Surgeons at Northwestern Medicine have successfully performed a double lung transplant on two patients who now remain cancer free — a potentially groundbreaking procedure for late-stage lung cancer patients.

Inside the procedure

When cancer spreads from one lung to the other and doesn't respond to standard treatments, patients typically have no options left, NBC News reports. Albert Khoury was diagnosed with lung cancer in 2020, and after two rounds of chemotherapy, the cancer had spread to both of his lungs.

"They told me, 'Just spend time with your siblings. You have a few months to live.'" Khoury said.

But in September 2021, Khoury received a double lung transplant at Northwestern, marking the first time a patient with stage 4 lung cancer had undergone the procedure. Since then, the procedure has also been performed on Tannaz Ameli, a 65-year-old woman who also had stage 4 lung cancer. Both patients are currently still cancer free.

"If all the options have been exhausted, only then are we going to consider this," said Ankit Bharat, chief of thoracic surgery and director of the Northwestern Medicine Canning Thoracic Institute.

Typically, lung transplants involve replacing one lung at a time, but the procedure can be risky, as the remaining cancerous lung can contaminate the new lung, and incisions can cause cancer cells to move into the bloodstream, NBC News reports.

At Northwestern, surgeons tried a different technique, removing and replacing both lungs at the same time while the patient is hooked up to a heart-lung bypass machine to keep them alive. The new technique wouldn't apply to every stage 4 lung cancer patient — only those whose cancer has spread from one lung to the other but nowhere else.

"Before we even enter the operating room, we've already established with a very high level of certainty that there is no cancer outside the lungs," Bharat said. "If the cancer is already outside the lung, we cannot do these double lung transplants."

Surgeons at Northwestern first discovered the new procedure through treating COVID-19 patients, ultimately performing the first double lung transplant on a COVID-19 patient in 2020.

"We learned that it was possible to take out heavily diseased lungs that have tons of bacteria in them, which most Covid patients had, carefully without spreading it into the bloodstream," Bharat said. "So that helped us learn about this approach, which I hope is going to be very helpful for cancer patients."

Going forward, Northwestern said it hopes to perform at least 10 to 15 double lung transplants each year.

Bharat said his team is "really excited about this because these are patients that are some of the most hopeless patients because a lot of them are going to be at the end of the road, and to be able to make such a dramatic impact, it's quite compelling."

Bharat added that he believes there will be some recurrences of cancer, but he thinks the majority of patients will live cancer free after their procedure.

"Even if we could take a few patients and give them a new life, that's quite profound," he said. (Sullivan/Snow, NBC News, 3/15; Schencker, Chicago Tribune, 3/15)