Melissa Benoit’s terminal lung infection called for risky and unprecedented procedure while she waited for double transplant at Toronto hospital In what is believed to be the first procedure of its kind in the world, doctors in Canada have saved a young mother’s life by resorting to a radical solution – they removed her lungs for six days while she waited for a transplant. In April, Melissa Benoit arrived at a Toronto hospital with a severe lung infection. Doctors soon realised that Benoit, who had been born with cystic fibrosis, had just hours to live, leading them to consider the unprecedented approach. “It was a difficult discussion because when we’re talking about something that had never to our knowledge been done before, there were a lot of unknowns,” Dr Niall Ferguson of the University Health Network, the health authority responsible for the Toronto general hospital, told a news conference on Wednesday. A recent bout with influenza had left the then 32-year-old fighting off respiratory failure, forcing doctors to keep her sedated and on a ventilator to help her breathe. “She got into a spiral from which her lungs were not going to recover,” said Ferguson. “Her only hope of recovery was a lung transplant.” Benoit was put on a temporary life support device but her condition continued to deteriorate; the bacteria in her lungs became resistant to most antibiotics, sending her body into septic shock and her blood pressure dropping. One by one, her organs began shutting down. Her team of doctors gathered together to weigh a bold solution they had contemplated for years but never carried out – the removal of both her lungs in hopes of eliminating the source of the bacterial infection. The list of unknowns was long, from the risk of bleeding into the empty chest cavity to whether her blood pressure and oxygen levels could be sustained once her lungs were removed. “What helped us is the fact that we knew it was a matter of hours before she would die,” said Dr Shaf Keshavjee, one of three surgeons who operated on Benoit. “That gave us the courage to say, if we’re ever going to save this woman, we’re going to do it now.” Benoit’s husband, Chris, gave doctors the go-ahead, thinking of their three-year-old daughter. “We needed this chance,” he said. “Things were so bad for so long, we needed something to go right.” In mid-April, a team of 13 began a nine-hour surgery to remove Benoit’s lungs. Filled with mucous, each lung was swollen and as hard as a football, said Keshavjee. “Technically, it was difficult to get them out of her chest.” Hours later, her condition began to dramatically improve. “And literally within minutes – it was probably around 20 minutes after having taken those infected lungs out – her blood pressure normalised, and they could remove all the blood-pressure-supporting drugs and just leave her on the pumps that were providing the circulation,” Keshavjee told the Canadian Press. A small artificial lung was connected to Benoit’s heart, while other devices oxygenated and circulated her blood. As they waited for replacement lungs to become available, doctors wondered how long she could be supported like this. “We didn’t know if we’d get [them] in one day or one month,” said Keshavjee. Six days later a pair of donor lungs became available and Benoit underwent a successful lung transplant. Since then, her strength has steadily improved. Months in the hospital had initially left her without the ability to hold her head up, sit up or stand, but in the past month she has begun walking without a cane or walker. The ordeal also damaged her kidneys, but Benoit is soon hoping to be well enough to receive a kidney transplant from her mother. When Benoit first learned of the surgery that had saved her life, she didn’t believe it. “It took me a while to realise what happened. I just couldn’t piece it together,” she said. “You really come from the brink of death to back living at home. But I’m just so grateful, so happy to be home.” Source
