Two particular transplantation performed for the first time in Viet Nam
Viet Duc University Hospital (Hanoi) has reported a series of multi-organs transplantation from brain-dead donor including heart, two lungs, liver, two kidneys were successfully performed. Among them, there are two particular cases that were performed for the first time in Vietnam
In the first case, both lungs were transplanted at the same time with an open-heart surgery to repair a congenital malformation (heart repair – lung transplant). The second case is a combined liver and kidney transplantation in the same patient.
Regarding of lung transplantation case, the patient was Ms. P.T.H., 30 years-old, suffered from a congenital large atrial septal defect that had come to the end-stage since 3 years ago due to late diagnosis so out of transplantation, there was no curative treatment and a very poor prognosis with certain death for her due to cardio-pulmonary failure.
According to Prof. TRAN Binh Giang – Director of Viet Duc University Hospital, this lung transplantation was performed in the patient with necessity of congenital heart defect repair (repair of atrial septal defect and tricuspid valve) so this 12-hour surgical procedure was very complicated and at high risks. Luckily, post-transplantation early result was amazing with the recovery of hemodynamic and pulmonary index toward those with normal lungs.
The success of this particular lung transplantation case is great meaningfully significant and could open a new opportunity for young patients in Vietnam. The combined treatment of “ congenital heart defect repair and lung transplantation” will go with better early and long-term outcomes in comparison with “combined heart – lung transplantation”.
Regarding of combined liver – kidney transplantation in a patient with hepato-renal failure:
Patient M.S. (59 years-old, Laotian) has suffered from diabetes and arterial hypertension for many years. In April 2019, a diagnosis of chronic renal failure associated with alcoholic liver cirrhosis confirmed, then the patient was transferred to Viet Duc University Hospital as a candidate or liver and kidney transplantation.
On admission, the patient was diagnosed the hepato-renal failure requiring the periodical hemodialysis. He suffered from 2 periods of digestive hemorrhage that controlled by medical treatment. The diagnosis was confirmed the renal failure of stage IV and alcoholic liver cirrhosis with portal hypertension.
The patient was indicated for liver and kidney transplantation at the same time or separately. After consulting by multi-disciplinary specialties in hospital, and the hospital decided to perform combined liver kidney transplantation (1 stage) from a brain-death donor in order to replace two failure organs by two new organs and tried to avoid the risks of two alternative operations.
The technical procedure of combined liver kidney transplant has been discussed and agreed by all hospital specialists in organ transplantation, cardiovascular surgery, anesthesiology, hemodialysis, blood tests, diagnostic imaging … and experienced of 840 cases of kidney transplantation and 74 cases of liver transplantation already performed.
“On December 17th, we removed multi-organs from a 19 years-old brain-dead donor due to severe head trauma then his lungs, heart, liver and kidneys were transplanted to recipients. Particularly, the patient M.S. received liver and one kidney at the same time. This technique was performed for the first time at our hospital and also in Vietnam with the requirement of continuous hemodialysis in replacing the impaired kidney during the operation” shared Prof. Giang.
After 12 hours (from 9h to 21h), nearly 100 specialists in organ transplant participated the procedure and the operation were successfully performed. Transplanted liver and kidney started working. After the operation, without requirement of hemodialysis, the patient was alert, removed the intubation in 3rd day. At present, he can self-breathe normally and liver and kidney functions have gradually recovered.