As a pulmonologist, Dr. Gary Gibbon never expected to be diagnosed with lung disease himself, let alone need a new set of lungs.
“I had no significant medical history. I wasn’t taking any medications regularly,” Gibbon, of Santa Monica, Calif., told NBC News.
When he started coughing and then lost weight, Gibbon had a chest X-ray and a CT scan of his lungs. The results were shocking. In the spring of 2023, Gibbon, who recently turned 69, was diagnosed with advanced lung cancer.
Lung cancer is by far the leading cause of cancer deaths in the United States, accounting for approximately 1 in 5 cancer deaths each year, according to the American Cancer Society.
After months of aggressive treatment with chemotherapy, radiation and immunotherapy, Gibbon’s cancer had shrunk, but his lungs were suffering irreversible damage. His doctors determined that Gibbon had exhausted his treatment options.
“I should throw in the towel,” Gibbon said. “I would have been in palliative care from July 2023.”
It was then that he remembered a news report he had seen that he thought could save his life.
Last year, NBC News reported on a breakthrough treatment for patients with advanced lung cancer: the first-ever double lung transplant, successfully performed on two patients.
When the story aired, Gibbon’s wife, Nola Roller, dragged her husband into their living room to watch it. He had already been diagnosed with lung cancer, but “I didn’t even realize it was something we were going to need,” Roller said.
Under conventional treatment, the fact that Gibbon had advanced lung cancer disqualified him as a transplant candidate. But in the NBC News article, that’s precisely what doctors at Northwestern Medicine in Chicago were doing.
Lung transplants in cancer patients have historically been reserved for people with early stages of cancer and involved replacing one lung at a time. The technique is risky. Cancer can spread from the remaining lung, contaminating the new one, and surgical incisions can allow cancer cells to infiltrate the bloodstream.
Northwestern Medicine’s DREAM program pioneered a new approach that was successfully performed on two stage 4 lung cancer patients. By simultaneously removing both cancerous lungs from the body and replacing them with two transplanted healthy lungs, the surgical team significantly reduces the risk of cancer cells contaminating both the new organs and other parts of the body. The team has successfully performed more than 30 lung transplants for advanced lung cancer since 2021.
Gibbons asked his doctors in California to contact the Northwest team to introduce him as the next candidate. His cancer had not spread outside his lungs, which would have disqualified him for surgery. But initial tests revealed another complication: Gary’s liver had begun to fail because of his cancer treatments.
He now needed a triple transplant: two lungs and a liver.
This procedure in a cancer patient “had not been done in this country,” said Dr. Ankit Bharat, director of the Northwestern Medicine Canning Thoracic Institute.
Rescue logistics
The team had to quickly decide whether or not to attempt the procedure. Gibbon was already in UCLA’s intensive care unit with liver and lung failure. He was malnourished and on oxygen. Figuring out how to transport it safely from Los Angeles to Chicago was only the beginning.
“Then (we had to) determine his eligibility for something that had never been done and then get consensus from the team and figure out all the steps we would have to take to get him through a complex double lung and a liver transplant,” Bharat said.
The team had the technology and skills to perform the procedure, but they didn’t know exactly how. Bharat’s colleague, Dr. Satish Nadig, director of the Comprehensive Transplant Center and chief of organ transplantation at Northwestern University Feinberg School of Medicine, remembers the phone call he received from Bharat last summer to talk to him about Gibbon’s case.
“The first thing I thought was, ‘How can we achieve this?’ “, Nadig said. “This patient needed it, and we were the only place in the world that could do it. »
A month after an initial video call with Northwestern doctors, Gibbon was in Chicago. Four days after his arrival, a set of lungs and a liver were available.
The procedure was incredibly complex.
“On a scale of 1 to 10, this is out of the ordinary,” Nadig said, noting that lung and liver transplants are two of the most difficult transplants to perform alone, let alone combined.
A new technology called liver perfusion, sometimes called “liver in a box,” kept the donated liver alive while surgeons carefully removed Gibbon’s cancerous lungs and replaced them with the grafts. The perfusion machine was in the operating room, pumping blood at body temperature through the new liver to keep it alive and functioning as it would inside the body, until the body of Gibbon be ready for this.
Incredibly, an operation that would normally take at least 14 hours only took the team 10.
Six months after surgery, Gibbon is cancer-free.
Roller remembers the moment she first saw her husband’s chest move up and down as the new lungs inflated, something she hadn’t seen in months and describes as “the most beautiful moment for me.”
Bharat said the biggest lesson the care team of more than 20 people learned from Gibbon’s transplant is that a good team can change the definition of what is or is not possible. He believes more transplant centers will soon be performing more complex surgeries like these.
“Other centers have already contacted us to ask if they could participate in this program,” Bharat said. “Often what is possible depends on the team and experience.”
He encourages patients to do their homework if they are told they are out of options. Nadig said he was surprised by the role the media played in connecting Gibbon to the DREAM program.
When asked what would have happened if she and her husband had not seen the NBC News report, Roller responded immediately. “He would have died.”
News Source : www.nbcnews.com
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