The first successful simultaneous heart and lung transplant in Vietnam

The 38-year-old female patient in Ninh Binh is the first case in Vietnam to successfully transplant both heart and lungs at the same time, with two lungs larger than her chest cavity.

Simultaneous heart and lung transplant for 38-year-old female patient

On August 13, Viet Duc Friendship Hospital announced the first successful simultaneous heart and lung transplant in Vietnam.

Patient Tran Nhu Q. (38 years old) in Ninh Binh , suffered from multiple organ failure, was hospitalized for many days, if she did not receive a heart and lung transplant, this could be her last hospital stay. She received a heart and two lungs from a 34-year-old brain-dead male patient.

The first successful simultaneous heart and lung transplant in Vietnam was performed by doctors at Viet Duc Friendship Hospital.

PHOTO: THAO MY

According to Dr. Duong Duc Hung, Director of Viet Duc Friendship Hospital, heart-lung transplantation is the most difficult technique, in which both the patient's heart and lungs are replaced simultaneously with a healthy heart and lungs from a suitable donor.

This is the last resort treatment for patients with both end-stage heart and lung disease, when all other treatments have failed.

The surgery requires high technique, coordination of many specialties and a special resuscitation and post-operative care system.

For patient Q. mentioned above, not only was the transplant difficult technically, it was also difficult because the two donated lungs were larger than the chest and were infected with multi-resistant bacteria.

After 7 hours, the transplant was successful. During the surgery, specialists had to use extracorporeal circulation to temporarily replace the heart and lungs during the surgery, ensuring the heart functioned well but at the same time avoiding the need to transfuse too much fluid causing pulmonary edema; using less anesthesia and using the most advanced hemodynamic monitoring equipment.

The doctors had to cut off both lungs to fit the recipient's chest; connect the two main bronchi instead of the traditional tracheal anastomosis to better perfuse the anastomosis, and use a flexible bronchoscope during the surgery to evaluate the two main bronchial anastomoses.

Mr. Hung added that each year, only about 50 - 100 transplants are performed worldwide due to the need for rare organ sources, complicated surgical procedures and high risk of complications.

A member participating in the transplant said that after the transplant, the patient's vital parameters were stable, and the chest was closed immediately after surgery. ECMO (extracorporeal circulation support, helping to replace the function of the heart and lungs after the transplant) was not used, thereby helping to avoid other incidents.

The patient needed to take about 30 medications, which was very difficult, requiring doctors to calculate the dosage very carefully and meticulously, ensuring no liver or kidney failure, and still ensuring the patient was protected against transplant rejection.

According to transplant experts, with advances in surgery, resuscitation and post-transplant care, the results of heart and lung transplants have improved significantly. In the UK, the 90-day survival rate is about 85% and 72% after 1 year.

In the US, some leading centers such as Stanford Health Care record 1-year survival rates of nearly 90%.

Many international reports show that the 5-year survival rate after transplantation is currently around 60%, demonstrating the effectiveness of this method in prolonging and improving the quality of life for patients.

Source: https://thanhnien.vn/ca-ghep-dong-thoi-tim-phoi-dau-tien-thanh-cong-tai-viet-nam-185250813104137857.htm