dekalb

Robotic-assisted bronchoscopy is one of several robotic-assisted procedures Northwestern Medicine Kishwaukee Hospital offers. Last year, they completed a $15 million renovation of its surgery suite. Upgrades included adding a second surgical robot and expanding access to minimally invasive robotic surgeries.

“We’re dedicated to making sure our patients have access to these advanced, minimally invasive procedures close to home. This is critical to early diagnosis and treatments for our patients and ensures the highest level of care is available for our community, in our community,” said Maura O’Toole, president of Northwestern Medicine Kishwaukee Hospital.

Robotic-assisted procedures enable a gentler, more precise approach, helping patients heal faster and return to their daily routines with minimal downtime. Robotic surgical technology can also support prostate, kidney, bladder, and gynecological operations, as well as general surgery procedures like hernia repairs, bowel resections, and appendix removals. 

November is Lung Cancer Awareness Month. Lung cancer is the leading cause of cancer death in the United States, about one in five cancer deaths. More people die of lung cancer than of colon, breast, and prostate cancers combined.

To learn more about robotic-assisted bronchoscopy at Northwestern Medicine, visit https://www.nm.org/conditions-and-care-areas/treatments/ion-lung-screening.

For more information on the Northwestern Medicine Canning Thoracic Institute, visit https://www.nm.org/conditions-and-care-areas/pulmonary.

CHICAGO – November 20, 2025 – In a new study of nearly 1,000 consecutive patients treated for lung cancer at Northwestern Medicine, researchers discovered only 35% would have qualified for screening according to the U.S. Preventive Services Task Force (USPSTF) screening criteria. The two-thirds of patients who would have been excluded were disproportionately women and never-smokers. Currently, USPSTF recommends annual lung cancer screenings for adults ages 50-80 who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years – a narrow window that excludes many vulnerable individuals.  

In the new study, published on November 21 in JAMA Network Open, Northwestern Medicine researchers recommend expanding the universal age-based screening to 40-85. They estimate this would detect 94% of lung cancers, preventing more than 26,000 extra deaths annually. The research also demonstrates that such screening would be remarkably cost-effective, with the minimal risks from radiation exposure or biopsies far outweighed by the potential to save lives.

“We moved to universal age-based screening for breast and colon cancer with tremendous success, and we need to move to the same approach for lung cancer. Chest screening offers something unique – with one low-dose scan, we can assess lungs, heart and bones comprehensively. This baseline scan becomes invaluable for monitoring their health over time,” said Ankit Bharat, MD, chief of thoracic surgery and executive director of the Northwestern Medicine Canning Thoracic Institute.

Lung cancer remains America’s deadliest cancer, claiming more lives than breast, colon and prostate cancers combined, accounting for one in every five cancer deaths among both men and women. The disease is particularly insidious: nearly 80% of cases aren’t discovered until they’ve reached advanced stages, largely because symptoms rarely appear until it’s too late. The widespread misconception that only smokers develop lung cancer, combined with limited screening access for those without tobacco history, contributes to these devastating statistics. Researchers at the Canning Thoracic Institute predict that a universal age-based screening (40-85) could enhance detection, improve cost-effectiveness and address health inequities. 

Providing low-dose CT screening to all eligible adults

In response to these findings, Northwestern Medicine has launched the Lung Health Center at the Canning Thoracic Institute to detect lung, heart and bone conditions earlier. The center, supported by a generous gift from John and Rita Canning, will encourage lung cancer screening for Northwestern Medicine patients and conduct studies to evaluate low-dose CT screening with necessary assessments in patients who might not qualify for lung cancer screening. In addition, scans from all patients will be evaluated for their ability to detect early pulmonary fibrosis, post- COVID lung damage, cardiovascular disease, osteoporosis and other conditions affecting millions of Americans. The results of these screenings will be studied and published to inform changes to existing guidelines.  

The scan that takes less than 10 seconds and doesn’t need any intravenous dyes provides a complete picture of the chest cavity, creating a baseline image patients can keep for life. This approach also addresses critical gaps in preventive care, particularly for the growing number of patients experiencing lasting respiratory effects from COVID-19 and other environmental exposures.

"Nearly six years after the pandemic's start, we're seeing increasing numbers of patients with lung scarring and fibrosis from COVID-19, especially those who get reinfected with respiratory viruses," said Dr. Bharat. “The damage compounds with each infection. Early detection through comprehensive screening can help us intervene before these conditions progress to requiring transplantation.”

Health concerns beyond the lungs

The Lung Health Center addresses multiple health concerns simultaneously. Beyond respiratory conditions, the screening can detect coronary calcium deposits that indicate cardiovascular risk and can identify early signs of osteoporosis, which is particularly important for women's health. Currently, cardiovascular disease remains the leading cause of non-cancer deaths nationally, while lung disease, including cancer, represents the top cancer-related mortality for both men and women.

"This initiative transforms how we approach chest health comprehensively," said Momen Wahidi, MD, interventional pulmonologist and medical director of the Canning Thoracic Institute. "Instead of waiting for symptoms to appear, we're giving patients and physicians a complete picture of chest health that can guide preventive care across multiple specialties."

The center particularly encourages screening for individuals who may have sustained lung damage from various sources:

·       COVID-19 survivors experiencing ongoing respiratory issues

·       People exposed to wildfire smoke, industrial pollution, or high radon levels

·       Individuals with family history of lung disease or pulmonary fibrosis

·       Those exposed to secondhand smoke, vaping, or marijuana use

·       Asian women and other demographics at elevated risk for lung conditions

·       Anyone seeking baseline chest health assessment

“We're seeing younger patients with respiratory problems from vaping, environmental exposures, and COVID-19 who would never qualify for traditional screening,” said Scott Budinger, MD, chief of pulmonary and critical care at the Canning Thoracic Institute. “This lung screening approach allows us to catch interstitial lung disease, pulmonary fibrosis, lung cancer, and other conditions years before they'd typically be diagnosed.”

Young mothers diagnosed with lung cancer

Danielle Hoeg

Danielle Hoeg, a 45-year-old mother of three from Chicago, knows the importance of comprehensive screenings. In March 2023, Hoeg had finished breastfeeding her son and felt like something was “off” in her body. She scheduled appointments for a mammogram, colonoscopy, skin check and bloodwork, but everything came back normal – still, Hoeg couldn’t help but feel like something was wrong.

In March 2024, Hoeg underwent a full body MRI scan and the findings revealed something was happening on her lung. She was urged to see Dr. Bharat who ordered a CT and PET scan and the results came back showing the spot on Hoeg’s lung was 99.9% cancerous. Hoeg was in disbelief as she had never smoked and was in picture perfect health. Soon after, she underwent a minimally invasive lung conserving surgery at Northwestern Memorial Hospital where Dr. Bharat removed the spot on her lung and confirmed the non-smoker had an aggressive stage 1 lung cancer. Today, Hoeg is cancer-free but still carries the experience with her.

“Every young person I see, I immediately think, ‘do they have lung cancer? How do I convince them to get checked out?’” said Hoeg. “With more women, never-smokers and young people being diagnosed with lung cancer, I’m a huge advocate for the Lung Health Center and encourage adults to get screened.”  

Carla Tapia

Carla Tapia, a mother of three from Beltsville, Md., was shocked to learn about her stage 4 lung cancer diagnosis at the age of 33. Tapia had some smoking exposure during her teenage years but quit when she was 18 and currently doesn’t meet the USPSTF screening criteria for lung cancer.

In December 2019, Tapia developed a fever and was diagnosed with pneumonia. Her symptoms progressed to a bad cough with mucus, but as the COVID pandemic hit, Tapia remained focused on her three kids and put her own health on the backburner.

By July 2020, she could no longer catch her breath and that’s when she was diagnosed with stage 4 lung cancer, which had spread to both lungs and was inoperable. For the next four years, Tapia underwent chemotherapy treatments, but the cancer kept growing. Out of options, she heard about the DREAM Program at Northwestern Medicine, which provides double-lung transplants to select patients with advanced lung cancers.

By the summer of 2024, Tapia’s health was quickly declining, and she flew to Chicago on supplemental oxygen for a transplant evaluation. On September 12, 2024, Tapia received a life-saving double-lung transplant at Northwestern Memorial, and the 38-year-old is now back home in Maryland.

“When I was diagnosed with stage 4 lung cancer, I was told there was no cure, but thanks to Northwestern Medicine, I’m alive today and no longer having to go to the hospital for weekly chemotherapy treatments. Instead, I just finished by bachelor’s degree and am hoping to go to law school,” said Tapia. “I keep hearing stories about young people being diagnosed with lung cancer, and if we could expand the screening guidelines, I believe more lung cancers could be caught at earlier stages, and more lives would be saved.”

To schedule an appointment

Patients can access the Lung Health Center through a simple process beginning with a phone consultation. Marisol Munoz, nurse practitioner for the program, guides patients through each step.

“We make this as seamless as possible for patients,” said Munoz. “From the initial call through receiving results in 24-48 hours, our team coordinates everything. We work with insurance when covered and ensure eligible patients have access regardless of coverage through the Canning's philanthropic support.”

The Lung Health Center also includes a research component where participants contribute de-identified data to help establish new screening guidelines. The center incorporates artificial intelligence to provide rapid, highly sensitive analysis of results, with the goal of delivering comprehensive health insights within seconds of scanning.

The Lung Health Center has already launched at Northwestern Medicine McHenry Hospital and is expanding systemwide by the end of the year. Anyone over the age of 21 is eligible, with particular emphasis on those over 40 or with risk factors.

For more information or to schedule a screening consultation, call 312.695.1800 and mention the Lung Health Center, or email lunghealthcenter@nm.org.

The pulmonology and lung surgery program at Northwestern Memorial Hospital is proud to be the highest-ranked in Illinois for 14 straight years and No. 7 in the U.S. For more information, visit nm.org/pulmonary.

CHICAGO – October 20, 2025 – Tonni Richard of LeClaire, Iowa, spent her entire career caring for others. The 65-year-old was an army nurse for 20 years, before working as a visiting nurse, then in hospice care and orthopaedics. After retiring from the profession she loved, Richard found a new passion — Pilates — and credits the workout for shedding light on a recent cancer diagnosis in her lung.

“I started having muscle spasms on the right side of my back during Pilates classes. When the symptoms didn’t go away, I underwent a CT scan at a local hospital where they discovered a neuroendocrine tumor on my lower right lung,” said Richard. “The thoracic surgeon told me they'd need to remove the entire lower lobe of my lung which would cause me to lose 20% of my oxygen capacity. After the appointment, my husband and I agreed — there had to be a better option.”

Richard searched the Internet for a “lung preservation specialist” and found Kalvin Lung, MD, a thoracic surgeon at the Northwestern Medicine Canning Thoracic Institute in Chicago, who specializes in removing less lung tissue during surgery to preserve lung function and improve the quality of life for patients. 

From CT scan to surgical console: new 3D technology helps save lung

Using new state-of-the-art technology, Dr. Lung was able to convert Richard's CT scan into a 3D model that was integrated directly into the console of the da Vinci 5 surgical robot. The technology confirmed it was possible to perform a rare procedure for Richard without compromising cancer outcomes.

Previously, surgeons could only view 3D images of tumors on their phone or laptop, causing them to have to look away from the console during surgery to study the images. With the new technology, the 3D model now appears inside the console, so thoracic surgeons can look at it in real time as they operate with the robot. This allows surgeons to operate deeper into the lung without the risk of damaging the lung that is not removed.

On September 30, Richard was the first lung surgery patient to undergo a procedure with the new 3D model at Northwestern Medicine.

“When a normal CT scan is performed, it doesn’t give us all the details of the lung’s anatomy. For example, it’s kind of like looking at ‘Google Earth’ from far away — you can see the state of Iowa, but you can’t make out any cities,” explained Dr. Lung. “When we’re sitting at the robot with this new 3D technology, it provides us with remarkable precision, allowing us to remove the tumor while saving most of the lung. In Tonni’s case, her tumor was in a segment of the lung where surgery isn’t commonly done, and that’s why the 3D technology was so instrumental.”

Thanks to the new technology, Dr. Lung was able to remove Richard's tumor and only 5% of her lung. 

“I’m so lucky to have found the tumor when I did, and even more lucky to have found Dr. Lung at Northwestern Medicine who helped preserve my lung and my oxygen capacity,” said Richard. “I hope my story encourages others to seek a second opinion when they aren’t satisfied with the answer, and to undergo annual lung cancer screenings if they qualify."

Importance of lung cancer screenings

Lung cancer is the leading cause of cancer-related deaths in the United States, accounting for one in five of all cancer deaths. Each year, more people die of lung cancer than of colon, breast and prostate cancers combined. The U.S. Preventive Services Task Force recommends annual lung cancer screenings in adults ages 50-80 who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years.

The Canning Thoracic Institute has pioneered several transformative minimally invasive thoracic procedures such as the A-PLUS program for lung cancer, robotic SAINT program for advanced stage lung cancer, the robotic PREMIER program for esophageal cancer, and the robotic lung volume reduction surgery for emphysema. The pulmonology and lung surgery program at Northwestern Memorial Hospital is proud to be the highest-ranked in Illinois for 14 straight years and No. 7 in the U.S.

For more information, visit nm.org/pulmonary or call 312-695-1800.

CHICAGO – September 30, 2025 – Northwestern Medicine has successfully performed the first known robotic lung transplant in Illinois, bringing this advanced minimally invasive surgical option to patients in the region. The sophisticated surgical approach uses small chest incisions and robotic precision instead of traditional open-chest surgery, offering select patients reduced surgical trauma and the potential for enhanced recovery.

Instead of sawing through the breastbone and spreading the chest open for 8-10 hours of surgery, surgeons with the Northwestern Medicine Canning Thoracic Institute used the da Vinci Xi robotic system to perform the entire lung transplant through small incisions on each side of the chest.

“A conventional lung transplant, where we cut through the breastbone and ultimately put it back together, is perhaps the most invasive, complex procedure performed at any hospital. We must open the chest like the hood of a car, so we have full access to the engine (lungs),” said Ankit Bharat, MD, chief of thoracic surgery and director of the Canning Thoracic Institute who performed the transplant. “A robotic approach allows us to dramatically reduce the invasiveness of the procedure, and we hope it will cut down on the recovery time for patients.”

The procedure was successfully performed in August on a 63-year-old Illinois man with chronic obstructive pulmonary disease (COPD). The patient was discharged from the hospital and continues to make an optimal recovery.

Advanced surgical benefits

The robotic approach allows surgeons to work with unprecedented precision using 3D visualization while seated at a console, rather than standing over an open chest for nearly ten hours. The robot’s micro-instruments navigate through 4-5 small incisions per side, carefully removing diseased lungs and implanting healthy ones.

“The precision we achieve with robotic surgery is remarkable. We can perform incredibly complex maneuvers in tight spaces that human hands simply cannot access as effectively,” said Samuel Kim, MD, thoracic surgeon and director of Robotic Thoracic Surgery at the Canning Thoracic Institute who performed the procedure with Dr. Bharat. “While more long-term data is still needed, we believe recovery time for these patients will be cut in half because they’ll have less post-operative discomfort. Robotic surgery is rapidly evolving, especially in the field of thoracic surgery, and we believe there’s a clear role for lung transplantation in carefully selected patients.”

Available for select candidates

The procedure is ideal for patients with emphysema or lung fibrosis who have large chest cavities, no prior chest surgeries, stable heart function, and appropriate anatomy for the robotic approach.

“Every lung transplant carries life-or-death stakes with zero margin for error. We carefully select patients where robotics offers clear advantages without compromising safety or speed,” said Dr. Kim. “I don’t think robotic lung transplant will completely replace conventional lung transplant, but I do think it will become more popular in the future.”

“At the Canning Thoracic Institute, we have pioneered several transformative minimally invasive thoracic procedures such as the robotic lung volume reduction surgery for emphysema, A-PLUS program for lung cancer, robotic SAINT program for advanced stage lung cancer, and the robotic PREMIER program for esophageal cancer, so developing a robotic lung transplant program was quite easy for us,” said Dr. Bharat.

Illinois’ leading lung transplant program adds robotic capability

The Canning Thoracic Institute performed 148 lung transplants in 2024 – more than any other transplant center in the United States – with the shortest wait time of just four days. The addition of robotic lung transplantation enhances the program’s comprehensive surgical options.

Since 2014, the Lung Transplant Program has completed more than 600 lung transplants and pioneered multiple innovative approaches, including the first COVID-19 lung transplants in the U.S. and the DREAM program for advanced lung cancer patients. The pulmonology and lung surgery program at Northwestern Memorial Hospital is proud to be the highest-ranked in Illinois for 14 straight years and No. 7 in the U.S.

Patients with end-stage lung disease interested in being evaluated for a lung transplant can contact the 24-hour referral line at 312.695.5864 or 844.639.5864. For more information about the Lung Transplant Program, visit nm.org/pulmonary. 

CHICAGO – September 16, 2025 – Northwestern Medicine is the first health system in Illinois to adopt the da Vinci SP (Single Port) surgical system for thoracic surgery, marking a significant advancement in minimally invasive care for patients with lung and chest conditions. The new robotic platform enables thoracic surgeons to perform complex procedures through one small incision in the upper abdomen versus multiple incisions in the chest, allowing for improved outcomes and faster recovery times for patients undergoing thoracic surgeries involving tumors in the chest and lungs. 

“This robot is different from ones we’ve used in the past because it allows us to perform minimally invasive operations using one single port with a small incision, opposed to previously using several different ports at the same time with multiple incisions,” said Samuel Kim, MD, a thoracic surgeon and director of Robotic Thoracic Surgery at the Northwestern Medicine Canning Thoracic Institute. 

Traditionally, thoracic surgeons would perform these types of minimally invasive procedures by going in through the chest wall which has a lot of nerves and is associated with more pain. With the new da Vinci SP surgical system, Dr. Kim is able to make a single two-to-three-inch incision in the abdomen area, which causes less pain. The robot was designed to improve recovery and help patients return to their normal activities sooner. 

“For patients who have received this new type of procedure, their recovery has been much faster and less painful, allowing them to get home and get back to work easier. It’s especially a great option for elderly and more frail patients because it decreases their risk of falling post-surgery since they have a reduced need for opioid pain medications,” said Dr. Kim. 

For 74-year-old Rodolfo (who chose to keep his last name private), undergoing surgery with a new robot was a bit exciting, since he spent the majority of his career as a computer engineer, working with robots and fixing computers and electronics. After doctors discovered a rare, slow-growing tumor in his thymus gland called thymoma, Rodolfo was deemed a perfect candidate to undergo surgery at Northwestern Memorial Hospital with the new da Vinci SP surgical system.

“I’m very supportive of medical advancements – especially when they involve a robot – so when Dr. Kim told me the new robotic platform would help me recover more quickly with less pain, I was all for it,” said Rodolfo, who underwent his procedure in mid-August.

“Rodolfo’s surgery went extremely well and after removing the tumor, we determined it was non-cancerous. He could have went home the same day but preferred to stay one night in the hospital for monitoring,” said Dr. Kim. “Two weeks post-surgery, I saw Rodolfo in clinic, and he didn’t have any pain. He’s back to living a normal life, enjoying retirement.”

The da Vinci Single Port (SP) surgical system by Intuitive was recently approved by the Food and Drug Administration (FDA) for thoracic and chest cases. The system features a high-definition 3D camera, which allows surgeons to sit behind a console, visualize the surgical site and operate the robot with greater range of motion than the human hand. It can be used for procedures such as thymectomy, lobectomy and other chest surgeries.

 For more information on leading-edge lung and chest care from the Canning Thoracic Institute, visit nm.org.  

Chicago, IL – August 5, 2025 – For 28-year-old Dean Comstock of Syracuse, New York, music has always played an important role in his life. When he started playing guitar at the age of nine, one of his favorite songs was “Sweet Home Chicago,” but little did he know, 19 years later, that song would hold a whole new meaning.

In October 2023, Dean developed a cough that wouldn’t go away. At first, his doctors thought it was pneumonia or acid reflux, but on August 8, 2024, Dean was diagnosed with stage 4 lung cancer. As an active community member who worked three jobs and didn’t have a history of smoking, Dean was shocked. He started chemotherapy, but his breathing got worse, and he soon had to rely on supplemental oxygen. Dean’s cancer was terminal, and he was quickly running out of options.  

That’s when his mom, Jill Comstock, who happened to receive a lung transplant in 2021 for pulmonary fibrosis at another hospital, asked her medical team if a lung transplant could be a possibility for him at their site. Her doctors told the family only one health system in the United States was known to perform lung transplants on patients with terminal lung cancer, and Dean would need to travel to Northwestern Medicine in Chicago to participate in a clinical trial known as DREAM, where select patients with advanced lung cancers receive double-lung transplants.

This March, Dean arrived at Northwestern Memorial Hospital where he underwent a transplant evaluation and met with Ankit Bharat, MD, chief of thoracic surgery and director of the Northwestern Medicine Canning Thoracic Institute.

By May 8, Dean was listed for a double-lung transplant and eight days later, he received his new lungs on May 16.

Making beautiful music together

One month later, on June 27, Dean celebrated his five-year wedding anniversary with his wife, McKayla Comstock, who is a music teacher at Jordan-Elbridge High School in Jordan, New York. In fact, the two first met in the same music room where McKayla now teaches, and they often play music together at weddings and special events.

Two months after his transplant, Dean and McKayla played for an audience in Chicago they’ll never forget – Dr. Bharat and members of the lung transplant team who helped save Dean’s life. Dean strummed his guitar in a clinic exam room as McKayla sang the lyrics to “Sweet Home Chicago.”

“The song has always been one of my favorite songs to play, and I really never knew why since I’m from Syracuse, New York, but now that a team of surgeons, doctors and nurses in Chicago saved my life, the city and the song will always hold a special place in my heart,” said Dean. “This is where miracles happen; right here at Northwestern Medicine.”  

Dean will remain in Chicago for one-year post-transplant so he can be near his medical team, and he’s looking forward to the future.

“I’m so thankful to be able to breathe fresh air every day. I’m thankful for my donor, my community, my family and everyone who has helped me along the way. I’m going to smell the roses a little bit more and enjoy life. Once you go through something like this, you learn how precious life really is,” said Dean.

Lung cancer cases on the rise in young people

Cancers of the lung are the leading cause of cancer-related deaths in the United States with more people dying of lung cancer than colon, breast and prostate cancers combined, and doctors have noticed a startling new trend.

“On a daily basis, we’re seeing more young people being diagnosed with lung cancer,” said Dr. Bharat. “Conventionally, lung cancer has been associated with smoking and older age. While smoking certainly increases your chances of developing lung cancer, we’re seeing an explosion of lung cancer cases in patients who have never smoked or had limited smoking exposure – like Dean.”

The Canning Thoracic Institute has launched a universal lung cancer screening program where patients who meet certain criteria can get screened for lung cancer, even if their insurance doesn’t provide financial support. The goal is to share the findings with the U.S. Preventative Services Task Force and urge them to let all patients beyond a certain age receive an annual lung cancer screening.

“If lung cancer is causing the most deaths in this country, impacting smokers and nonsmokers, we need a universal screening program just like we have for breast and colon cancer,” added Dr. Bharat.

About the DREAM Program

To date, Northwestern Medicine surgeons have performed more than 50 lung transplants for patients with advanced lung cancers.

Using lessons learned from pioneering COVID-19 lung transplantation in the U.S., they developed the novel surgical technique to clear the cancer during surgery while minimizing the risk of spread that has plagued prior such attempts at other hospitals.

“We’re very proud of the DREAM Program. This innovative technique involves putting the patient on full heart and lung bypass, delicately taking both cancer-ridden lungs out at the same time along with the lymph nodes, washing the airways and the chest cavity to clear the cancer, and then putting new lungs in,” said Dr. Bharat. “These patients can have billions of cancer cells in the lungs, so we must be extremely meticulous to not let a single cell spill into the patient’s chest cavity or blood stream. We believe this technique can help reduce the risk of recurrence, which we learned through our experience with pioneering COVID-19 lung transplants in 2020.”

Since Northwestern Medicine’s Lung Transplant Program first started in 2014, they’ve performed more than 600 lung transplant procedures for patients with end-stage lung diseases such as COVID, lung cancer, cystic fibrosis, chronic obstructive pulmonary disease (COPD) and more. In 2024, Northwestern Medicine had the shortest wait time for a lung transplant in the U.S. with a median wait time of four days. They also performed 148 lung transplants, the most performed at any transplant center in the U.S. for 2024.

Patients interested in being evaluated for a lung transplant can contact the 24-hour referral line at 312.695.5864 or 844.639.5864. For more information about the Lung Transplant Program or lung cancer screenings, visit nm.org. 

CHICAGO – May 11, 2025 – Eight months after giving birth to twins, Cornelia Tischmacher of Berlin, Germany, had a case of pneumonia that wouldn’t go away. The then 40-year-old went to the doctor in January 2018, where tests showed she had stage 3 lung cancer. As a nonsmoker who was healthy, worked out and had a busy career as an art historian and gallerist, Tischmacher was shocked by the diagnosis.

“I absolutely loved my job and had to travel quite a bit for work, but when I was diagnosed with advanced lung cancer, my priorities immediately shifted. I knew I had to do everything I could to stay alive for my children,” said Tischmacher. “My twins would never hear me say the words, ‘Mommy is going to die.’”

In June 2018, Tischmacher underwent surgery and chemotherapy to get rid of the cancer, but by October 2019, it returned. Doctors told her palliative care with chemotherapy and immunotherapy was the only option to possibly slow down the cancer’s relentless progression.  

By June 2024, she could no longer breathe without supplemental oxygen and that’s when Tischmacher discovered a first-of-its-kind clinical program at Northwestern Medicine in Chicago called DREAM (Double Lung Transplant Registry Aimed for Lung-Limited Malignancies), where select patients with advanced lung cancers confined to the lungs can be considered for a double-lung transplant. Currently, Northwestern Medicine is one of the only known health systems in the world with a dedicated lung transplant program for patients with advanced cancers limited to the lungs. 

“During our first telehealth visit with Cornelia, it was clear to us that she was at the end of the road,” said Ankit Bharat, MD, chief of thoracic surgery and director of the Northwestern Medicine Canning Thoracic Institute who performed Tischmacher’s transplant. “Cornelia had failed every other medical treatment available to her, including surgeries, chemotherapy and immunotherapy, but the cancer continued to progress to stage 4 and became so advanced that it was causing her lungs to fail. She couldn’t breathe, and a lung transplant was her only option to fix the lung failure, remove all the cancer cells from her body, and give her a fighting chance to be there for her twins.”

Leaving her life in Berlin for a second chance at life

After being accepted to the DREAM Program, Tischmacher boarded an air ambulance and flew from Berlin to Chicago in December 2024. She was admitted to the intensive care unit (ICU) at Northwestern Memorial Hospital and placed on the transplant waiting list on Christmas Eve. Two days after being listed, Tischmacher received new lungs on December 26, which was the second day of Christmas in Germany.

“With how quickly her disease was progressing, it was clear to us that Cornelia would not be able to leave the hospital without receiving a lung transplant. She was requiring up to 60 liters of oxygen per minute through her nasal cannulae, which is the absolute limit you can supply without a ventilator. For that very reason, we worked around the clock to complete her lung transplant workup and arrange all the logistics needed for her to stay in the United States,” said Krishnan Warrior, MD, a lung transplant pulmonologist at the Canning Thoracic Institute who has been caring for Tischmacher since her arrival.

“Receiving my lung transplant on December 26 was the best Christmas present I could have asked for,” said Tischmacher. “I remember waking up and thinking for the first time in a long time, I will be able to go to museums and go for bike rides with my kids without bringing an oxygen tank with me. I could finally breathe again. It was such a gift that I don’t take for granted, and I encourage everyone (who is able) to register as an organ donor – not just in the United States, but also in Germany.”

Reuniting with her 8-year-old twins

Tischmacher spent one week recovering at Northwestern Memorial before being discharged to an apartment in Chicago. The 48-year-old will remain in the city for one-year post-transplant to be near her medical team. The most difficult part is being far away from her husband, Udo Kittelmann, and their 8-year-old twins, Leo and Lucie, who remain in Berlin to continue their schooling. The twins were able to visit their mom for the first time since December, when they were reunited in Chicago in mid-April for spring break.

“Seeing my children for the first time in four months was absolutely wonderful. The weight of my illness had weighed them down, and to see me healthy again was overwhelming – but in a good way,” said Tischmacher. “It’s a happy continuation of the story because it could have been so different. When we said our initial ‘goodbyes’ in December, it was much more dramatic because we didn’t know how things would go.”

Tischmacher currently has no signs of cancer in her body and is now able to walk around Chicago, touring the local art galleries, breathing on her own. She was the first patient from Germany to receive a lung transplant at Northwestern Medicine. In the past, patients have also traveled from Asia, Brazil, Colombia, Canada, the Middle East and other parts of Europe for a lung transplant. The team at Northwestern Medicine International Health welcomes patients from around the globe who seek advanced treatment for a variety of medical conditions.   

“Medicine is evolving rapidly, but unfortunately, the way medicine is practiced globally, not all treatments are available at all sites right away,” said Dr. Bharat. “Often when a center develops something new, it takes years for it to be available across the country or internationally. It’s very important for patients to find a second opinion and take matters into their own hands when they’re being told there are no other options.”

Lung cancer cases on the rise in young women

Cancers of the lung are the leading cause of cancer-related deaths in the United States with more people dying of lung cancer than colon, breast and prostate cancers combined, and doctors have noticed a startling new trend.

“On a daily basis, we’re seeing more young women being diagnosed with lung cancer,” said Dr. Bharat. “Conventionally, lung cancer has been associated with smoking and older age. While smoking certainly increases your chances of developing lung cancer, we’re seeing an explosion of lung cancer cases in patients who have never smoked or had limited smoking exposure – like Cornelia. The majority of them are young, and the majority are women, and we still aren’t sure why this is happening.”

The Canning Thoracic Institute has started several research programs to try and understand why more women are being diagnosed with lung cancer. They also launched a universal lung cancer screening program where patients who meet certain criteria can get screened for lung cancer, even if their insurance doesn’t provide financial support. The goal is to share the findings with the U.S. Preventative Services Task Force and urge them to let all patients beyond a certain age receive an annual lung cancer screening.

“If lung cancer is causing the most deaths in this country, impacting smokers and nonsmokers, we need a universal screening program just like we have for breast and colon cancer,” added Dr. Bharat.

About the DREAM Program

To date, Northwestern Medicine surgeons have performed more than 50 lung transplants for patients with advanced lung cancers.

Using lessons learned from pioneering COVID-19 lung transplantation in the U.S., they developed the novel surgical technique to clear the cancer during surgery while minimizing the risk of spread that has plagued prior such attempts at other hospitals.

“We’re very proud of the DREAM Program. This innovative technique involves putting the patient on full heart and lung bypass, delicately taking both cancer-ridden lungs out at the same time along with the lymph nodes, washing the airways and the chest cavity to clear the cancer, and then putting new lungs in,” said Dr. Bharat. “These patients can have billions of cancer cells in the lungs, so we must be extremely meticulous to not let a single cell spill into the patient’s chest cavity or blood stream. We believe this technique can help reduce the risk of recurrence, which we learned through our experience with pioneering COVID-19 lung transplants in 2020.”

Since Northwestern Medicine’s Lung Transplant Program first started in 2014, they’ve performed more than 600 lung transplant procedures for patients with end-stage lung diseases such as COVID, lung cancer, cystic fibrosis, chronic obstructive pulmonary disease (COPD) and more. In 2024, Northwestern Medicine had the shortest wait time for a lung transplant in the U.S. with a median wait time of four days. They also performed 148 lung transplants, the most performed at any transplant center in the U.S. for 2024.

Patients interested in being evaluated for a lung transplant can contact the 24-hour referral line at 312.695.5864 or 844.639.5864. For more information about the Lung Transplant Program or lung cancer screenings, visit nm.org. 

CHICAGO – February 5, 2025 – In an effort to expand the donor pool for lung transplant recipients and give surgeons more time to removed diseased lungs, the Northwestern Medicine Canning Thoracic Institute (CTI) is now routinely repairing damaged donor lungs using “lungs in a box” (lung perfusion) technology and storing them for transplantation by putting “lungs in a fridge” (lung refrigeration). These innovative approaches are yielding dramatic benefits for patients and staff alike.

In 2024, CTI’s Lung Transplant Program finished the year by performing 148 lung transplants, their highest volume for a single year since the program began 10 years ago. For the first time, CTI also become the highest volume lung transplant center in the United States and achieved the shortest wait time for a lung transplant, with a median wait time of four days. 

“Since our lung transplant program launched 10 years ago, several innovations helped us reach these achievements for 2024. From performing the first COVID-19 lung transplants in the U.S., to starting a lung transplant program for select patients with advanced lung cancers, and replacing diseased lungs with breast implants to bridge patients to lung transplantation, we’re continuously thinking outside the box and ‘lungs in a fridge’ is another example,” said Ankit Bharat, MD, chief of thoracic surgery and director of the Canning Thoracic Institute. “In 2024, we used ‘lungs in a box’ to repair the most number of donor lungs that weren’t initially usable at Northwestern Medicine, enabling us to achieve a record wait list time of only four days. And now, with controlled lung refrigeration, we can keep the lungs alive outside the human body for an extended period of time, giving us more time to prepare for transplantation and perform the surgery.”

“With a combination of ‘lungs in a box’ and ‘lungs in a fridge’ technologies, we also now have the option for patients at any transplant center in the country or overseas who experience longer wait-times to dual list with us, and in 2024, patients traveled from places such as Germany, the United Kingdom and Columbia to receive a lung transplant at Northwestern Medicine,” said Ambalavanan Arunachalam, MD, pulmonologist and interim medical director of CTI’s Lung Transplant Program.  

Lung refrigeration was pioneered in Canada and Europe, and within the last few months, it was adopted successfully at Northwestern Medicine, where organ procurement specialists travel to hospitals across the United States to collect donor lungs, and once the lungs arrive at Northwestern Memorial Hospital, staff place them in a special refrigerator which is set at 10 degrees Celsius. The lungs can remain in the fridge up to 12 hours before transplantation when the conventional techniques only allowed them to stay outside for about six hours.  

“Prior to using the fridge, we were storing the donor lungs on ice, which is four degrees Celsius, and we had to perform the recipient lung implant surgery immediately without the opportunity to extend the preservation time,” said Anitha Chandrasekhar, DMSc, clinical lead for lung bioengineering with the Canning Thoracic Institute. “Studies show that 10-degree Celsius storage of lungs allows safe prolongation of cold ischemic times, results in better mitochondrial health with reduced inflammatory response, ultimately leading to better post-transplant outcomes, benefitting patients and health care teams.”

Four main benefits for using “lungs in a fridge”

Widens the donor pool

Lung refrigeration widens the donor pool by allowing Northwestern Medicine’s organ procurement team to travel greater distances for donor lungs. Previously, there was only so much time that the lungs could be kept alive outside the body, which restricted how far the organ procurement specialists could travel. From the moment they’d take the lungs out of the donor, they’d have six hours to package up the lungs, get to a local airport, fly to Chicago, drive to Northwestern Memorial, take the old lungs out and put the new lungs in.

“With this new type of preservation, our organ procurement specialists can fly to the East Coast, West Coast and potentially even Canada or Mexico. As a result, our wait times for lung transplant patients have dramatically gone down,” said Dr. Arunachalam.

Fewer overnight transplants

Storing donor lungs at 10 degrees Celsius allows for more flexible transplant scheduling. Lung refrigeration helps improve transplant logistics, which in turn, makes lung transplantation a semi-elective procedure performed during normal working hours.

“Previously, these transplants would happen in the middle of the night when the team may not be in the best physical or mental capacity. For example, if the procurement team arrives at 1 am with the donor lungs, we can now put the lungs in the fridge and wait to do the transplant at 7 am. By keeping the lungs preserved at 10 degrees Celsius, the team can operate during regular hours after a full night’s rest, which helps with success rates and lowers the chance of medical errors,” said Dr. Bharat. “Also, given the tough hours for lung transplant surgery, fewer surgeons have been interested in the field, resulting in a significant shortage of thoracic surgeons. But with this new strategy, more talented surgeons may be interested in adopting lung transplantation in their career.”

Improves surgical schedules

Transplants are often unpredictable. Donor lungs can become available on short notice, so in some instances, elective surgeries have to be cancelled in order to get the transplant done in time, which causes an inconvenience for patients who have been waiting for their elective surgeries (ex: cancer patients). “Lungs in a fridge” allows the surgical team to keep elective surgeries and schedule the lung transplant procedures during times that work best for staff and patients. It also helps lung transplant recipients because they no longer have to rush from their home to the hospital in a short period of time to get their lung transplants within the six-hour window.

“Lung refrigeration provides us with more options for getting our transplant recipients one step closer to a better quality of life,” said Denisha Gardner, organ procurement specialist with the Canning Thoracic Institute. “There are times when our recipients need a certain medication to be given hours before transplantation. Having the fridge allows us the opportunity to make sure everything is aligned for a successful procedure.”

More time to remove diseased lungs

Double-lung transplants are one of the most complex medical procedures in health care. Lung refrigeration gives surgeons more time to remove the diseased lungs, especially in patients with lung cancer.

Northwestern Medicine started a first-of-its-kind clinical program called DREAM that provides double-lung transplants to select patients with advanced lung cancers who are out of treatment options. With these patients, their cancer-ridden lungs must delicately be taken out at the same time along with the lymph nodes, then surgeons need to wash the airways and the chest cavity to clear the cancer before transplanting new lungs. These patients can have billions of cancer cells in the lungs, so surgeons must be extremely meticulous to not let a single cell spill into the patient’s chest cavity or blood stream.

Having more time in the operating room to remove the cancer-ridden lungs can help reduce the risk of recurrence.

Successful patient outcomes with lung refrigeration

Tadd Crosslin – Mansfield, Texas

Tadd Crosslin of Mansfield, Texas, (located in the Dallas-Fort Worth metropolitan area) received a double-lung transplant at Northwestern Memorial on September 23, 2024. The 49-year-old who is married (wife is Courtney) with twin sons (Cody and Blake), was diagnosed with stage 3 colorectal cancer in 2016 at the age of 40, and it advanced to stage 4 by 2019.

While undergoing chemotherapy and surgery, Crosslin’s medical team noticed lung nodules forming but told him not to worry. Soon, the lung nodules started multiplying and Crosslin had hundreds of tumors on his lungs, which caused him to have difficulty breathing.

“I traveled to major health systems in Texas, California, Florida, New Jersey, New York and even Germany, looking for a second opinion, but they all told me there was nothing more they could do,” said Crosslin. “Giving up was never an option for me, and Northwestern Medicine doesn’t shy away from exploring new techniques and technology. Without them, I wouldn’t be here today.”

On September 23, Crosslin received his new lungs, but the surgery wasn’t easy. Because there were so many tumors and extensive cancer inside Crosslin’s old lungs, his explant was extremely difficult (see pictures here).

“Having the refrigerator was a game-changer in Tadd’s lung transplant procedure,” added Dr. Bharat. “Because his diseased lungs were fused so tightly to his chest cavity, we kept needing more time to remove them. We couldn’t let his new lungs go bad, so we were able to store them in the fridge until we were ready to transplant them.”

The Double Lung Replacement and Multidisciplinary Care (DREAM) Program is a first-of-its-kind clinical initiative at Northwestern Medicine that provides double-lung transplants to select patients with advanced lung cancers who are not responding to conventional treatments. To date, more than 40 patients have received double-lung transplants through the DREAM Program.

Amanda Long – Nashville, Tennessee

Amanda Long of Nashville, Tenn., is also a DREAM patient. The 48-year-old wife (husband is James) and mother of three daughters (Kenzie, Maddie and Makenna) was diagnosed with stage 4 lung cancer in September 2023.

“As a non-smoker who eats healthy and works out five-days-a-week, I was completely shocked by the diagnosis,” said Long.

When immunotherapy and chemotherapy treatments didn’t work, Long’s medical team in Nashville recommended she reach out to the lung transplant team at Northwestern Medicine. Long was listed for a lung transplant on August 15, 2024, and received her new lungs on August 21.

Because it took the surgical team longer to remove her diseased lungs due to the cancer, lung refrigeration was also used to store Long’s new lungs. Long is now back home in Nashville and will return to Northwestern Memorial once-a-month for follow up appointments.   

“The fridge is so simple and doesn’t further complicate what might be one of the more complex procedures in health care. If anything, it makes everything go more smoothly for the team in the operating room,” added Jeff Lysne, practice administrator for the Canning Thoracic Institute. “Overall, it’s been great to see such a simple innovation used to expand our donor pool and help more patients.”

For more information

In 2024, the lung transplant team used “lungs in a fridge” for approximately 12 patients, all with good outcomes. Since CTI’s Lung Transplant Program started in 2014, they’ve performed nearly 600 lung transplant procedures. Currently, more than 900 patients in the U.S. are waiting for new lungs.

Patients interested in being evaluated for a lung transplant can contact the referral line at 844.639.5864. For more information about Northwestern Medicine, as well as advanced therapies, visit nm.org. 

CHICAGO – December 24, 2024 – In December 2023, while pregnant with her first child, MaKenna Lauterbach developed a cough that wouldn’t go away. The then 26-year-old, who lives on a farm with horses and goats in Washburn, Ill., mentioned the cough to her local doctors, but because she was pregnant, her doctors were reluctant to perform chest scans due to possible radiation exposure.

“I give hay to the horses every morning and noticed how winded I was becoming with a dry cough. My body felt like I just ran two miles, when in reality, I had only walked to the barn and back,” said Lauterbach. “I knew something was wrong.”

By the time Lauterbach was 36-weeks pregnant, the cough was so bad that she started throwing up while coughing. After she was hospitalized for shortness of breath, doctors obtained imaging and discovered a large, grapefruit-sized tumor in her middle chest cavity and right lung, completely blocking the artery to the right lung. 

Lauterbach was in respiratory distress, which meant both she and the baby weren’t getting adequate oxygen. Due to her critical condition, Lauterbach was flown to Northwestern Memorial Hospital in Chicago and rushed to an intensive care unit where a large team of obstetricians, surgeons, anesthesiologists, pediatricians, nurses and staff awaited her. There, the maternal-fetal medicine team also noticed Lauterbach’s blood pressure was rising, she was contracting, and the baby wasn’t tolerating the contractions well.

“MaKenna was in real trouble, and we had to act quickly – this wasn’t something that could wait for Monday morning,” said Lynn Yee, MD, maternal-fetal medicine specialist at Northwestern Medicine. “When you’re pregnant with a baby that’s nearly full-term, your lungs already aren’t functioning at full capacity, and when you add a huge tumor on top of it, you run the risk of having respiratory collapse and cardiac arrest.”

In the early hours of Easter Sunday on March 31, after preparing the patient to potentially need extracorporeal life support (ECMO) after delivery, Dr. Yee performed an emergency cesarean section and a healthy baby boy named Colter was born. He remained in the neonatal intensive care unit (NICU) at Northwestern Medicine Prentice Women’s Hospital for one week, where the family formed a connection with the nursing staff, especially clinical nurse Mary Schuessler.

“Because of the tumor, the delivery happened so quickly. I was grieving the birth plan I had spent months preparing for, while also dealing with the news of my unexpected diagnosis,” said Lauterbach. “My situation was serious, and while my clinical team was working on a plan to treat my cancer, it was comforting to know that Mary and the rest of the NICU nurses were taking such wonderful care of our son. My husband (Parker) and I can’t thank them enough.”

Making the Diagnosis and Developing a Treatment Plan

Following the delivery, doctors needed to figure out what type of tumor Lauterbach had. Kalvin Lung, MD, a thoracic surgeon with the Northwestern Medicine Canning Thoracic Institute, was able to obtain a sample of the tumor with advanced bronchoscopy to diagnose Lauterbach with stage 3 melanoma. Knowing the benefit of a team approach to provide the most innovative treatments, Dr. Lung reached out to Sunandana Chandra, MD, medical oncologist with the Robert H. Lurie Comprehensive Cancer Center of Northwestern University at Northwestern Memorial Hospital, to see if there was anything to offer Lauterbach to help shrink the tumor before surgery.

“MaKenna’s diagnosis was difficult to make because we weren’t sure if the melanoma started in the chest or somewhere else, and there isn’t much literature or published cases on how to best treat tumors like these, so we had to rely on the expertise that we’ve developed here at Northwestern Medicine,” said Dr. Lung.

Based on a nationwide clinical trial that Northwestern Medicine was a part of, researchers discovered pre-surgical immunotherapy can ultimately improve surgical outcomes for advanced melanoma patients. Dr. Chandra recommended Lauterbach go through three cycles of immunotherapy before surgery, which helped shrink the tumor from 13 centimeters to nine centimeters, allowing Dr. Lung and Chris Mehta, MD, a cardiac surgeon with the Northwestern Medicine Bluhm Cardiovascular Institute who specializes in complex heart reconstruction, to remove Lauterbach’s entire right lung, parts of the main pulmonary artery and lymph nodes. 

“The tumor was sitting on top of MaKenna’s heart and extended into the right lung, impacting all three lobes and the entire main trunk of the pulmonary artery, which is why we had to remove the right lung,” said Dr. Lung.

“It's extremely rare to see this type of tumor invading into the major blood vessels of the heart,” added Dr. Mehta. “We may see something like this once every few years.”

“We think at some point, MaKenna had a melanoma on her skin and her own immune system took care of it, but not before a cell or two may have escaped and eventually started growing inside her body,” explained Dr. Chandra. “After three doses of immunotherapy, once she was taken to surgery, the surgical specimen showed no melanoma cells that were viable. MaKenna’s scans currently show no evidence of metastatic melanoma, and the hope is with continued surveillance, we’ll continue to show she has no evidence of disease. Medically, this is an amazing story with profound results. This type of outcome for our patients is what we always hope for.”

Celebrating the Milestones

Lauterbach will continue immunotherapy treatments for one year. Her cancer is currently a stable disease, meaning no new tumors have appeared. She celebrated her 27th birthday in October and is looking forward to her son’s first Christmas on the farm.

“Colter's the best baby. He's always happy and sleeps through the night,” said Lauterbach. “I’m so grateful to have Colter and Parker in my life, and I can’t say enough about the wonderful medical team that saved my life. Because of Northwestern Medicine, I’m here today.”

“It brings tears to my eyes to see MaKenna doing so well, and seeing Colter thriving is amazing. It just goes to show that when you get all the right medical teams in place, you can truly help families thrive,” said Dr. Yee.

To learn more about Northwestern Medicine, visit nm.org.  

CHICAGO – November 15, 2024 – Can lessons from the COVID-19 pandemic help treat cancer? A new study led by researchers at the Northwestern Medicine Canning Thoracic Institute and published in the Journal of Clinical Investigation has revealed a connection between COVID-19 infection and cancer regression. The team’s discovery could pave the way for novel cancer treatments.

In an unexpected twist, researchers observed that the RNA from the SARS-CoV-2 virus – responsible for COVID-19 – triggered the development of a unique type of immune cell with anti-cancer properties. These cells, dubbed “inducible nonclassical monocytes (I-NCMs),” were found to attack cancer cells and could potentially be harnessed to treat cancers that are resistant to current therapies. These findings possibly explain the mechanism behind the reported regression of certain cancers following COVID-19 infection.

“This discovery opens up a new avenue for cancer treatment,” said Ankit Bharat, MD, chief of thoracic surgery and director of the Canning Thoracic Institute. “We found that the same cells activated by severe COVID-19 could be induced with a drug to fight cancer, and we specifically saw a response with melanoma, lung, breast and colon cancer in the study. While this is still in the early stages and the effectiveness was only studied in preclinical animal models, it offers hope that we might be able to use this approach to benefit patients with advanced cancers that have not responded to other treatments.”

The study, conducted using both human tissues and animal models, found that these unique immune cells could be pharmacologically stimulated using small molecules, potentially creating a new therapeutic option for cancer patients. This discovery could have significant implications, particularly for patients with aggressive or advanced cancers who have exhausted traditional treatment options such as immunotherapies.

How the Body’s Response to COVID-19 Could Help Fight Cancer
The researchers discovered that during COVID-19, a special subset of immune cells can be stimulated in the body. This process begins when the RNA from the virus activates certain signals in the immune system. These signals cause the transformation of common monocytes – an ordinary type of white blood cell – into I-NCMs. These newly formed cells have the ability to move into both the blood vessels and the surrounding tissue where tumors grow, something most other immune cells can’t do.

“What makes these cells so special is their dual capability,” said Dr. Bharat, who is also professor of surgery at Northwestern University Feinberg School of Medicine. “Typically, immune cells called non-classical monocytes patrol blood vessels, looking for threats. But they can't enter the tumor site itself due to the lack of specific receptors. In contrast, the I-NCMs created during severe COVID-19 retain a unique receptor called CCR2, allowing them to travel beyond blood vessels and infiltrate the tumor environment. Once there, they release certain chemicals to recruit body’s natural killer cells. These killer cells then swarm the tumor and start attacking the cancer cells directly, helping to shrink the tumor.”

What’s Next?
While this research is promising, Dr. Bharat cautions that more work is needed before this approach can be used in clinical settings.

“We are in the early stages, but the potential to transform cancer treatment is there. Our next steps will involve clinical trials to see if we can safely and effectively use these findings to help cancer patients,” added Dr. Bharat.

The team hopes that, with further research, they can develop therapies that specifically target these cells to treat cancers that are currently difficult to manage. This could lead to new treatment options for patients who have exhausted all other possibilities.

The research could potentially play an important role with the Canning Thoracic Institute’s Double Lung Replacement and Multidisciplinary Care (DREAM) Program, a first-of-its-kind clinical initiative at Northwestern Medicine that provides double-lung transplants to select patients with advanced lung cancers who are not responding to conventional treatments. To date, more than 40 patients have received double-lung transplants through the DREAM Program.

“While the program has been highly successful, we do anticipate that some patients might have recurrence. Since we’re using monocytes with our research, we could potentially treat DREAM patients without risking rejection of their new lungs,” said Dr. Bharat.

The research was funded by the National Institutes of Health (NIH), Canning Thoracic Institute, and conducted by a team of scientists from Feinberg School of Medicine and clinicians at Northwestern Memorial Hospital. For more information about Northwestern Medicine, visit nm.org. 

CHICAGO – November 12, 2024 – At six years old, Luke Bucciarelli already knows he wants to be a surgeon when he grows up. But not just any surgeon – a thoracic surgeon; someone who operates on organs in the chest, including the lungs, esophagus, trachea and heart.

“I want to be a thoracic surgeon because we need lungs to breathe, and when the lungs get sick, I want to help make people feel better,” said Luke.

The kindergartner from Brentwood, Tenn., loves watching surgical videos on YouTube and when he stumbled across an “Inside the OR” video of Sam Kim, MD, a thoracic surgeon at Northwestern Medicine Canning Thoracic Institute, performing robotic lung cancer surgery, Luke couldn’t stop watching. In fact, Luke started performing “surgery” on a banana with surgical tools he borrowed from a retired surgeon and family friend, and was able to attend an educational event where he could test out a surgical robot. (Photos of the banana and surgical robot linked here.)

“The da Vinci® surgical robot that Dr. Kim uses for his cancer cases has different joystick levers, so it’s like watching a video game, which is very cool,” Luke said. 

“We created that ‘Inside the OR’ video several years ago for our patients who have lung cancer, because many patients get scared and don’t know what’s going to happen inside the operating room,” explained Dr. Kim. “With the video, we’re able to demystify the process and make patients feel more comfortable before surgery.”

Dr. Kim Surprises His Biggest (Little) Fan

Wanting to thank Dr. Kim for inspiring her son to become a thoracic surgeon, Luke’s mom, Katherine Bucciarelli, called Northwestern Medicine and left a message – anticipating maybe an email response. To her shock, not only did Dr. Kim want to talk to Luke, but he had a very special surprise for him.

“Dr. Kim called Luke via FaceTime and took him virtually inside his operating room, letting Luke see the surgical robot up close and personal. Dr. Kim also told us that if we’re ever in Chicago, we need to stop by Northwestern Memorial Hospital and he would give us a personal tour,” said Katherine. “Dr. Kim went above and beyond. Luke still hasn’t stopped talking about it!”

“It was so neat to see Dr. Kim’s operating room, and now I know how to wash my hands for surgery – you have to scrub past the elbows!” said Luke.

“I don’t have a lot of fans who are six years old, but when I heard that a kindergartner from Tennessee was watching our robotic lung cancer surgery video and it inspired him to one day become a thoracic surgeon, I knew I wanted to do something special for him,” said Dr. Kim. “Many kids want to grow up to be rockstars or athletes, but working in health care is a very fulfilling, rewarding job that does good for a lot of people. I hope videos like this inspire even more kids out there and demonstrates that if you apply yourself and are dedicated to your work, someday you can join me inside the operating room.”

Thoracic Surgeons in Demand

As the population grows and ages, demand for cardiothoracic surgeons is expected to increase. By 2035, the Health Resources and Services Administration (HRSA) projects 900 cardiothoracic surgeons will retire while demand for surgeries will increase by 20 percent, resulting in a 31 percent shortfall of surgeons within the specialty, which is the largest projected shortfall of any physician specialty.

“The demand for cardiothoracic surgeons is why it’s so important to inspire and invest in the next generation – like Luke,” added Dr. Kim. “While we’ve made strides in treating lung cancer, the disease is still the most commonly diagnosed cancer, and we need more surgeons who are willing and wanting to help these patients.”

Lung Cancer Awareness Month

November marks Lung Cancer Awareness Month. Lung cancer is the third most common cancer in the United States, and cancers of the lung are the leading cause of cancer-related deaths in the U.S. in both men and women with more people dying of lung cancer than colon, breast and prostate cancers combined.

While smoking is a major risk factor for developing lung cancer, it can also affect those who have never smoked. According to the Centers for Disease Control and Prevention (CDC), in the U.S., about 10 to 20 percent of lung cancers (20,000-40,000 cases) happen in people who have never smoked or smoked fewer than 100 cigarettes in their lifetime. Exposure to secondhand smoke, radon, air pollution, asbestos and having a family history of lung cancer are all contributing risk factors.

Symptoms of lung cancer can include:

-        Frequent cough

-        Shortness of breath

-        Chest pain

-        Coughing up blood

-        Wheezing

-        Feeling tired or not well all the time

Those at high risk for developing lung cancer should ask their primary care physician about scheduling a low-dose chest CT scan. For more information about lung cancer treatment options and scheduling a low-dose chest CT scan, visit nm.org.

CHICAGO – October 4, 2024 – Long COVID occurs in approximately a third of COVID-19 survivors, with the CDC estimating 1 in 13 adults in the United States have long COVID symptoms such as brain fog, shortness of breath and chest pain. In a new study published in Nature Immunology, pulmonologists at the Northwestern Medicine Comprehensive COVID-19 Center (CCC) noticed that many patients referred to the CCC for long COVID symptoms had persistently abnormal CT scans of their lungs. Some patients would recover, while others would remain with scar tissue. They called this respiratory post-acute sequelae of COVID-19 (PASC) with radiographic abnormalities (RPRA). In collaboration with Brigham and Women’s Hospital, The Ohio State University and Duke University, Northwestern Medicine researchers combined state-of-the-art gene expression technology and CT scan analysis to determine which cells and molecules were responsible for radiographic abnormalities in long COVID patients, which could help inform future treatment options.

“Our understanding of long COVID is still in its early stages and there are no FDA-approved or even widely agreed-upon treatments for long COVID,” said Marc Sala, MD, co-director of the Northwestern Medicine Comprehensive COVID-19 Center and a pulmonary and critical care specialist with the Northwestern Medicine Canning Thoracic Institute. “The underlying cells and molecules that contribute to radiographic abnormalities in long COVID patients are now better established, and equally important, it appears to be the same biological processes responsible for other types of lung injury that result in pulmonary fibrosis. This common denominator explanation may help not only in developing treatments for long COVID as it continues to evolve in the future, but also contributes to our understanding of pulmonary fibrosis due to other conditions.”

The team evaluated 35 patients who had long COVID at the CCC between November 2020 and May 2022. These patients had respiratory symptoms such as cough and shortness of breath, but also had abnormal lung tissue on their CT scans. Researchers focused on this group to better understand what was causing some cases of radiographic abnormalities to worsen or improve. 

AMONG THE PATIENTS TESTED

-        Median age was 62 (range from 32 to 83)

-        43% were female

-        66% were white, 17% were Black and 20% were Hispanic

-        All patients had respiratory symptoms on presentation with shortness of breath being the most common symptom (97%) followed by cough (69%)

-        Nine patients had never been hospitalized; and of the 26 who had been hospitalized, 17 were admitted to the intensive care unit

-        Two patients ultimately required lung transplantation after their COVID diagnosis

-        43% of patients required oxygen therapy, including the two patients who required lung transplantation

Researchers compared patients within this cohort whose lungs improved on subsequent imaging to patients who did not improve. In additional analyses, data were compared between RPRA and previous studies involving patients who required lung transplantation after COVID, healthy control specimens, and samples from patients who had idiopathic pulmonary fibrosis.

KEY FINDINGS

1.     CT scans done an average of 145 days after COVID infection were analyzed and showed 39% pulmonary fibrosis and 22% inflammatory changes in the 35 patients tested.

2.     Samples from lung fluid on a subset of these patients an average of 5.3 months (but up to 1.5 years after COVID infection), showed high levels of pro-inflammatory molecules leading to ongoing immune cell migration into their lungs.

3.     There was a persistent migration of white blood cells (including neutrophils and monocytes) into the lungs of people with radiographic abnormalities that was correlated with the severity of CT scan changes. In particular, monocyte-derived alveolar macrophages (MoAM) have been found in both mice and humans to be involved in the progression to pulmonary fibrosis.

4.     The MoAMs did not appear to switch to a “repair mode.” Patients with radiographic abnormalities that improved, worsened or remained the same all had similar-appearing MoAMs. This was supported by comparing their molecular characteristics to samples from patients who had end-stage pulmonary fibrosis from COVID and idiopathic pulmonary fibrosis.

“What surprised us the most was the ongoing influx of pro-inflammatory and pro-fibrotic immune cells from blood into lungs even one year after the COVID infection. Historically, we assume infection-related lung inflammation resolves by this point. The highly overlapping biological processes involving radiographic abnormalities and other non-COVID conditions that lead to fibrosis is an important finding,” said Dr. Sala.

NEXT STEPS

According to researchers, understanding the underlying drivers for protracted lung inflammation in radiographic abnormalities is an important step in addressing long COVID, which can involve nearly any organ system. Steroids were given to many patients in this cohort, but it remains to be determined whether this strategy is helpful in some patients more than others. The study serves as a step forward in understanding pulmonary fibrosis in general to aid investigations in the discovery of better medical treatments.

“The more invisible manifestations of long COVID, such as brain fog, shortness of breath, rapid heart rate and fatigue, may well involve similar prolonged inflammation and this study is an important step forward in supporting this idea,” said Dr. Sala. “The study also supports a broader point that understanding COVID and its ongoing impacts can serve to inform our understanding of other chronic respiratory illnesses that lead to pulmonary fibrosis.”

To date, the CCC has treated more than 4,000 patients since May 2020 with neurology, pulmonology and cardiology being the most commonly sought specialties. For more information on the CCC, visit nm.org and to schedule an appointment, please call 312.926.9900.

CHICAGO – September 25, 2024 – In a pioneering medical breakthrough at Northwestern Medicine, surgeons have successfully performed a double-lung transplant on a patient with stage 4 colorectal cancer who had limited time to live. The procedure was achieved through the Double Lung Replacement and Multidisciplinary Care (DREAM) Program, a first-of-its-kind clinical initiative that was designed for select patients with advanced lung cancers that do not respond to contemporary treatments.

The patient, 42-year-old Amanda “Mandy” Wilk of Savage, Minn., had been battling stage 4 colorectal cancer since 2017, which had initially spread to her liver. After undergoing cancer treatments and receiving a liver transplant from her brother, the cancer returned – this time in her lungs. Facing few options for survival, Wilk sought out the DREAM program at Northwestern Medicine.

On June 3, Wilk received new lungs and was discharged from Northwestern Memorial Hospital one week later on June 10 – her 42^nd birthday. In a moment she had been waiting eight years for, Wilk rang the bell signaling she had completed cancer treatment. She currently has no signs of cancer in her body and doesn’t require any further cancer therapy.

“This is a first-of-its-kind surgery at Northwestern Medicine where a patient with stage 4 colorectal cancer has successfully received a double-lung transplant,” said Ankit Bharat, MD, chief of thoracic surgery and director of the Northwestern Medicine Canning Thoracic Institute. “Our surgical team meticulously removed Mandy’s cancer-ridden lungs without allowing any cancerous cells to spill into her bloodstream, and then we transplanted new lungs. Based on all the testing that’s available to us – CT scans, PET scans, and molecular analyses of circulating cancer DNA in Mandy’s blood – we don’t see any remaining signs of cancer in her body. While we’re optimistic about her future, it’s important to approach this with cautious optimism as further research is needed to understand the long-term outcomes.”

A Journey of Resilience and Innovation

Colorectal cancer is the third most common cancer diagnosed in both men and women in the United States, with increasing numbers of people being diagnosed under the age of 50. When it metastasizes, it typically spreads to the liver or lungs, leaving few options for possible survival. Cancers of the lungs or those that travel to the lungs result in the most cancer-related deaths in the U.S.

Originally from Lake Zurich, Ill., Wilk moved to Minnesota where she works with the kindergarten through fifth grade teaching staff of Bloomington as an elementary curriculum and instruction specialist. In her spare time, Wilk enjoys running, the arts and attending sporting events with her partner and brothers.

In 2017, at the age of 34, Wilk thought she had food poisoning, but persistent symptoms led to a diagnosis of stage 4 colorectal cancer that had already spread to the liver. Wilk was given approximately two years to live. Treatments included a partial colon resection, chemotherapy, liver ablations and radiation beads on the liver, before receiving a liver transplant from her younger brother, Adam, in 2020. But six months later, the cancer returned – this time to the lungs.

“I traveled to almost every major health system across the country, and they all told me there was nothing more they could do,” said Wilk. “I believe in forward-thinking and was not going to take ‘no’ for answer, so when I inquired about the DREAM program at Northwestern Medicine, I was ecstatic that they were ready and eager to help me live.”

Wilk’s partner, Chris Withers, is a television producer for the Chicago White Sox, so Chicago was already like a second home to the couple. During the offseason, they live in Minnesota, but for Mandy, much of the summer is spent between Minnesota and Chicago. In March 2024, Wilk traveled to Chicago for a lung transplant evaluation and was then listed the day after Memorial Day. On June 3, Wilk received new lungs and one week later, she was doing so well that she was discharged from Northwestern Memorial on June 10 – which happened to be her 42nd birthday.

“Throughout my eight-year journey of battling cancer, the one thing I’ve always wanted to do was ‘ring the bell,’ signaling my completion of cancer treatment,” said Wilk. “Many doctors told me I’d never be able to ring it, so when my lung transplant social worker made it happen on my birthday, there was no greater feeling. I was finally able to celebrate being cancer-free.”

A New Chapter for Patients Facing Terminal Diagnoses

Wilk was recently given the “green light” by her lung transplant pulmonologist to start running again. While she continues to recover in Chicago for the next several months, Wilk can be found walking and jogging along Chicago’s lakefront trail. Her new goal is to one day run a marathon.

“Mandy has flown through the recovery process. Typically, lung transplant patients require several days, if not weeks, in a rehabilitation center, but because Mandy was young and made exercise a priority before transplant, rehab wasn’t needed,” said Catherine Myers, MD, lung transplant pulmonologist with the Northwestern Medicine Canning Thoracic Institute. “When Mandy asked me about being able to run again, I told her to start slow and gradually build up speed. Her determination has no limits, and I wouldn’t be surprised to see Mandy cross another finish line in the near future. As a runner myself, if Mandy decides to run the Chicago Marathon someday, I would love to run alongside her.”

Giving Back and Inspiring Others

Beyond her medical journey, Wilk is passionate about art and uses the skill to help pay it forward. Four years ago, her brother Adam started Mandy’s Foundation which has raised more than $60,000 for the art therapy program at the Ann and Robert H. Lurie Children’s Hospital in Chicago. Since Mandy’s career has been dedicated to helping children, the goal is to provide positive experiences to children who are hospitalized during cancer treatment.  

“I have been given a new gift of life not once, but twice – first with my new liver, and now with my new lungs,” said Wilk. “When you’re diagnosed with cancer, often times you’re treated like a number and not a person, but my team at Northwestern Medicine, from the nurses, doctors, respiratory therapists and even the food service workers, all saw and treated me as Mandy. I hope my story inspires others to continue advocating for themselves.”

About the DREAM Program

The Northwestern Medicine Canning Thoracic Institute is currently the only clinical site in the nation offering this treatment for lung cancer patients without any options. Using lessons learned from pioneering COVID-19 lung transplantation in the United States, surgeons developed the novel surgical technique to clear the cancer during surgery while minimizing the risk of spread that has plagued prior such attempts at other hospitals.

“Unlike the conventional technique of sequential transplants, this innovative technique involves putting the patient on full heart and lung bypass, delicately taking both cancer-ridden lungs out at the same time along with the lymph nodes, washing the airways and the chest cavity to clear the cancer, and then transplanting new lungs,” said Dr. Bharat. “These patients can have billions of cancer cells in the lungs, so we must be extremely meticulous to not let a single cell spill into the patient’s chest cavity or blood stream. We believe this technique can help reduce the risk of recurrence.”

To date, surgeons have performed more than 40 successful lung transplants for cancer patients under the DREAM program. The outcomes of the program’s patients are being tracked in a research registry also called DREAM.

“While we are encouraged by success stories like Mandy's, it's important to recognize that this is a highly specialized procedure that may not be suitable for all patients with metastatic cancer,” added Dr. Bharat. “Careful evaluation and selection are key to ensuring the best possible outcomes.”

Patients interested in being evaluated for a lung transplant can contact the referral line at 844.639.5864. 

For more information about Northwestern Medicine’s lung transplant programs, as well as advanced therapies, visit nm.org. 

CHICAGO – May 13, 2024 – For the first time at Northwestern Medicine, surgeons have successfully performed a double-lung transplant on a patient who had the one lung damaged from lung cancer and the other damaged by COVID-19. The patient, 56-year-old Arthur “Art” Gillespie of Chicago, has worked in law enforcement for nearly 30 years, most recently as a captain with the University of Chicago Police Department. When doctors at other health systems told Gillespie there was nothing more they could do for him, he turned to the Northwestern Medicine Canning Thoracic Institute, where surgeons pioneered lung transplantation for COVID-19 patients in the United States and using those same lessons, developed lung transplantation for select patients with advanced lung cancer through a first-of-its-kind clinical program called the Double Lung Replacement and Multidisciplinary Care (DREAM) Program.

“Arthur was in a unique situation because he got a severe case of COVID in March 2020 right around the same time he was diagnosed with lung cancer,” said Ankit Bharat, MD, chief of thoracic surgery and director of the Canning Thoracic Institute who performed Gillespie’s transplant. “When Arthur first came to see us in September 2023, even though he looked physically strong, he could barely speak a single sentence without getting short of breath or take a few steps before having to sit down. The pressure inside the lungs had also increased to a point that it was causing heart failure, and his only option for survival was a double-lung transplant.”

“Four years after the start of the pandemic, COVID still has an impact on patients, but in a different way,” said Rade Tomic, MD, pulmonologist and medical director of the Lung Transplant Program. “While lung transplants for acute damage from COVID is quite rare these days, we’re now starting to see patients who may have had moderate to severe cases of COVID coming in with signs of lung fibrosis. The scarring of the lungs gets more heightened in patients who recovered from COVID but get another respiratory infection like COVID, RSV or influenza because it compounds the original damage that COVID caused.”

When the pandemic started, Gillespie never imagined it would lead to him needing a double-lung transplant, or the impact the virus would have on his family.

“I lost my dad, uncle and cousin to COVID,” said Gillespie. “In February 2020, my dad and I went to visit my uncle in a nursing facility and by early March, we were all sick. I was hospitalized for 12 days with a high fever and cough, and during that time, they were taking scans of my lungs, which showed stage 1 lung cancer on my right lung. I had no symptoms of lung cancer, so in a way – because of COVID – we were able to catch the cancer early.”

After being discharged from the hospital, Gillespie started chemotherapy treatments and underwent surgery at another health system in November 2020 to have two-thirds of his right lung removed. His intent was to get better and return to work, but that never happened. For the next three years, Gillespie continued physical therapy treatments and worked out at his home gym, but his body was getting weaker, and he needed supplemental oxygen daily.

“Despite my best efforts, I could feel myself going backwards. My right remaining lung was damaged from lung cancer, and my left lung was damaged from COVID. My circumstances were exactly what the Canning Thoracic Institute was built for, and I knew I needed to seek a second opinion,” said Gillespie.

In September 2023, Gillespie had his first consultation at Northwestern Medicine, and by November he was listed for a double-lung transplant. On January 6, Gillespie received his new lungs at Northwestern Memorial Hospital and continues getting stronger every day. May 12-18 marks National Police Week, and while Gillespie still isn’t sure if or when he can return to work as a police captain, he hopes his story resonates with fellow officers to prioritize their health.  

“My recovery from the double-lung transplant has been easier than my recovery from lung cancer surgery,” said Gillespie. “I want my story to serve as a lesson to others – especially those in law enforcement. When you’re a public servant, it’s easy to become distracted with the routine of the job. You’re used to putting others before your own health, but we have to be equally proactive and seek a second opinion when we know something isn’t right. A second opinion saved my life and I’m overwhelmed with gratitude for Northwestern Medicine. The lung transplant team listened to my concerns, didn’t dismiss them, and gave me a sense of direction.”

“Arthur is a fighter. He had two major problems – lung cancer and COVID. Historically, both would be considered non-salvageable for lung transplantation, but we were able to treat both of those conditions with a double-lung transplant procedure,” said Dr. Bharat. “Despite being told ‘no’ by other doctors, Arthur had the courage and determination to keep searching for answers. I feel honored that we were able to help him since he spent so many years helping the community as a police captain.”

 To date, the Canning Thoracic Institute has performed more than 45 lung transplants for COVID-19 patients, and more than 40 lung transplants for lung cancer patients. The Institute is currently the only clinical site in the nation offering this treatment for lung cancer patients without any other options.

Cancers of the lung are the leading cause of cancer-related deaths in the United States in both men and women with more people dying of lung cancer than colon, breast and prostate cancers combined. Patients interested in being evaluated for a lung transplant can contact the referral line at 844.639.5864. For more information about Northwestern Medicine’s transplant programs, as well as advanced therapies, visit nm.org. 

CHICAGO – March 28, 2024 – For the first time at Northwestern Medicine, surgeons have successfully performed a combined lung-liver transplant on a patient with advanced lung cancer who had limited time to live. The patient, 69-year-old Gary Gibbon, MD, a pulmonologist, allergist and immunologist from Santa Monica, Cali., was diagnosed with stage 3 lung cancer in March 2023. After undergoing chemotherapy, radiation and immunotherapy at a California hospital, Dr. Gibbon was admitted to the intensive care unit, where he learned the immunotherapy had not only permanently destroyed his lungs, but also caused irreparable damage to his liver. His only option for survival would be traveling to Chicago for a combined lung-liver transplant, where a first-of-its-kind clinical program called Double Lung Replacement and Multidisciplinary Care (DREAM) was established for select patients with advanced lung cancers that do not respond to conventional treatments. In September 2023, Dr. Gibbon received his new lungs and liver from the same donor, and six months after surgery, Dr. Gibbon still has no signs of cancer in his body and doesn’t require any further cancer therapy.

“To our knowledge, this is the first known case in the nation where a patient with advanced lung cancer has successfully received a combined lung-liver transplant,” said Ankit Bharat, MD, chief of thoracic surgery and director of the Northwestern Medicine Canning Thoracic Institute who performed Dr. Gibbon’s lung transplant. “The purpose of DREAM is to help patients with some forms of late-stage cancers that are only limited to the lungs through double-lung transplantation if conventional or experimental treatments have failed. In Dr. Gibbon’s case, he received all possible treatments for his aggressive lung cancer. Unfortunately, not only did his cancer not get treated, but he also developed severe damage to his lungs and liver that was unsustainable with life. He was running out of time, and the DREAM program was his only option for survival.”  

“Even though a combined lung-liver transplant for advanced lung cancer had never been done before, our team was confident we could do this, and more importantly, Dr. Gibbon had full confidence in us,” said Satish Nadig, MD, PhD, transplant surgeon and director of the Northwestern Medicine Comprehensive Transplant Center who performed Dr. Gibbon’s liver transplant. “We’re not just here to do transplant – we’re here to change the world of transplantation by innovating and moving the field forward. Out-of-the-box thinking is exactly what we hang our hat on at Northwestern Medicine, and without this procedure, I can confidently say that Dr. Gibbon would not be here today, cancer-free, breathing on his own, celebrating his 69^th birthday.”

Originally from Cape Town, South Africa, Dr. Gibbon moved to Santa Monica where he was in private practice for 33 years until his recent hospitalization. He’s also an associate professor at UCLA’s David Geffen School of Medicine. In March 2023, Dr. Gibbon started coughing and losing weight; a chest X-ray confirmed a mass with a diagnosis of stage 3 lung cancer. He proceeded with chemotherapy, immunotherapy and radiation, and by mid-July he was hospitalized with septic shock, pneumonia and multiple organ failure. His lungs had become fibrotic due to the cancer treatment, and he was fighting for his life in a Los Angeles intensive care unit.

“As a pulmonologist, I never imagined I’d ever need a lung transplant – let alone for lung cancer,” said Dr. Gibbon. “While my doctors in California had done everything they could, we knew there was only one place in the entire country that could give me a fighting chance, and after speaking with Dr. Bharat, I could see the light at the end of the tunnel.”

“Dr. Gibbon met the criteria to receive a double-lung transplant through our DREAM program, but as the preliminary evaluation was performed prior to his acceptance to Northwestern Medicine, our team discovered that he had also developed liver cirrhosis from the immunotherapy. We had to modify our DREAM program and work with Dr. Nadig’s team to formulate a pathway for Dr. Gibbon to receive not only a double-lung transplant, but a concurrent liver transplant. Fortunately, we were able to do it just in time for Dr. Gibbon to receive this first-of-its-kind procedure,” said Dr. Bharat.

On Sept. 10, the then 68-year-old was transported to Chicago via a four-hour medical flight and waited for new organs from his ICU bed at Northwestern Memorial Hospital. After spending 12 days on the transplant waitlist, Dr. Gibbon received his new lungs shortly before midnight on Sept. 26, and his new liver in the early hours on Sept. 27.

Drs. Bharat and Nadig worked together during the 10-hour procedure. While the new lungs were put in first, the donor liver was kept alive outside the body thanks to new technology called liver perfusion – or “liver in a box.” The liver was attached to a machine that pumps warm, oxygenated and nutrient-enriched blood through the organ. With the liver was on the pump, the team could assess its function to ensure the liver was ideal for transplantation.

“Transplantation is ever evolving and we’re embarking upon the era of technology. Dr. Bharat anticipated that the lung transplant would be extremely challenging due to the size of Dr. Gibbon’s tumor and the different types of treatments, including radiation, to the lungs and chest which would result in the lungs getting fused to the surrounding structures. To give Dr. Bharat sufficient time to meticulously remove the damaged lungs and all the cancer, we used the new liver perfusion technology through which we were able to keep the liver alive outside the body for an extended duration,” said Dr. Nadig. “Dr. Gibbon’s transplant took so many resources and teams across multiple departments at multiple health systems. To leave his ICU bed in California, travel to Chicago, get him listed, then transplanted, while using technologies and techniques that aren’t common, took extreme efforts. Northwestern Medicine handles complicated cases very well.”

To date, the Canning Thoracic Institute (CTI) has performed more than 30 lung transplants for patients under the DREAM program, including several with terminal stage IV lung cancer and one in which cancer from another organ had spread to the lungs. Using lessons learned from pioneering COVID-19 lung transplantation in the United States, CTI surgeons developed the novel surgical technique to clear the cancer during surgery while minimizing the risk of spread that has plagued prior such attempts at other hospitals.

“Unlike the conventional technique of sequential transplants, this innovative technique involves putting the patient on full heart and lung bypass, delicately taking both cancer-ridden lungs out at the same time along with the lymph nodes, washing the airways and the chest cavity to clear the cancer, and then putting new lungs in,” said Dr. Bharat. “These patients can have billions of cancer cells in the lungs, so we must be extremely meticulous to not let a single cell spill into the patient’s chest cavity or blood stream. We believe this technique can help reduce the risk of recurrence, which we learned through our experience with pioneering COVID-19 lung transplants.”

The outcomes of the program’s patients are being tracked in a research registry also called DREAM. Dr. Gibbon is grateful to have his name added to the list and is even more appreciative to celebrate his birthday (March 27) and National Doctors’ Day (March 30) with two of the physicians who helped save his life. To date, the Northwestern Medicine Canning Thoracic Institute is the only place in the nation offering this treatment for patients without any other hope.

“I’ve been a physician for decades, and we tend to be conservative at times with our treatment plans, which is why the enormity of the science that went into this procedure is awe-inspiring to me,” said Dr. Gibbon. “As a physician, I knew I was in the right place. I wasn’t just stepping on the moon by myself. It took surgeons, oncologists, transplant specialists, nurses, respiratory therapists and most importantly, my donor, to help me get my ‘Triple L’ – two lungs and a liver. This DREAM program is new territory for transplantation and the fact that I could experience it and have a wonderful outcome makes me feel so blessed. I wouldn’t be here today without Northwestern Medicine.”

“Because Dr. Gibbon is a pulmonologist and allergy specialist, he’s familiar with lung diseases, which made this case even more special,” said Dr. Bharat. “As physicians helping another physician, we feel very proud that we were able to do something that hopefully opens the doors for future patients who would otherwise not survive.”

Cancers of the lung are the leading cause of cancer-related deaths in the United States with more people dying of lung cancer than colon, breast and prostate cancers combined. Lung cancer patients interested in being evaluated for a lung transplant can contact the referral line at 844.639.5864. For more information about Northwestern Medicine’s transplant programs, as well as advanced therapies, visit nm.org.  

CHICAGO, IL – February 13, 2024 – February is Heart Month, a time when people are encouraged to focus on heart health. But what happens when the heart stops? Inside the Medical Intensive Care Unit (MICU) at Northwestern Memorial Hospital, the nurses are going above and beyond with a simple gesture that involves a “heartbeat in a bottle.”

In the summer of 2023, Northwestern Medicine clinical nurses Hira Malik and Lydia Hillary were caring for a patient who was actively dying. The patient had been in the MICU for several days, and the patient’s family was extremely grateful for everything the nurses were doing. As the patient was nearing their final breath, Malik remembered something she learned in nursing school called “heartbeat in a bottle,” where the patient’s last few steady heartbeats from the EKG machine are printed off, placed in a glass bottle, and a name tag is attached with ribbon.

“In the ICU, especially during the COVID-19 pandemic, we saw death much more frequently, and a lot of the deaths were lonely due to visitor restrictions at the time,” said Malik. “I remember thinking, now that family is able to come and be with loved ones, is there anything we can give them to remember them by?”

At the time, Malik and Hillary didn’t have a glass bottle or ribbon on hand, so they improvised and used a clean, empty pill bottle, along with the strings from a surgical mask to attach a name tag. They gave the “heartbeat in a bottle” to the patient’s spouse who was extremely grateful for the gesture, and it offered closure to the patient’s family. 

“The family really enjoyed it and gave Hira a hug when she presented it to them,” said Hillary. “A lot of times, the ICU can be a scary place for patients and their loved ones. That’s one of our main roles as ICU nurses, is to help walk our patients and their families through this transition.”

Khalilah Gates, MD, a pulmonary and critical care specialist in the MICU, noticed Malik and Hillary’s kind gesture. Dr. Gates spoke with other physicians on the unit, and they agreed to purchase the necessary supplies for “heartbeat in a bottle” so the nurses could continue doing it for families in the future.

“Our nurses are really the heart and soul of what we do here in the MICU, in fact, they’re what critical care medicine is all about,” said Dr. Gates, who is part of the Northwestern Medicine Canning Thoracic Institute. “The nurses are always at the bedside, taking care of patients and interacting with families during some of the darkest moments. ‘Heartbeat in a bottle’ demonstrates the empathy and sympathy our nurses have during the transition from life to death, which is very important.”

To date, the MICU nurses have created approximately three dozen “heartbeat in a bottle” keepsakes with the new supplies, which includes glass bottles, purple name tags and string. 

“There have been so many beautiful memories, but one that stands out, is when we presented a ‘heartbeat in a bottle’ to a patient’s family, and they were so moved by the keepsake that they requested ten more bottles for the rest of their family,” said Hillary. “It helps me to know that the family of my patient will remember the care their loved one received during those final moments.”

“No two deaths are ever the same, and from an ICU nursing perspective, we want each patient to die with dignity, in the most painless manner, surrounded by familiar voices and family. It’s one of the greatest comforts we can offer them,” added Malik. “My hope is that when families look at that little keepsake, it reminds them of all the precious, happy memories that define their loved one.”

CHICAGO – November 8, 2023 – For the first time at Northwestern Medicine, surgeons used an artificial lung and breast implants to save the life of a Missouri man who vaped for years, caught the flu and needed a double-lung transplant when his lungs became infected.

The innovative procedure happened in late May, as Northwestern Medicine Canning Thoracic Institute surgeons removed 34-year-old David “Davey” Bauer’s infected lungs, created an artificial lung to keep him alive, placed DD breast implants inside his chest cavity to keep the heart in place, and listed Bauer for a double-lung transplant, finding a match within 24-hours. Bauer was discharged from Northwestern Memorial Hospital in late September and continues to recover at optimal pace in Chicago.

“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.”

Bauer, who enjoys snowboarding, skateboarding, gaming and golfing, works in landscaping and hardscaping in De Soto, Mo., which is near St. Louis. He started smoking cigarettes when he was 21 years old and typically smoked a pack of cigarettes a day until he switched to vaping in 2014.

“Vaping felt better, and I thought it was the healthier alternative, but in all honesty, I found it more addicting than cigarettes,” said Bauer.

In April, Bauer started experiencing shortness of breath, was diagnosed with influenza A (the flu) and developed a lung infection that was resistant to antibiotics. Bauer didn’t receive the flu shot, and up until that point, had never been seriously ill. He was admitted to a hospital in St. Louis and placed on ECMO, a device that does the work of the heart and the lungs, but he continued to decline and a double-lung transplant was his only option for survival.

“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.”

The surgical team quickly came up with a strategy to remove the infected lungs and engineer an “artificial lung” that could attach to Bauer’s body, keeping the blood flowing to the heart, while also keeping his brain and other organs perfused. With both lungs removed, surgeons needed a way to keep Bauer’s heart from physically collapsing inside the chest cavity, and that’s where the idea for DD breast implants came into the picture.     

“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.”

Once the infected lungs were removed on May 26, Bauer’s body immediately started clearing the infection and he was listed for a double-lung transplant. The team received an offer for new lungs the following day (May 27), and on May 28, the breast implants were taken out and the donor lungs were put in. Bauer spent several months recovering in the intensive care unit before being discharged to rehabilitation therapy in late September.

“Still to this day, I can’t believe Davey lived without any lungs. He was breathing, blood pumping without lungs,” said Bauer’s girlfriend and caretaker, Susan Gore. “While we waited inside his hospital room at Northwestern, I would take a breath in and say, ‘one breath for me and one for Davey.’ It’s hard to wrap my mind around it, and I’m still in awe that Davey was able to do this – it truly shows his strength.”

“I’m so grateful to be alive and know I wouldn’t be here today without the support of my girlfriend, family, friends and my Northwestern Medicine transplant team who never gave up on me,” said Bauer. “While we don’t have definitive ways of proving my years of vaping caused my medical condition, doctors do know for a fact that vaping causes lung injury. If I could go back in time, I never would have picked up a cigarette or vape pen, and I hope my story can help encourage others to quit, because I wouldn’t wish this difficult journey on anyone.”

As for being the first Northwestern Medicine lung transplant patient to have both lungs removed and breast implants temporarily put in their place, Bauer jokes that his new nickname is “DD Davey.”

“I plan to get a t-shirt made that says ‘DD Davey’ on it and change all my gaming profiles,” he said. “But in all seriousness, I’m so proud to be the first Northwestern Medicine patient to undergo this innovative procedure, and I hope this medical first paves the way for more critically ill patients to receive lung transplants in the near future.”

Bauer will remain in Chicago for the next year so his transplant team can continue to closely monitor him. While he misses St. Louis (especially Cardinals’ baseball games), he’s looking forward to enjoying the holidays in a new city with his new lungs. To learn more about Bauer’s medical journey, visit his GoFundMe page.

Patients interested in being evaluated for a lung transplant can contact the referral line at 844.639.5864. For more information about Northwestern Medicine’s lung transplant program, as well as advanced therapies, visit nm.org. 

CHICAGO, IL – September 26, 2023 – Josh Burton was born in Guatemala and adopted as a baby by his mother, Kelly Burton. The 17-year-old grew up in Madison, Wis., where he became fascinated with dinosaurs and paleontology. In 2020, during the height of the COVID-19 pandemic, Burton started having problems breathing and was diagnosed with pulmonary veno occlusive disease, a rare condition that causes the small veins in the lungs to narrow and impair blood flow. 

In the spring of 2021, at the age of 14, Burton received a double-lung transplant at a Wisconsin hospital in order to survive, but one year later, he contracted RSV, a common respiratory virus, and his new lungs started to fail. Retransplantation for new lungs is difficult – especially given Burton’s young age and the fact he was only one year out from the first transplant.

According to Burton’s mom, Kelly, more than 20 hospitals turned him away for a retransplant, until he came to Northwestern Medicine, whose lung transplant team is known for taking on the most difficult cases, including pioneering the first COVID lung transplants in the United States and starting a lung transplant clinical program for select patients with stage 4 lung cancer.  

After being accepted at Northwestern, Burton’s lung function quickly deteriorated, and he was hooked up to ECMO, a machine that does the work of the heart and lungs. Burton almost died several times and endured 13 “dry runs” – where surgeons received a call for new lungs, but once they inspected the donor lungs on site, they weren’t usable for Burton. Finally, on June 28, they found a perfect match and Burton underwent a successful surgery.

“In my entire career, I’ve never witnessed 13 dry runs for new lungs. It was a roller coaster of emotions for Josh’s family, but this can happen due to undetected pneumonia or other illnesses in the donor lungs,” explained Ankit Bharat, MD, chief of thoracic surgery and director of the Northwestern Medicine Canning Thoracic Institute. “Josh was battling a bad viral infection, he was on ECMO for a long time, he was critically ill and most importantly – his anatomy was completely altered due to his previous lung transplant. Josh’s case was tricky for a number of reasons, but these are the types of cases our team takes on because we want to be known as a destination of hope.”

“Throughout this transplant journey, I could see Josh giving up, but the transplant team at Northwestern Medicine saved him, and he’s been rallying ever since. They are our heroes, no question,” said Kelly Burton.

Inside Burton’s hospital room at Northwestern Memorial Hospital, dinosaurs were everywhere. Burton wants to be a paleontologist someday, but because of his transplants, he’s unable to work with dirt.

“Lung transplant patients are asked to avoid dirt because they have a higher risk of fungal infections than other solid-organ recipients, which can lead to pneumonia and other serious health issues. The lungs are the only organs exposed to outside environmental factors, therefore, putting lung transplant patients at higher risk. After transplant, patients should avoid working with dirt their entire lives,” said Dr. Bharat.   

Field Museum Scientists Showcase Paleo Work Without the Dirt

Burton absolutely loves visiting the Field Museum in Chicago which houses SUE the T. rex, one of the most famous fossils in the world. When the Field Museum learned how much Burton enjoys dinosaurs, they offered to make him an “honorary paleontologist for a day.” Jingmai O’Connor, associate curator of fossil reptiles (who is also known as the “punk rock paleontologist”), and Bill Simpson, head of geological collections, wanted to show Burton that he can still be a paleontologist without working in the dirt.

“Training the next generation of paleontologists is one of the most rewarding and important aspects of my job,” said Dr. O’Connor. “I would really argue that a vast majority of methods and techniques that are utilized by paleontologists today, especially the most exciting and cutting-edge techniques, are all techniques that would be totally accessible to Josh. There are lots of fossils waiting to be studied and even new species to discover in our collections without going anywhere in the field.”

On Wednesday, Sept. 20, Dr. O’Connor and Simpson gave Burton an exclusive, behind the scenes tour of the Field Museum, letting him see and do things that are off limits to the public. 

The visit included:

-        Taking SUE’s skull out of its case and letting Burton interact with it up-close. Dr. O’Connor explained the scanning project she did to study the holes in SUE’s jaw; an example of how paleontologists can study dinosaurs without doing fieldwork/fossil prep that would be difficult with Burton’s medical condition. 

-        A special peek inside Dr. O’Connor’s lab to let Burton see fossil slides under the microscope and check 3D fossil footage on a computer screen.

-        A chance to see and interact with huge dinosaur bones and other fossils that are enormous – even Dwayne “the Rock” Johnson couldn’t pick them up.

With Burton now entering his senior year of high school, his mom calls this visit “crucial” to Burton deciding what his career path will be. She’s hopeful that despite her son’s transplants, he can still fulfill his dream of working with dinosaurs. 

“All kids tend to go through phases, but Josh never outgrew his love for dinosaurs. Because of his transplants, he’s been in school very little, so the fact he’s still interested in science is so important for his future. We will never forget this amazing experience at the Field Museum,” said Kelly Burton.

“I got to see SUE’s head out of its case – something that rarely happens – and that was such a highlight for me,” said Josh Burton. “When I was fourteen and had my first lung transplant, I gave up on my dream of being a paleontologist because I knew I couldn’t be around dust and dirt. So many medical centers turned me down for a second transplant, but Northwestern Medicine gave me a chance to live, to see my upcoming eighteenth birthday (this October), and to visualize a career path.”

Patients interested in being evaluated for a lung transplant can contact the referral line at 844.639.5864. For more information about Northwestern Medicine’s lung transplant program, as well as advanced therapies, visit nm.org. 

To learn more about Josh's journey, click here. 

CHICAGO, IL – September 19, 2023 – For the last three years, Justin Fiala, MD, has experienced the highest highs and the lowest lows while caring for critically ill COVID-19 patients in the Medical Intensive Care Unit (MICU) at Northwestern Memorial Hospital. He turned to oil painting as a form of therapy to release anxiety and stress through the height of the pandemic, the death of George Floyd, politicization of masking and the vaccine debate. Dr. Fiala’s art collection will publicly be displayed for the first time at TEDxChicago, a public event happening on Friday, Oct. 6, from 2-7 p.m. at the Harris Theater for Music and Dance.

“Painting has been a way for me to interpret the world around us and focus on the good instead of the bad. It’s always been my goal to publicly showcase my artwork, and I’m incredible honored to be chosen for TEDxChicago this year,” said Dr. Fiala, a pulmonary and critical care specialist with the Northwestern Medicine Canning Thoracic Institute. “When I was caring for COVID patients on a daily basis, it was hard not to internalize things. Critical care medicine is such a heavy field, and the visual arts have been a godsend for helping me process the gravity of it all.”

Dr. Fiala started painting as a child, but as life became busier with college and medical training, painting was pushed to the side. It wasn’t until the COVID pandemic hit that Dr. Fiala picked up his paint brush again, and started painting different scenes that were happening around him.

One painting shows a hand giving the peace sign with a mask hanging from the wrist. (See photo.)

“I was inspired to paint the hand displaying the peace sign amid the first glimpse of optimism during the summer of 2021. The dark-skinned hand is a nod to the racial disparities laid bare by the pandemic and the social justice movements that arose in its wake, while the 'V' it's signaling can be taken as representing peace, victory, and/or vaccination. The mask dangling at the wrist is a reminder to stay vigilant and continue masking when appropriate to protect the most vulnerable around us,” said Dr. Fiala.

Another painting depicts a COVID patient on ECMO – a life support machine that does the work of the heart and lungs. (See photo.)  

"The painting of the patient on ECMO explores some of the existential quagmires this kind of exceptional life support creates – for instance, a patient may be fully awake, aware that their lungs aren’t improving, and also inescapably aware that the only thing keeping them alive is the machine. As a doctor caring for these patients, I couldn't help but picture myself in that situation and wonder what decisions I'd make."

Dr. Fiala also donated a painting to Northwestern Memorial’s MICU called “Many Moons in the Medical ICU,” dedicated to the physicians, nurses, respiratory therapists, pharmacists and staff who risked their lives on the front lines. The painting hangs in The Renewal Room, a place for staff members who provide direct patient care to rest, reflect and unwind.

“This painting is recognition for the day in and day out sacrifices being made by front line health care workers, and it’s a love letter to my colleagues at Northwestern Medicine,” said Dr. Fiala. “The pandemic weighed particularly heavily on health care, and it has been heartbreaking to see so many of the colleagues that trained me – be they physicians, nurses, pharmacists, etc. – being driven out of the healing professions due to burnout and moral injury. To that end, I hope my art serves as a colorful 'thank you' to all my fellow health care workers who showed up early in the pandemic, kept showing up throughout, and are somehow continuing to persevere through it all."

TEDxChicago is offering a 20% discount on tickets to health care workers, first responders and students who write their occupation title at checkout and use the promo code TEDXCHICAGOLOVESTUDENTS8U4G.

The ticket is all-inclusive to the TEDxChicago experience, which includes seven TEDxChicago talks and over three live performances from the TEDxChicago stage; food and beverages from local vendors; and many opportunities to engage with local artists and fellow Chicagoans.

“TEDxChicago’s 2023 event is designed to encapsulate Chicago’s rich history of championing togetherness and embracing creativity in times of change,” said Dustin Huibregste, director and lead curator for TEDxChicago. “This immersive gathering beckons attendees to seize the spotlight, signifying an unwavering commitment to progress and unity.”

For more information, to purchase tickets, and to view the full biographies of speakers, performers, and event updates, visit tedxchicago.com.

Chicago – August 31, 2023 –  It was an emotional moment for Dan Spees of Lakewood, Ill., as the sound of the trumpet filled his Northwestern Medicine hospital room. Before receiving his double-lung transplant, Spees wondered if he would ever play again.

“I am so pleased to have this option back because I thought it was gone,” said Spees.

In 2018, the 64-year-old husband and father was diagnosed with pulmonary fibrosis (scarring of the lungs) caused by hypersensitivity pneumonitis, a rare immune disorder that triggers an allergic reaction when specific allergens are inhaled.

As the director of information technology for the Chicago Symphony Orchestra Association and an avid trumpet player, Spees found it increasingly difficult to keep up with his career and hobbies as his dependence on supplemental oxygen grew. By April 2023, he had to put down the trumpet altogether.

Four months after retiring his instrument, on August 3, 2023, Spees underwent a double-lung transplant at Northwestern Memorial Hospital. When Northwestern Medicine occupational therapist Brittany Hatlestad, OTR/L, learned of Spees’ musical ability, she suggested involving the trumpet in his rehabilitative care.

“Playing trumpet requires the patient to take deep breaths in and forceful exhales out through the mouth, which is reintroducing the breathing pattern that we want our transplant patients to utilize,” Hatlestad said. “It was wonderful to know that what he loved to do was also improving those foundational skills.”

“Recovery after a lung transplant is a journey of rebuilding both physical strength and confidence,” added Catherine Myers, MD, pulmonologist with the Northwestern Medicine Canning Thoracic Institute. “Occupational therapists like Brittany are essential in this process, guiding patients to regain their independence and engage in activities that matter most to them. I am so happy Dan’s medical team could help him return to the life he loves.”

Hatlestad monitored Spees’ blood oxygen levels as he played. His nurses and family watched as he warmed up with a few scales. Then Spees played Joy to the World at an ideal blood oxygen level of 98 percent. After hugging his wife, Spees shared that he texted his band director and told him to expect him back in the first chair by January 2024.

“I was able to do much more than I thought I would be able to do,” said Spees. “It’s still a long way to get back to where I want to be, but I know I’m going to make it. I’m very, very happy.”

Patients interested in being evaluated for a lung transplant can contact the referral line at 844.639.5864. For more information about Northwestern Medicine’s lung transplant program, as well as advanced therapies, visit nm.org. 

Chicago, IL – August 29, 2023 – Receiving a diagnosis of asthma, lung cancer or respiratory failure can be scary and challenging. Receiving care from a medical team that doesn’t speak your preferred language can make the experience more difficult. The Northwestern Medicine Canning Thoracic Institute Hispanic Program was recently launched to offer personalized care for lung and thoracic patients in their native language, making life-saving care more accessible for the Hispanic community and people who prefer to speak Spanish by removing cultural and linguistic barriers.

“Chicago and its surrounding areas are composed of a diverse population that continues to grow, but there isn’t a structured clinical program providing cutting-edge care for patients with lung or thoracic diseases in Spanish. People from different cultures may have specific needs for communicating with their physicians, and we’re honored to bring that personalized care to patients in their native language,” said Diego Mauricio Avella Patino, MD, a thoracic surgeon who grew up in Colombia and now leads the Northwestern Medicine Canning Thoracic Institute (CTI) Hispanic Program. “Speaking the same language provides a human touch, and we believe the CTI Hispanic Program will encourage patients to seek health care sooner, complete their recommended treatments, and experience better outcomes.”

In January, 45-year-old Nanci Alao of Chicago, Ill., was diagnosed with stage 1 lung cancer and underwent surgery with Dr. Avella to have the cancer removed. The surgery was successful, and Alao went home the next day cancer-free. She’s now back at work and no longer experiences pain and shortness of breath. Alao says, even though she understands English, Spanish is her primary language, and being able to communicate in Spanish with her medical team made the process seamless.   

“My care was excellent primarily because it was in Spanish,” said Alao. “Even though there are wonderful interpreters available at Northwestern Medicine, it’s different from being able to speak with a doctor in your same language. Dr. Avella explained the type of cancer I had and why follow up appointments are needed. If anything concerning appears down the road, I trust we’ll be able to detect it early. Having everything in Spanish was the best, and I felt like I was at home.”

Every team member with the CTI Hispanic Program speaks Spanish, and they have a dedicated phone line for patients who prefer to communicate in Spanish. The team includes a thoracic surgeon, pulmonologist, patient procedure schedulers, front desk staff, social workers, clinic nurses and operating room nurses.

“As the son of Mexican immigrants growing up on the southside of Chicago, I can personally relate to having the hardship of communicating with your doctor to truly comprehend issues with your health,” said Daniel Meza, MD, pulmonologist with the CTI Hispanic Program. “Our goal is to make patients feel comfortable talking with their medical team about everything from diagnosis to treatment, what they can expect shortly after surgery, and in the long-term. We want to provide this personalized care for as many patients as possible in the Chicagoland area.”

Thoracic services at the CTI Hispanic Program include surgical treatment for lung cancer, esophageal cancer, gastroesophageal reflux disease (GERD), lung transplantation and more. Pulmonary services include treatment for asthma, emphysema, long-term pulmonary disease, other respiratory illnesses and more. To view the full list of services and treatments, click here.

For more information or to schedule an appointment, call 847.738.4863.      

CHICAGO – July 13, 2023 – Long COVID occurs in approximately a third of COVID survivors and is now the third leading neurologic disorder in the United States. In May 2020, during the height of the pandemic, Northwestern Medicine physicians noticed this growing trend and established one of the first Comprehensive COVID-19 Centers in the United States to treat patients suffering from lingering impacts of the virus such as brain fog, shortness of breath and chest pain. Three years later, a new study published in the American Journal of Medicine reports key findings from more than 1,800 patients who were evaluated during the first 21 months at the Northwestern Medicine Comprehensive COVID-19 Center (CCC) with neurology, pulmonology and cardiology being the most commonly accessed specialties and still in high-demand today.  

“The COVID-19 public health emergency may be over, but the need for long COVID care still remains. To date, we’ve treated nearly 4,000 patients from 44 states at the CCC, and our team of 42 clinicians continue to see approximately 100 patients each month,” said Igor Koralnik, MD, chief of neuroinfectious diseases and global neurology at Northwestern Medicine, who is co-director of the Comprehensive COVID-19 Center. “The disease burden of long COVID continues to grow in this country with significant implications for the economy and population health.”

“Due to widespread vaccination, rates of acute COVID infection have decreased significantly, however, millions of patients are still suffering from persistent symptoms that may have occurred years ago,” said Marc Sala, MD, pulmonary and critical care specialist at Northwestern Medicine, who is co-director of the Comprehensive COVID-19 Center. “To date, little is known about the characteristics and outcomes of patients seeking care at multidisciplinary post-COVID centers and the approach to caring for these patients widely varies among institutions and providers. This study will help us understand what the biological causes of those symptoms are and how to structure clinics to care for them.”

KEY FINDINGS

The team evaluated 1,802 patients (350 post-hospitalization and 1,452 non-hospitalized) via telehealth or in-person at the CCC between May 2020 and February 2022. Patients were seen in 2,361 initial visits in 12 specialty clinics including neurology, pulmonology, cardiology, otolaryngology, gastroenterology, infectious diseases, endocrinology, nephrology, hematology, dermatology, psychiatry and rheumatology. Patients most commonly sought treatment from neurology (49%), pulmonology (25%) and cardiology (12%) specialists.

Among patients tested:

-        85% of patients reported decreased quality of life

-        51% had cognitive impairment

-        45% had altered lung function

-        83% had abnormal CT chest scans

-        12% had elevated heart rate on rhythm monitoring

-        Frequency of cognitive impairment and pulmonary dysfunction was associated with severity of acute COVID-19

-        Non-hospitalized patients with positive COVID-19 testing had similar findings than those with negative or no test results

DEMOGRAPHICS

-        65% of patients identified as female

-        Average age at first clinic visit was 47 years old

-        72% were White, 10% were Black, 4% were Asian and 13% were Hispanic

“The population predominantly consisted of females in their forties, and our data shows that critically ill, hospitalized, and non-hospitalized patients have distinct neurologic, pulmonary and cardiac manifestations of long COVID, which should be studied and treated differently,” said Joseph Bailey, MD, pulmonary and critical care specialist at Northwestern Medicine, who treats patients in the CCC.

“One of the key findings of this study is that there is a very wide range of long COVID manifestations that depend largely on the severity of acute COVID-19 illness, and that they can’t be treated with a ‘one size fits all’ approach,” said Dr. Koralnik. “Some patients who had severe COVID-19 may have sustained permanent organ damage, while persistent symptoms in those with mild initial disease may be caused by different mechanisms. This requires an individualized, precision medicine approach to long COVID care.”

“There is a great need for multidisciplinary clinics to form the backbone of the response to long COVID. With multiple clinicians caring for and evaluating patients under the same roof, multidisciplinary long COVID clinics can recognize and respond to different presentations and manifestations of long COVID more quickly than other care models,” added Dr. Sala. “This study is the first to show the impact of a multidisciplinary effort and could be an example for use in future viral outbreaks.”

For more information on the CCC, visit nm.org and to schedule an appointment, please call 312.926.9900.

CHICAGO – March 15, 2023 – Cancers of the lung are the leading cause of cancer-related deaths in the United States with more people dying of lung cancer than colon, breast and prostate cancers combined. For the second time at Northwestern Medicine, surgeons have successfully performed a double-lung transplant on a patient with stage 4 lung cancer who was being considered for hospice. The treatment option is now available for select patients with stage 4 lung cancers confined to the lungs in a first-of-its-kind clinical program at Northwestern Medicine called Double Lung Replacement and Multidisciplinary Care (DREAM).

“These are patients diagnosed with some forms of lung cancer that have spread within the lung, are out of treatment options and have limited time to live,” said Ankit Bharat, MD, chief of thoracic surgery and director of Northwestern Medicine Canning Thoracic Institute. “In this unique program we will include select patients with some forms of lung cancer that are limited to the lungs for the consideration of double-lung transplant if conventional or experimental treatments have failed. The purpose of DREAM is to provide the most comprehensive multidisciplinary care for these complex patients.”

“We’re excited to formally launch this unique multidisciplinary program that will include highly experienced specialists across disciplines such as thoracic surgery, pulmonary, and oncology, to help some of the most hopeless patients,” said Rade Tomic, MD, pulmonologist and medical director of the Northwestern Medicine Canning Thoracic Institute Lung Transplant Program.

On September 25, 2021, at the age of 54, Albert Khoury from Chicago, Ill., became the first patient with stage 4 lung cancer to receive a lung transplant at Northwestern Medicine. In early 2020, Khoury was working as a cement finisher when he developed back pain, sneezing, chills, and a cough with mucus. At first, Khoury thought it was COVID-19, but then he was diagnosed with lung cancer and ended up in the intensive care unit on a ventilator when chemotherapy treatments failed. As hospice care was being considered for Khoury, Northwestern Medicine surgeons determined that because his tumor was localized to the chest completely encasing both lungs and hadn’t spread to other parts of his body, he was a candidate for a double-lung transplant. Eighteen months after receiving the lifesaving surgery, Khoury still has no signs of cancer left in his body and has returned to work.

“My life went from zero to 100 because of Northwestern Medicine,” said Khoury. “You didn’t see this smile on my face for over a year, but now I can’t stop smiling. My medical team never gave up on me.”

As Khoury was receiving his transplant in September 2021, Tannaz Ameli of Minneapolis, Minn., was struggling with a lingering cough. By January 2022, the retired nurse went to a large health system in Minnesota where they confirmed she had stage 4 lung cancer. When chemotherapy treatments didn’t help and hospice was recommended, Ameli’s husband reached out to the Northwestern Medicine Canning Thoracic Institute’s Second Opinion Program. Because Ameli’s cancer was confined to the lungs and hadn’t spread to other parts of the body, the 64-year-old was listed for a transplant and received new lungs within 10 days on July 13, 2022.

“I begged my doctors in Minnesota to consider a lung transplant, but they wouldn’t do it. Luckily, my husband refused to give up and pushed for a second opinion,” said Ameli. “When I came to Northwestern Medicine, the first thing Dr. Bharat told me was, ‘I think we can make you cancer-free,’ and he delivered on those words. If you or your loved one has complex conditions such as lung cancer, Northwestern Medicine is the place to be. Everyone is amazing and I can’t thank them enough for saving my life.”

Khoury and Ameli didn’t require any further cancer therapy after transplant. 

“Innovation and research have always been a foundational cornerstone at Northwestern Medicine and we’re committed to continually improving the field of transplantation,” said Satish Nadig, MD, PhD, transplant surgeon and director of the Northwestern Medicine Comprehensive Transplant Center. “Liver transplantation for cancer is commonplace, and while it’s not suitable for all, it’s highly effective in many. Further, transplantation for metastatic cancer to the liver, from the colon, for example, is now past proof-of-concept. It will be exciting to better understand whether we can use transplant principles for certain lung cancer types that have only spread within the lungs.”

Northwestern Medicine surgeons were the first to perform double-lung transplants on COVID-19 patients in the United States, and in the largest single-center series published to date, the post-transplant survival at one year for those patients was above 90%, exceeding national metrics. Using lessons learned from pioneering COVID-19 lung transplantation, Northwestern Medicine surgeons developed a novel surgical technique to clear the cancer during surgery while minimizing the risk of spread that has plagued prior such attempts at other hospitals.

“While lung transplantation is an accepted indication for certain forms of lung cancer by national organizations, it’s infrequently performed due to the concerns of recurrence following surgery. Unlike the conventional technique of sequential transplants, this innovative technique involves putting the patient on full heart and lung bypass, delicately taking both cancer-ridden lungs out at the same time along with the lymph nodes, washing the airways and the chest cavity to clear the cancer, and then putting new lungs in,” said Dr. Bharat. “These patients can have billions of cancer cells in the lungs, so we must be extremely meticulous to not let a single cell spill into the patient’s chest cavity or blood stream. We believe this technique can help reduce the risk of recurrence, which we learned through our experience with pioneering COVID-19 lung transplants.”

“Similar to our experience with COVID-19 lung transplantation, when it comes to donor lung availability, we do not anticipate causing any disadvantage to the non-cancer patients awaiting lung transplant,” said Dr. Tomic. “We plan to mitigate any issues with donor lung availability using our newly launched 'lungs in a box' program, where our surgeons can repair damaged lungs and successfully use them for transplant.”

The outcomes of the program’s first 75 patients will be tracked in a new research registry also called DREAM (Double Lung Transplant Registry Aimed for Lung-limited Malignancies – a prospective observational registry study for patients undergoing lung transplantation for some forms of medically refractory lung cancer confined to the lungs) available on ClinicalTrials.gov. The research registry is focused on the outcomes of the treatment intervention. Participation in the research registry is voluntary. A patient may receive a double-lung transplant as part of the DREAM clinical program, without enrolling in the DREAM research registry.

“Encouraged by our first two patients, the goal of following these registry participants is to maintain close follow-up care by our multidisciplinary team and demonstrate good outcomes while learning new insights about lung cancer,” said Young Chae, MD, medical oncologist at Northwestern Medicine.

Patients interested in being evaluated for a lung transplant can contact the referral line at 844.639.5864. For more information about Northwestern Medicine’s lung cancer and lung transplant programs, as well as advanced therapies, visit nm.org.  

CHICAGO – When patients suffer life-threatening illness or injuries that prevent their lungs or heart from working properly, extracorporeal membrane oxygenation (ECMO), or extracorporeal life support, is needed. ECMO removes blood from the body, oxygenates it and returns it to the body, acting as artificial lungs. This allows the patient’s lungs to rest and provides more time for medical treatments to address the underlying condition. ECMO is typically performed at larger medical centers that have advanced technology for supporting the heart and lungs.

“When medications and a breathing machine aren’t enough, ECMO can serve as a ‘bridge’ to medical improvement or a lung transplant,” said Kalvin Lung, MD, thoracic surgeon with Northwestern Medicine Canning Thoracic Institute. “We tend to use ECMO for patients suffering severe lung failure from illness and injuries such as COVID-19, the flu, pneumonia, drowning and gunshot wounds. ECMO has fewer complications than intubating, or using a ventilator, to assist the lungs. In large part, we’ve become so much better with using ECMO because of COVID-19 and the flu.”

During the height of the COVID-19 pandemic, with more patients needing ECMO support, the Northwestern Medicine Regional Lung Rescue Program was created to provide community hospitals access to ECMO therapy. Because most patients with acute lung failure are too unstable for transport, the Regional Lung Rescue Program is mobile. The medical team travels to hospitals across Illinois, where they initiate ECMO at the bedside before safely transporting the patient via ambulance equipped with built-in ICU equipment to Northwestern Memorial Hospital in downtown Chicago for further treatment.

“Without ECMO, many of these patients wouldn’t have survived,” said Ankit Bharat, MD, chief of thoracic surgery and director of Northwestern Medicine Canning Thoracic Institute. “Since time is of the essence, we’re in constant communication with regional hospital staff to ensure all the necessary medications and resources are mobilized. During times like these, collaboration is vital and their work ahead of time plays a big part in the efficiency of the ECMO procedure.”

“Northwestern Medicine offers a comprehensive and multidisciplinary regional ECMO program. We have found this approach highly successful, and we want to train other physicians, nurses and respiratory therapists so they can offer the same level of care at their own institutions,” said Dr. Lung.  

On Wednesday, Feb. 15, Dr. Lung and his colleagues hosted a hands-on, interactive ECMO training course inside the new simulation and education center at Northwestern Medicine Lake Forest Hospital. The center includes numerous point of care spaces, including an ambulance and full-size operating room, where two ECMO scenarios will play out with simulation manikins. Participants include Northwestern Medicine thoracic surgeons, critical care physicians, ECMO specialists, respiratory therapists, nurses and local paramedics.

“Community hospitals not having access to ECMO is a nationwide problem,” said Randy Orr, MD, pulmonary and critical care specialist at Northwestern Medicine Lake Forest Hospital. “ECMO simulation isn’t widely used, and this is a wonderful opportunity to not only educate the medical community about ECMO and the Northwestern Medicine Regional Lung Rescue Program, but to promote the opening of the simulation and education center at Lake Forest Hospital and its benefits to clinical education.”

“Our goal is to offer this ECMO training course to hospitals across Illinois and eventually have it be replicated in other states. Whether you’re receiving care at an academic medical center or a community hospital, we want ECMO to be a universally available tool for treating severe lung failure,” said Dr. Lung.

To schedule an ECMO training course, contact Colleen McNulty at colleen.mcnulty@nm.org or 872.769.0467. For more information about ECMO at Northwestern Medicine, visit nm.org.   

Chicago – December 19, 2022 – Jessica Lopez is grateful to be alive this Christmas after surviving rare, life-threatening blood clots in her lungs.

In December 2021, the 32-year-old from Kissimmee, Fla., was on a cross-country road trip with her brother when her health took a turn for the worse.

“We’d done some sightseeing in Chicago the day before,” said Lopez. “The next morning, I woke up at the hotel and felt like there was something in my chest. I went to the bathroom and started coughing up blood.”

Lopez’s brother walked her across the street to the emergency department at Northwestern Memorial Hospital where CT scans revealed she had chronic thromboembolic pulmonary hypertension (CTEPH)– a condition where chronic blood clots obstruct the flow of blood to the lungs causing elevated blood pressure in the lung’s arteries.

“This is a very specialized disease state,” said Michael J. Cuttica, MD, pulmonologist at Northwestern Medicine Canning Thoracic Institute. “Not many people understand this disease or recognize it. I think this is evident by the fact that she had about five years of symptoms before she was finally diagnosed.”

While the diagnosis initially worried Lopez, it did provide some answers. The flat-track roller derby player had developed years of progressive shortness of breath and had to end her career with Orlando Roller Derby. Eventually, she had trouble just walking around her house.

After a few days of testing and treatment with the CTEPH team at Northwestern Medicine, Lopez underwent pulmonary thromboendarterectomy surgery (PTE), which can be curative.

“What’s special about Jessica’s case is that the right lung was completely blocked off by the clot. And there was smaller, harder-to-reach segmental disease on the left side,” said S. Chris Malaisrie, MD, cardiac surgeon at Northwestern Medicine Bluhm Cardiovascular Institute. “We are one of the few centers in the country to offer this curative surgery and the only multidisciplinary team in Illinois. The fact that she happened to be staying in a hotel across the street from a hospital that offers this is miraculous.”

One week after Christmas, Lopez was discharged from Northwestern Memorial and made the trek home to Florida. While blood thinning medication prevents her from returning to roller derby, she’s grateful to get back to other favorite activities like hiking and weightlifting.

“This whole ordeal has been life-changing,” said Lopez. “My brother was my saving grace and I’m incredibly grateful for my team at Northwestern Medicine. Any awareness I can bring to this disease going forward will be a major positive in my life.”

For more information about the Northwestern Medicine CTEPH team, visit nm.org.

Chicago, IL – Northwestern Medicine surgeons have successfully performed the health system’s first successful combined lung-liver transplant. The patient, 63-year-old Patricio Collera of Vernon Hills, Ill., is a retired nurse who worked at Northwestern Memorial Hospital for several years before being diagnosed with interstitial lung disease and nonalcoholic liver disease, which caused scarring of the lungs and liver cirrhosis. Less than 10 days after being added to the waitlist for new organs, Collera received the call on Aug. 24 that a new lung and liver were available. Thanksgiving Day marks three months since Collera received the lifechanging news, and he’s grateful to those who helped give him a second chance at life.   

“Without my transplant team and donor, I wouldn’t be here today,” said Collera. “Being the first Northwestern Medicine patient to successfully receive a combined lung-liver transplant will be my legacy, and it’s even more special receiving my new organs at the same place where I once worked as a nurse.”

Born in the Philippines, Collera trained to become a nurse and moved to the United States in 1988 with his family. For 25 years, he worked as a PICC line nurse, including two years at Northwestern Memorial, where he inserted catheters into veins for medications, fluids, nutrition and blood transfusions. In 2017, Collera developed a terrible cough, and by 2019 his breathing was so bad that he relied on supportive oxygen 24/7 and had to stop working.

“My life was miserable. I had to drag 50 feet of tubing and oxygen tanks with me everywhere I went. One tank would only last 30 minutes, so I’d have to bring two tanks with me to the grocery store,” said Collera.  

In February 2022, Collera was evaluated for a lung transplant, and testing showed his liver was fibrosed by 75 percent. This meant, Collera would also need a liver transplant to withstand the transplant medications he’d be on for the rest of his life.

“I immediately sent messages across the country to top-tier transplant centers and was informed that a lung-liver transplant wasn’t possible due to my age or their team’s lack of experience. One doctor told me, ‘Don’t do it – you’re going to die,’” said Collera. “But when I turned to Northwestern Medicine, I started crying tears of relief when they said, ‘Yes – we can do it.’”  

Collera was listed for a double-lung and liver transplant on Aug. 15, and by Aug. 24 he received the call that a single-lung and liver were available. Even though he was listed for a double-lung transplant, the team encouraged him to take the organs.

“A lung-liver transplant procedure is very rare. To date in the United States, only ten have been performed in 2022,” said Rade Tomic, MD, pulmonologist and medical director of the Northwestern Medicine Lung Transplant Program. “Patricio was in desperate need of a lung, and we didn’t have much time to keep waiting for a double-lung transplant. The outcomes of a single-lung transplant versus a double-lung transplant are very similar, so we decided to proceed with one lung because it was an excellent match.”

Once Collera was in the operating room, surgeons were in a race against the clock.

“With two different organs, you have to work twice as fast. You can’t start the second transplant until the first is completed and perfect. There’s zero margin of error. Many people are working closely to make this a success: lung team, liver team, anesthesiologists, nurses, perfusionists, donor team, etc. It’s an elegant and closely coordinated dance,” said Ankit Bharat, MD, chief of thoracic surgery at Northwestern Medicine Canning Thoracic Institute. “Patricio’s lung transplant was the fastest one I’ve ever done in my career, and the new lung is working great. In fact, his old left lung, new right lung and new liver are all very happy together.”

“Transplant is the ultimate team sport, and honestly, it’s one of the only fields I can think of that depends on humanity. Somebody has to give up their organs, either in life or in passing, to save someone else – often, someone they don’t know,” said Satish Nadig, MD, PhD, chief of organ transplantation at Northwestern Medicine. “With all the things happening in the world, it’s not only amazing to be able to replace someone’s lung and liver and they go on to live a normal life, but to also know we’re honoring the gift that someone has given up themselves.”

This Thanksgiving, Collera is looking forward to spending quality time with his wife, Evelyn, their children and grandkids. He’s now on a mission to share his story and bring hope to other patients.

“Look at me! No supportive oxygen and I’m free of tubing,” said Collera. “Because of Northwestern Medicine and my donor, I’m home for the holidays and doing well. I will not waste this lung and liver. I will live a good life and do something meaningful with it. Thank you from the bottom of my heart – you let me live.”

For more information about Northwestern Medicine’s lung and liver transplant programs, visit nm.org.

CHICAGO, IL -  At 34-years-old, firefighter Frank Nunez has spent the past few days saying his final goodbyes from a hospital room at Northwestern Memorial Hospital in Chicago.

In 2019, after experiencing pain in his left leg, Frank was diagnosed with a rare form of soft tissue cancer called synovial sarcoma. Frank was treated with chemotherapy, radiation, and surgery, and went into remission.

But in 2021, the cancer returned in his left lung. Frank participated in several clinical trials, and during his treatment he never stopped working at the Itasca Fire Protection District in Itasca, Illinois. 

Frank loved being a firefighter and had an incredibly strong work ethic. He started his career in 2014 and joined the Itasca Fire Protection District in 2018. Frank responded to fire alarms and medical emergencies and participated in fire prevention and training. He recently finished a fire inspector training class before being admitted to Northwestern Memorial in late September with terminal cancer.

During this hospitalization, Frank’s fellow firefighters have never left his side, rotating visits every day. Because Frank is intubated, the team communicates with Frank via text messages and dry erase boards. When asked to describe Frank, his colleagues told him:

• They wish they could have his personality
• He was admired
• A warrior
• Intelligent
• An incredible human

On Wednesday, Sept. 21, Frank celebrated his 34^th birthday with a commitment ceremony to his fiancé, Christina, inside his hospital room at Northwestern Memorial. Frank and Christina, who live in Crystal Lake, Illinois, met two months before Frank was diagnosed with cancer in 2019. From the moment they started dating, Frank knew Christina was “the one.” They got engaged in June 2022, and share a dog, Max, who still waits by the door for Frank to come home.

“All of my patients are absolutely wonderful, but every so often we get these phenomenal people like Frank who you just know would walk in a room and light up the room and make everyone feel safe,” said Khalilah Gates, MD, pulmonary and critical care specialist at Northwestern Memorial Hospital. “To provide care for Frank means a lot.”

“When you talk about someone who is dedicated and loves life, you're talking about Frank,” said Itasca Fire Chief Jack Schneidwind. “He has not missed a day and always came in with a great attitude wanting to make a difference to the people that we serve. When you talk about somebody who looked forward to living each day, that was Frank.”

Frank continues to provide counsel to other loved ones battling cancer – including his own mother, who just received a stem cell transplant for leukemia at Northwestern Memorial. Frank’s mother was able to visit him in the Medical Intensive Care Unit where the two shared their final goodbyes via messages on the dry erase board.

On Tuesday, Sept. 27, Frank went home on hospice care with a special escort. Itasca firefighters transported Frank in the very same ambulance he once used to transport patients. Members of the Chicago Fire Department were also there to salute Frank as he was lifted into the ambulance. As a first responder, Frank took his final ride home with his fellow firefighters, his fiancé, and furry friend Max – who couldn’t wait any longer for his best friend to come home. 

UPDATE: Frank died at his home on Sunday, Jan. 22, 2023. 

“I now call myself ‘Colette 2.0’ – new and improved. I have a second chance at life,” said Hurd.

In May 2020, Hurd noticed she was short of breath, but it wasn’t COVID-19. She was diagnosed with pulmonary hypertension (PH), which refers to high blood pressure in the lungs. PH is a rare disease that affects the blood vessels in the lungs and the right side of the heart. It causes the heart and lungs to weaken over time, which ultimately leads to death. 

By May 2021, Hurd’s lungs were failing, and she was admitted to Northwestern Memorial for consideration of a double-lung transplant. Due to Hurd’s heart failing on the right side, it caused poor kidney perfusion, which meant – Hurd also needed a kidney transplant. 

On July 7, 2021, Hurd was listed for a lung and kidney transplant, but it was difficult to find a match. 

Hurd was highly sensitized – meaning, she had developed a lot of antibodies in her bloodstream. This can happen during childbirth or through previous blood transfusions. Bottom line, these antibodies would reject new organs in Hurd’s body. 

 So, the transplant team took a chance. 

 On May 15, 2022, they accepted organs that were not the right match and created a protocol to get rid of the antibodies in Hurd’s bloodstream to make her a good match. 

They wiped Hurd’s immune system so she wouldn’t reject the new organs. This was achieved through medications and plasmapheresis treatment before and after surgery, which involves removing blood through a catheter and circulating it in a machine to remove the antibodies. Hurd was the first Northwestern Medicine lung transplant patient to receive this treatment. To date, it’s now been performed on five more Northwestern Medicine lung transplant patients. 

“Colette has opened the door for many more patients across the country who would otherwise die while waiting for a lung transplant,” said Rade Tomic, MD, medical director of the Northwestern Medicine Lung Transplant Program. “Until Colette, this type of treatment, where we immediately administer medications and plasmapheresis before and after surgery, was only done in Toronto for lung transplant patients. It’s very uncommon.”

“Transplant is such a young field that we’re still learning what the boundaries are,” said Satish Nadig, MD, PhD, chief of organ transplantation at Northwestern Medicine, who performed Hurd’s kidney transplant. “With Colette’s case, our transplant team was able to push that boundary, immunologically speaking, even further to the benefit of those requiring life-saving organs globally.”

During her 15-month hospitalization, Hurd developed strong relationships with her medical team – especially Kari Brouwer, OTR/L, a Northwestern Medicine occupational therapist, who helped Hurd’s husband, Dennis, surprise his wife with a vow renewal at the hospital chapel for their 20^th wedding anniversary.

“Colette is such a bright light and rubs off on everyone she meets,” said Brouwer. “She wants to support you, remembers your name, renews your hope, and reminds you why you got into health care in the first place. We will never forget her.”

On August 11, hospital staff lined the hallway, cheering Hurd on as she was officially discharged from Northwestern Memorial.  

“This team at Northwestern Medicine never gave up on me. Even though I had so many issues with the antibodies in my blood, they were always thinking outside the box,” said Hurd. “I hope my story encourages others to register as organ donors – especially the African American community. I’ve been a registered donor since I first got my driver’s license, and we need more African Americans to sign up as donors. It will help someone else – just like somebody helped me.”