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Northwestern Medicine Researchers Solve Mystery of Deadly Transplant Infection

After the death of a patient, a Northwestern Medicine thoracic surgeon determines possible cause of rare infection, likely saving lives of future lung transplant patients


News provided by

Northwestern Medicine

Apr 28, 2015, 12:06 ET

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CHICAGO, April 28, 2015 /PRNewswire-USNewswire/ -- When Harlan Dorbin passed away from a rare infection one month after his successful lung transplant surgery, his surgeon turned to Dorbin's sister and made a promise.

"I told her I would get to the bottom of this," said Ankit Bharat, MD, a thoracic surgeon and surgical director of the Northwestern Medicine® lung transplant program. "It was a perfect operation yet this infection caused an abnormal buildup of ammonia that a person's body can't sustain. It's rare but it's almost always fatal. No one knew the cause or how to prevent it. This simply wasn't acceptable to me."

In 2014, there were about 2,100 lung transplant surgeries in the United States. The ailment Dorbin acquired happens in about four percent of all lung transplant recipients, said Bharat, who is also an assistant professor in thoracic surgery at the Northwestern University Feinberg School of Medicine.

After Dorbin's death, Bharat spent the next several months researching this infection using Dorbin as a case study and testing samples from hospitals all over the county, including a donor sample from Loyola Medicine. Through his research he was able to identify a specific bacteria as a cause of this condition and also demonstrated that it can be successfully treated with antibiotics. Bharat is lead author of the multi-center study, which was published in Science Translational Medicine on April 22, 2015.

"To think this condition is treatable and perhaps even preventable is very exciting news," Bharat said. "Further studies need to be done, but this research has already saved other patients. Other centers who had patients with this infection have reached out to us and I know of two patients who have recovered because of the antibiotics."

For seven years, sarcoidosis gradually destroyed Dorbin's lungs, leading to the need for a double lung transplant surgery in July 2014. Doctors believe sarcoidosis results from the body's immune system responding to an unknown substance, most likely something inhaled from the air. Dorbin, 47, spent years working in a factory where he was exposed to chemicals. Eventually, he was dependent on a wheelchair to get around and oxygen to shower, eat and sleep. Because of his limitations, Dorbin couldn't work or leave the house for anything other than doctor appointments at the time of his surgery.

"It was devastating to lose a patient like Harlan, especially after an otherwise perfect transplant procedure," Bharat said. "But this research and these findings would never have been discovered without him. He has helped so many other future lung transplant patients."

Dorbin came down with the infection almost immediately after surgery and passed away about a month later. His older sister Crystal Dorbin was one of the first people Bharat told about his research findings.

"Words can't express how happy I was to hear this," said Crystal Dorbin, who lives in Chicago. "Harlan never let his disease control him. He lived life to the fullest and was smiling and laughing all the time even though we knew every breath was a struggle. I think he'd be proud to know he was helping other people like him."

Lungs are one of the most difficult organs to transplant because unlike other organs, lungs are exposed to the external atmospheric elements during normal respiration, leading to possible infection and damage. Because timing is so critical, surgeons typically have about six hours to transport lungs from a donor and transplant into the recipient. However, for lung transplant patients, their quality of life post-surgery is nothing short of remarkable. More than 80 percent of these patients go from being oxygen dependent to having minimal or no limitations on their physical activity.

Since launching its lung transplant program in May 2014, Northwestern Medicine has completed 12 successful lung transplants. 

"For patients with end-stage lung diseases, a lung transplant gives them not only a new set of lungs but a much better quality of life," said Malcolm DeCamp, MD, chief of the division of thoracic surgery at Northwestern Memorial Hospital and Northwestern University Feinberg School of Medicine. "Northwestern Medicine has a premier lung transplant program because of our outstanding patient care and our clinical trials and research which uncover the new and life-saving treatments of the future."

To learn more about the Northwestern Medicine Lung Transplant Program or to schedule an appointment, click here or call 312-695-LUNG. 

About Northwestern Medicine®
Northwestern Medicine® is the collaboration between Northwestern Memorial HealthCare and Northwestern University Feinberg School of Medicine around a strategic vision to transform the future of healthcare.  It encompasses the research, teaching and patient care activities of the academic medical center. Sharing a commitment to superior quality, academic excellence and patient safety, the organizations within Northwestern Medicine comprise more than 9,000 clinical and administrative staff, 3,100 medical and science faculty and 700 students. The entities involved in Northwestern Medicine remain separate organizations. Northwestern Medicine is a trademark of Northwestern Memorial HealthCare and is used by Northwestern University.

About Northwestern Memorial Hospital
Northwestern Memorial is one of the country's premier academic medical center hospitals and is the primary teaching hospital of the Northwestern University Feinberg School of Medicine. Along with its Prentice Women's Hospital and Stone Institute of Psychiatry, the hospital has 1,705 affiliated physicians and 6,769 employees. Northwestern Memorial is recognized for providing exemplary patient care and state-of-the art advancements in the areas of cardiovascular care; women's health; oncology; neurology and neurosurgery; solid organ and soft tissue transplants and orthopaedics.

Northwestern Memorial has nursing Magnet Status, the nation's highest recognition for patient care and nursing excellence. Northwestern Memorial ranks 10th in the nation in the U.S. News & World Report 2014-15 Honor Roll of America's Best Hospitals. The hospital is recognized in 14 of 16 clinical specialties rated by U.S. News and is No. 1 in Illinois and Chicago in U.S. News' 2014-15 state and metro rankings, respectively. For 14 years running, Northwestern Memorial has been rated among the "100 Best Companies for Working Mothers" guide by Working Mother magazine. The hospital is a recipient of the prestigious National Quality Health Care Award and has been chosen by Chicagoans as the Consumer Choice according to the National Research Corporation's annual survey for 15 consecutive years.

SOURCE Northwestern Medicine

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