In a high-stakes operation that reads like a medical thriller, surgeons at Northwestern Memorial Hospital in Chicago have performed a rare quadruple-organ transplant on a 36-year-old Iowa woman, replacing her failing lungs and giving her a liver and kidney from a single donor in one coordinated push.
The patient, Elizabeth Wehrle of Montezuma, Iowa, had been critically ill after contracting pneumonia in January, landing on ECMO and a ventilator before doctors concluded she would need another major operation. Wehrle previously received a lung transplant in 2017 for cystic fibrosis, and hospital staff say the disease ultimately damaged multiple organs. Her family and clinicians report that she is now awake, working with therapists and making steady progress.
How surgeons staged the operation
The transplant team tackled the procedure in carefully planned stages. Surgeons first freed the rejected lungs, then moved ahead with implanting the new donor lungs while preserving the abdominal organs for later in the case. The donor liver and kidney were kept viable on perfusion machines while the thoracic teams worked, a bit like putting the organs on pause until the operating room choreography caught up.
Once the lung transplant was completed, the abdominal surgeons moved in to transplant the liver and kidney. The whole effort, which relied on tight coordination across services, lasted about eight hours, as reported by the Chicago Tribune.
Surgeons describe the challenge
Northwestern’s transplant leaders are not sugarcoating how complex this was. “The team was able to save her life in a way not done before,” Dr. Satish Nadig said, highlighting just how unusual the combination of organs and timing was. Dr. Ankit Bharat noted that a second lung transplant after severe rejection is technically very difficult on its own, even before you add a liver and kidney to the mix.
The operation pulled in specialists from thoracic surgery, abdominal transplant and critical-care services, all working off the same playbook and clock. Every shift in blood flow and every move to preserve organ function had to be timed to minimize risk for Wehrle, according to the Chicago Tribune.
A rare operation in national context
Operations that replace lungs, liver and kidney in one go are exceptionally rare in the United States. Earlier this year, UChicago Medicine detailed a 36-hour quadruple transplant it described as the first of its kind in Illinois, and transplant experts have noted that even at top centers these cases are extreme outliers.
Taken together, the few reported cases highlight why multi-team coordination, advances in organ-preservation technology and careful patient selection are so critical when several organs are failing at once. The American College of Surgeons has similarly pointed to these operations as examples of how far complex transplant science has come, even if they remain rare.
Recovery and what comes next
After the operation, Wehrle spent several weeks under close watch at Northwestern, then moved to inpatient rehabilitation at the Shirley Ryan AbilityLab. Therapists there have focused on rebuilding her stamina after a long hospitalization, and clinicians say she lost significant weight during her illness but is now walking during therapy sessions and slowly regaining strength.
The transplant team will continue to monitor her as an outpatient for any signs of rejection or infection and will keep fine-tuning the complex immunosuppression regimen that follows any multiorgan transplant.
Why it matters
Surgeons involved in these rare cases say they have become possible only because organ-preservation tools have caught up with surgical ambition. A recent review in Transplant International found that machine perfusion has expanded the safe use of higher-risk donor livers and improved early outcomes, giving transplant teams more flexibility when time is tight.
For patients like Wehrle, who once had few if any options, the combination of better preservation technology, refined surgical technique and deeply coordinated, multi-disciplinary care can open the door to a second chance. “I’m incredibly grateful that they decided to take this chance on me,” she told reporters.
