A woman who underwent surgery to have her lungs removed was kept alive artificially for six days until she regained enough strength to receive donor lungs, doctors at Toronto General Hospital said, calling the life-saving effort a world-first success.
Melissa Benoit, 33, was born with cystic fibrosis — a genetic disease that can cause phlegm buildup in the lungs and affect the digestive system. Last April, the Burlington, Ont., resident had a bout with influenza that required her to receive oxygen and then go into intensive care.
The bacteria in her lungs became resistant to most antibiotics and spread throughout her body, and she slid into septic shock — when an infection becomes serious enough for blood pressure to plummet and affect bodily functions. Her organs shut down despite life support systems running at maximum capacity.
As her oxygen levels and blood pressure dipped and her condition worsened, doctors told the family how they carefully weighed the risks.
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"They pulled me back from the dead," Benoit said, also thanking her family at a hospital news conference on Wednesday.
She encouraged organ donation, saying it gave her a second chance to be a mom, daughter and niece.
"Foremost I have to thank my donor and my donor's family. Without them, whatever procedure the physicians would have performed would have been useless."
While risky, taking out her lungs removed the source of her sepsis problem, said Dr. Shaf Keshavjee, director of TGH's lung transplant program.
"It was her only option," Keshavjee said. "For the first time ever, we had a patient in our intensive care unit with no lungs. In fact, she technically was on an artificial lung, an artificial heart and an artificial kidney for six days."
Did not believe it
On a ventilator and in an induced coma, the mother of a three-year-old daughter had been unaware of how close she had come to dying or what doctors had done to save her life.
Before the transplant, the medical team put Benoit on two machines:
- A Novalung to take the place of the lungs in infusing blood with oxygen while removing carbon dioxide.
- Extracorporeal membrane oxygenation, or ECMO, to helped her heart pump blood through her body.
When she was first told she had lived without lungs, Benoit, a nurse, "thought it was a piece of science fiction."
"I did not believe my mom or my husband, the people that I trust the most that I had had a lung transplantation and I lived for six days on life support with an empty chest cavity," she said in an interview.
Her muscles essentially became paralyzed from lack of use. As part of her recovery, Benoit had to relearn how to hold her head up, sit, move her hands, sit, stand and then walk.
Her husband, Christopher Benoit, said the family had come to accept her continuous coughing from cystic fibrosis as something in the background. Now when she coughs, "that's strange," he said.
Benoit said her biggest motivations were to see her daughter grow up and swim with her again, and to eat again after five months of being fed through a tube.
While no one knows her prognosis, she is delighted and thankful to the surgical team.
"I'm the first in the world that they've tried this on. I'll be the first in the world to see how long we live," Benoit said.
Her mother, Sue Dupuis, also can't believe it all.
"All I heard was one per cent chance we can save her life," Dupuis recalled. "I still can't believe it. I still can't believe [when] I see her X-rays with no lungs, it's like it happened to another family."
"I still have a hard time believing it happened to us and to Melissa, because she looks great."
The surgical team's report on the case is published in Wednesday's issue of the Journal of Thoracic and Cardiovascular Surgery.