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Researchers solve mystery of deadly transplant infection

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Surgical Site Infections

A rare infection after a successful lung surgery resulted fatally for Harlan Dorbin and he lost his battle for life after a month post-surgery. This surgeon found this unacceptable and he made a promise to Dorbin's sister that he would get to the bottom of it.

Ankit Bharat, MD, a thoracic surgeon and surgical director of the Northwestern Medicine lung transplant program said that even though it was a perfect operation, this infection caused an abnormal buildup of ammonia that a person’s body can’t handle. Such an infection is rare but it’s almost always fatal. The irony is that no one knows what causes it, how to prevent or treat it.

In the year 2014 as many as 2100 lung transplant surgeries took place in the United States. Statistics reveals that the infection which happened to Dorbin happened to about 4% of all the lung transplant recipients. After the death of Dorbin, Bharat, who is also an assistant professor in thoracic surgery at the Northwestern University Feinberg School of Medicine spent the next several months studying and researching this infection. He used Dorbin as a case study and tested samples from hospitals all over the county, including a donor sample from Loyola Medicine.

Finally, his research bore fruits and he was able to identify specific bacteria as a cause of this condition. He went a step ahead and also demonstrated how it can be successfully treated with antibiotics.

The exciting news here is that this condition is treatable and perhaps preventable too said Bharat. Further studies are needed to understand it better, but the good thing about the study so far is that it has already saved other patients. Bharat, who is also the lead author of the multi-center study, which was published in Science Translational Medicine on April 22, 2015 said that other centers who had patients with this infection have reached out to us and there are two patients who have recovered because of the antibiotics.

Dorbin, 47, worked in a factory where he was exposed to chemicals. He developed sarcoidosis and in seven years his lungs were gradually destroyed which lead to the need of doing a double lung transplant surgery in July 2014. Dorbin sustained on oxygen and was practically dependent on others for all his chores.

Bharat said that it was really devastating to lose a patient like Dorbin, especially after a successful transplant. But, his death did not go in vain. It is due to him these finding were possible which saved others' lives and will save the lives of many future lung transplant patients.

Dorbin got the infection almost immediately after surgery and passed away about a month later. Crystal Dorbin, his sister was one of the first people Bharat told about his research findings.

Crystal Dorbin said that he was truly very happy when she heard the news about Bharat's findings. She said her brother was a lively person and he never let his disease control him. Even though every breath was a struggle for him he was smiling and laughing all the time. He would be proud to know he helped other people like him.

Timing is of prime importance in a lung transplant. Typically surgeons have about 6 hours to transport lungs from a donor and transplant it into the recipient. But, in 80% of the cases post-surgery patients go from being oxygen dependent to having minimal or no limitations on their physical activity.

The lung transplant program at Northwestern Medicine was launched in May 2014, and since then it has completed 12 successful lung transplants.