Pulmonologist Dr. Gary Gibbon never expected he would be diagnosed with a lung disease, much less that he would need new lungs.
“I had no prior significant medical history. I didn’t take any medications on a regular basis,” Gibbon, who lives in Santa Monica, Calif., told NBC News.
Because of his cough and weight loss, Gibbon underwent 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 told he had advanced stage lung cancer.
Lung cancer is by far the leading cause of cancer death in the United States, accounting for approximately one in five cancer deaths each year. American Cancer Society.
After months of aggressive treatment with chemotherapy, radiotherapy and immunotherapy, the gibbon’s cancer had shrunk, but its lungs had suffered irreversible damage. Doctors determined that Gibbon had exhausted treatment options.
“We’ll just have to throw in the towel,” Gibbon said. “He would have been on palliative hospice care starting in July 2023.”
Then he remembered a news article he had seen earlier and thought it might save his life.
Last year, NBC News reported on a breakthrough treatment for patients with terminal lung cancer: the first-ever successful double-lung transplant in two patients.
After the story aired, Gibbon’s wife, Nora Lawler, took her husband into the living room to watch it. Although he had already been diagnosed with lung cancer, “I never thought this was something we needed,” Lawler said.
According to conventional treatment, the fact that Gibbon had terminal lung cancer disqualified him as a transplant candidate. But according to an NBC News article, doctors at Chicago’s Northwestern Medical School were doing just that.
Lung transplants for cancer patients have historically been for people in the early stages of cancer, and involved transplanting one lung at a time. Techniques come with risks. Cancer can spread from the remaining lung and contaminate the new lung, and surgical incisions can leak cancer cells into the bloodstream.
northwestern medicine dream program pioneered a new approach that was successfully implemented in two patients with stage 4 lung cancer. The surgical team removed both cancerous lungs from her body at the same time and replaced them with her two healthy transplanted lungs, greatly reducing the risk of cancer cells contaminating both the new organ and other parts of the body. To do. Since 2021, the team has successfully performed more than 30 lung transplants for advanced lung cancer.
Gibbons asked the California doctor to contact Northwestern and pitch him as their next candidate. Since his cancer had not spread outside the lungs, he would not have been eligible for surgery. However, initial tests revealed another complication. As a result of cancer treatment, Gary’s liver had begun to fail.
He now required three transplants: two lungs and one liver.
Such a procedure for cancer patients “has never been done in this country,” said Dr. Ankit Bharat, director of Northwestern Medicine’s Chest Institute.
lifesaving logistics
The team needed to quickly decide whether to try this procedure. Gibbon had liver and lung problems and was already in UCLA’s intensive care unit. He was malnourished and required oxygen. Finding a way to safely transport him from Los Angeles to Chicago was just the beginning.
“after that [we had] The need to determine his eligibility for something that has never been done before and then, with team agreement, decide on all the steps to take to make him survive a complex double lung and liver transplant. There is,” Bharat said. .
The team had the technology and skills to perform this procedure, but they didn’t know exactly how. Dr. Satish Nadig, a colleague of Bharat’s and director of the Center for Comprehensive Transplantation and director of organ transplantation at Northwestern University Feinberg School of Medicine, remembers the phone call he received last summer telling him about the gibbon case.
“My first thought was, ‘How am I going to get this done?'” Nadig said. “This patient needed it, and we were the only ones in the world who could do it.”
A month after his first video call with Northwestern doctors, Gibbon was in Chicago. Four days after his arrival, a lung and liver set became available.
The procedure was incredibly complicated.
“On a scale of 1 to 10, this is off the charts,” Nadig said, noting that lung and liver transplants are two of the most difficult transplants to perform alone, but in combination. He pointed out that it was even worse.
A new technique called liver perfusion, also known as “liver in a box,” kept the donated liver alive while surgeons carefully removed the gibbon’s cancerous lung and replaced it with a transplanted liver. A perfusion device was installed in the operating room to pump warm blood into the new liver, keeping it alive and functioning as it would in the body until the gibbon’s body was ready.
Incredibly, the surgery, which normally takes at least 14 hours, took the team just 10 hours.
Six months after surgery, the gibbon is cancer-free.
Laura remembers the first moment she saw her husband’s chest rise and fall as his new lungs expanded. It was a sight she hadn’t seen in months, and she says it was “the most beautiful moment for me.”
Bharat said the biggest lesson his care team of more than 20 people learned through Gibbon’s transplant was that a good team can redefine what is possible and what is not. He believes more transplant centers will soon be performing these more complex surgeries.
“We are already receiving inquiries from other centers asking if they can participate in this program,” Bharat said. “What is possible is often a function of team and experience.”
He encourages patients who are told they don’t have a choice to do their homework. Nadig said he was amazed at the role of media in connecting Gibbon with the DREAM program.
When asked what would have happened if she and her husband hadn’t seen the NBC News report, Lawler was quick to respond. “He would have died.”
