Northwestern Medicine Performs First Known Quadruple-Organ Transplant Involving Retransplanted Lungs

Chicago, IL – July 14, 2026 – Northwestern Medicine surgeons have performed the first known quadruple-organ transplant involving retransplanted lungs in the United States. Elizabeth Wehrle, a 36-year-old mother from Montezuma, Iowa, received two donor lungs for a second time, along with a liver and kidney, after complications from cystic fibrosis and chronic rejection of her first lung transplant left her critically ill. The groundbreaking surgery happened at Northwestern Memorial Hospital and involved a multidisciplinary transplan't team uniquely equipped to manage one of the most complex surgical cases ever undertaken.

• According to the Scientific Registry of Transplant Recipients (SRTR), Wehrle is the first patient in the United States to receive a quadruple-organ transplant involving retransplanted lungs. 

• According to SRTR, Northwestern Medicine is the sixth transplant program in the U.S. to perform a quadruple-organ transplant, but the first to perform one with retransplanted lungs.

• To date, only seven quadruple-organ transplant procedures have been performed in the U.S. (one transplant center performed two).

• Redo lung transplantation is among the most technically challenging procedures in medicine. Previous surgeries create extensive scar tissue, obscuring normal anatomy and making operations significantly more complex.

“Retransplanting lungs is extraordinarily difficult because prior surgery can leave the chest densely scarred and the normal anatomy severely distorted,” said Ankit Bharat, MD, chief of thoracic surgery and executive director of the Northwestern Medicine Canning Thoracic Institute. “Adding a liver and kidney transplant placed Elizabeth’s case in a category few transplant programs ever encounter. Her outcome reflects not just surgical skill, but an entire system built to care for the most complex patients. Elizabeth’s initial double-lung transplant from 2017 left extensive scar tissue which severely distorted the normal anatomy of her chest. When you make an incision, the risk of bleeding and injury to nearby organs and blood vessels increases, and with four organs involved, there’s an even greater risk of organ rejection and serious infection.”

“Every transplant case is unique, but Elizabeth’s case was extremely rare and difficult,” said Satish Nadig, MD, PhD, transplant surgeon and director of the Northwestern Medicine Comprehensive Transplant Center. “This operation worked because the thoracic, abdominal transplant, anesthesia, intensive care unit, perfusion and nursing teams functioned as one coordinated team. Because we all worked so well together, the surgical implantation was completed in approximately eight hours. It truly highlights why Northwestern Medicine’s expertise can take on some of the most complex transplant cases in the world.”

Wehrle, a patient with cystic fibrosis, previously underwent a double-lung transplant in 2017 at another health system and had regained her quality of life before getting sick in January and eventually being diagnosed with a severe form of chronic rejection in late February. While chronic rejection is common in lung transplant patients, Wehrle’s case was especially rare and life-threatening.

“Unfortunately, she developed a rare form of rejection called restrictive allograft syndrome (RAS) which is often fatal and so high-risk that many transplant centers wouldn’t consider repeat lung transplantation,” said Dr. Bharat. 

As physicians evaluated Wehrle’s condition, they discovered additional organ failure caused by cystic fibrosis complications – she would also need a liver and kidney transplant. By the time Wehrle’s medical team in Iowa referred her to Northwestern Medicine, she had progressive respiratory failure and required both a ventilator and life support machine known as extracorporeal membrane oxygenation (ECMO). 

“Even though a redo double-lung transplant plus a liver and kidney transplant had not been identified in U.S. registry data, we thought we could help Elizabeth because of our experience with some of the most challenging transplant cases and the multidisciplinary systems we’ve built at Northwestern Medicine to care for these patients,” said Dr. Bharat.    

On March 17, Wehrle was admitted to the Cardiothoracic Intensive Care Unit at Northwestern Memorial and was listed for a quadruple-organ transplant on March 19. Three days later, she received word that four organs were available. Thoracic surgeons started on the double-lung retransplant the evening of March 22, and abdominal surgeons followed in the early morning hours of March 23 with the liver and kidney transplant. 

To overcome the challenges associated with prolonged transplant surgeries, Northwestern Medicine used advanced machine perfusion technology to preserve donor organs outside the body, giving surgeons more time than traditional cold storage alone. This approach allowed the thoracic team to focus on the complex lung retransplantation while the liver and kidney remained safely supported. The surgery required extensive preparation and precise choreography.

“The liver and kidney were on a machine perfusion pump, which was fantastic because it allowed the lung team to take their time and make sure the lungs went in safely without being on the clock for the abdominal organs,” said Dr. Nadig. “When the abdominal organs went in and blood flow was restored, they began functioning straight away.”

"If one surgeon had tried to do this as a single 20-hour operation, that would have been too much stress on a critically ill patient. By separating it out this way, we were able to achieve the outcome we hoped for in only eight hours," said Chitaru Kurihara, MD, a thoracic surgeon and surgical director of the Lung Transplant Program at the Canning Thoracic Institute.

For Wehrle, the historic surgery represented an opportunity to return to the life she had built with her family after her first transplant in 2017.

"Life was great after my first double-lung transplant," Wehrle said. "I was a stay-at-home mom, I homeschooled my son, and I was busy with all his activities. I had my life back. But as my health deteriorated, simple daily tasks became overwhelming. There were days that I couldn't get myself dressed because I just couldn't breathe.”

Following the transplant in March, Wehrle quickly recovered, with her new lungs, liver and kidney functioning well. In less than three weeks, she was discharged from Northwestern Memorial and began rebuilding her strength. She’s currently walking 3-4 miles per day and doing light weightlifting.

“Before surgery, there was so much tightness in my chest and I couldn’t breathe. Almost immediately after transplant, I felt like a new person,” said Wehrle. “Without my four new organs, I know I wouldn’t be here today.”

Wehrle will return home to Iowa on July 17 and be reunited with her 11-year-old son, Landen, who got to experience a Chicago summer when he visited his mom in June. The scars from Wehrle’s surgeries are a visible reminder of her journey and she doesn’t take them for granted. 

"I don't hide my scars," Wehrle said. “I’m looking forward to going to the swimming pool this summer and showing off my battle scars. I earned them. They saved my life.”

"I'm so proud of this case because of the way our teams came together to anticipate every challenge and be prepared for it," said Dr. Bharat. "There was a tremendous amount of passion to help Elizabeth. The thought of reuniting her with her child and giving her a new lease on life makes all of us incredibly happy."

The procedure was made possible by the generosity of an organ donor and donor family.

Since Northwestern Medicine’s Lung Transplant Program first started in 2014, they’ve performed more than 700 lung transplant procedures for patients with end-stage lung diseases such as COVID, cancer, cystic fibrosis, chronic obstructive pulmonary disease (COPD) and more. Northwestern Medicine has one of the shortest wait times for a lung transplant in the U.S. with a median wait time of three days. 

(Newswise/HG)