Northwestern Medicine doctors in Chicago successfully performed a double lung transplant on a second COVID-19 patient in July thanks to medical advancements involving animal research.

Animals models helped researchers develop extracorporeal membrane oxygenation (ECMO) life support, ventilators and transplant techniques the medical team used to save the lives of a man in his 60s and a woman in her 20s.

“Nothing compares to what we see now with these two cases with COVID. The amount of lung destruction is by far nothing I’ve really seen in my lifetime,” Dr. Samuel Kim, a thoracic surgeon at Northwestern Medicine, told ABC7 Chicago.

The Illinois man spent 100 days on ECMO before the procedure at Northwestern Memorial Hospital over the July Fourth weekend. The Hispanic woman survived the first known double lung transplant on a COVID-19 patient in the U.S. in June at the same hospital.

The damage to the first patient’s lungs was beyond repair. (Credit: Northwestern Medicine Lung Transplant Program)

The damage to the first patient’s lungs was beyond repair. (Credit: Northwestern Medicine Lung Transplant Program)

“Our first patient continues to recover at optimal pace,” Dr. Rade Tomic, medical director of Northwestern’s Lung Transplant Program, said in a statement on July 9. “Our second patient is already off the ventilator and is talking to his family.”

Both procedures lasted about 10 hours. The woman, who reportedly had no serious underlying health conditions, spent six weeks on a ventilator and ECMO device before the surgery.

The patients were eligible for new lungs after testing negative for COVID-19.

“Due to the ability of Northwestern Medicine’s ECMO program to support patients with life-threatening lung failure for extended durations, the patient could get adequate time to clear the virus from her body, allowing the consideration of transplantation,” Dr. Ankit Bharat, chief of thoracic surgery at Northwestern Medicine, said in a statement on June 11.

The Food and Drug Administration (FDA) expanded access to ECMO therapy, which researchers developed in sheep before use in humans, for management of patients with COVID-19 in April. The devices help oxygenate the blood of patients with heart or lung problems.

Here is an ECMO machine. (Credit: Northwestern Medicine Lung Transplant Program)

Here is an ECMO machine. (Credit: Northwestern Medicine Lung Transplant Program)

Dr. Robert Bartlett, 81, helped develop the life-saving technology, and his research with sheep made ECMO a reality. He successfully treated the first infant patient with ECMO at the University of California, Irvine in 1975.

“The heart-lung machine we [previously] used for cardiac surgery could support life, but only for a few hours. Our research determined the limitations and extended the use of mechanical life support to days, then weeks,” he said in a statement. “This was research that required experiments in animals.”

Research teams developing ventilator models for broad distribution in response to the COVID-19 pandemic used sheep, pig and goat models in preclinical trials around the world.

For example, an Auburn University team is working to mass produce an emergency ventilator device. The team built the CPAP-to-ventilator device, RE-InVENT, and successfully tested it with a goat in April.

“A functioning ventilator is one of the most important tools hospitals have for helping COVID-19 patients,” Dr. Stuart Clark-Price, who supervised the first animal test of the RE-InVENT device, said in a statement.

“In our test we were able to ventilate the goat and safely maintain appropriate oxygen content in its blood. Then it was brought out from under anesthesia and fully recovered to return to normal activity,” he continued.

Researchers ventilated a 200-pound goat at Auburn. (Credit: RE-InVENT project/ Auburn University)

Researchers ventilated a 200-pound goat at Auburn. (Credit: RE-InVENT project/ Auburn University)

Animal research is also valuable to lung transplant procedures for people such as the Northwestern Memorial patients. Doctors reportedly performed lung transplants on COVID-19 patients in China, Vienna, Australia and South Korea too.

Most transplantation research is with rodents, according to a 2007 Frontiers in Bioscience article; however, large animal models are also used to meet FDA safety requirements.

A team of researchers at the University of Texas Medical Branch in Galveston successfully transplanted bioengineered lungs into pigs, according to a study published in 2018. This breakthrough is paving the way for transplantation of bioengineered lungs in human patients.

Animal research is behind virtually every medical treatment. For instance, transplant recipients must take immunosuppressant drugs. Azathioprine and cyclosporin are frequently prescribed to patients who undergo lung transplants.

Researchers discovered azathioprine in the 1950s and demonstrated results in canine models. Scientists determined cyclosporin was safe for human clinical trials in 1976 after studying its effects with dogs, rats, pigs and nonhuman primates.

Animal research made it possible to save both COVID-19 patients in Chicago, whether they know it or not.

“We’re optimistic that both patients will make a full recovery and return to their daily lives,” Tomic said.

Medical breakthroughs will continue to get humanity through the coronavirus pandemic.

Visit the Foundation for Biomedical Research’s COVID-19 resources page to learn more about animal research on the front lines of the COVID-19 pandemic.

Featured image caption: Dr. Ankit Bharat is pictured with the second patient’s lung scan before surgery. (Credit: Northwestern Medicine Lung Transplant Program) 

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