Another miracle of Vietnam's medical industry: The first successful simultaneous heart-lung transplant for a patient with multiple organ failure

Dr. Duong Duc Hung - Director of Viet Duc Friendship Hospital emotionally emphasized the above information in an information sharing session with the press this morning - August 13 organized by this hospital.

Dr. Duong Duc Hung - Director of Viet Duc Friendship Hospital shared information with the press.

More than 3 weeks ago, patient Tran Nhu Q (38 years old) underwent the first multi-organ transplant in the history of organ transplants in Vietnam - simultaneous heart and lung transplant.

Previously, the female patient had a history of: atrial septal defect - severe pulmonary hypertension that was closed despite the atrial septal defect at Hanoi Heart Hospital in 2011, not regularly monitored, had only been taking medication for 1 year, the patient had no history of cerebrovascular accident.

Associate Professor, Dr. Pham Huu Lu - Deputy Head of the Department of Cardiovascular and Thoracic Surgery, Cardiovascular Center, Viet Duc Friendship Hospital said that the patient was admitted to the hospital with the diagnosis of: Eisenmenger syndrome - irreversible right ventricular failure - severe tricuspid regurgitation / history of atrial septal defect, the possibility of death is calculated in days, there is an indication for simultaneous heart and lung transplantation although there is not enough time to treat malnutrition and the donor lung is infected with Acinetor Baummani and is larger than the recipient's chest.

"We had an interdisciplinary consultation because to perform the improved simultaneous heart-lung transplant technique, there must be interdisciplinary coordination: cardiothoracic medicine, anesthesia - resuscitation, surgery, rehabilitation, nutrition..." - Dr. Lu said.

During the 7-hour surgery, experts from Viet Duc Friendship Hospital had to use extracorporeal circulation to temporarily replace the heart and lungs during that time; to ensure the heart functioned well, it was necessary to avoid infusing too much fluid causing pulmonary edema, using less anesthesia and using the most advanced hemodynamic monitoring equipment;

Doctors also performed bilateral lung resection to fit, connected the two main bronchi instead of the traditional trachea to better perfuse the anastomosis, and used a flexible bronchoscope during surgery to evaluate the two main bronchial anastomoses.

After lung transplantation, the patient needs to use strong immunosuppressants but is very susceptible to infection because it is connected to the outside and the donor lung is already infected with multi-resistant A. Baummani bacteria, so it is necessary to balance the dose of immunosuppressants (because the drug reduces resistance); Ultrafiltration of the blood to treat kidney failure due to many causes, the team consulted to stop nephrotoxic antibiotics and control the concentration of immunosuppressants so that the kidney is less toxic and recovers after 2 weeks; Increase intravenous and digestive nutrition, clean the lungs by tracheostomy, suction endoscopy and rehabilitation exercises. The patient continues to be monitored for resuscitation after transplantation.

The donor's heart and lungs are prepared for transplantation into the patient.

According to Dr. Hung, this is an extremely rare case, requiring interdisciplinary coordination, applying the most advanced surgical and resuscitation techniques available today.

"Heart-lung transplantation is an advanced medical technique in which the patient's heart and lungs are simultaneously replaced with a healthy heart and lungs from a suitable donor. This is the ultimate treatment solution for patients with both end-stage heart and lung disease, when all other treatments are no longer effective," said Dr. Duong Duc Hung, adding: This surgery requires high technique, coordination of many specialties, and a special resuscitation and post-operative care system.

"We have continued to plant the red flag with yellow star of Vietnam on the map of multiple organ transplantation, especially in simultaneous heart-lung transplantation."

Mr. Hung also informed that in the world , heart-lung transplants are rarely performed due to the requirement for rare organ sources, complicated surgical procedures and high risk of complications; they are indicated for cases of simultaneous heart disease and end-stage lung disease when all other treatment methods are no longer effective.

The success of the simultaneous heart-lung transplant not only marked a major step forward in organ transplant capacity, especially multi-organ transplant, but also affirmed the expertise of the Vietnamese medical team in the field of surgery. This achievement opened up new opportunities for life and treatment for patients with end-stage heart and lung disease.

"Today is exactly 24 days since the transplant. The past few days have been really stressful for the resuscitation team and surgeons involved in performing this multi-organ transplant. Only today do we feel lighter."

With the success of this heart-lung transplant, we have continued to plant the red flag with yellow star of Vietnam on the map of multiple organ transplants, especially in simultaneous heart-lung transplants because currently heart-lung transplants are very rare. Due to the requirement of rare organ sources and extremely complicated techniques, each year the world only performs about 100 transplants like this" - Dr. Duong Duc Hung shared.

The team performed a simultaneous heart-lung transplant surgery for the patient.

Common situations include: complex congenital heart disease with Eisenmenger-type pulmonary hypertension; severe pulmonary hypertension that has caused irreversible right-sided heart failure; or end-stage lung disease with irreparable left-sided heart disease. Due to the need for rare organs and the extremely complex techniques, only about 100 of these transplants are performed worldwide each year.

Success rates at major centers around the world: Thanks to advances in surgery, resuscitation, and post-transplant care, heart-lung transplant outcomes have improved significantly.

In the UK, the 90-day survival rate is around 85% and at 1 year it is 72%.

In the United States, some leading centers such as Stanford Health Care record one-year survival rates of nearly 90%, higher than the national average.

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.

Doctors participating in the transplant and patients in the hospital room of Viet Duc Friendship Hospital.

Dr. Ha Anh Duc - Director of the Department of Medical Examination and Treatment Management said: The doctors of Viet Duc Friendship Hospital 'mainly self-studied and the procedure has not been approved by us yet', but 40 experts directly participated in this transplant, not to mention the indirect team. This is the most difficult transplant the world is currently doing.

"I talked to Mr. Hung - the hospital director, if we wait for the approval process, what will happen to the patient? Mr. Hung said the patient will die. So, why wait for the approval process, while we have made careful preparations, are ready to perform the transplant and have the organ source to save the patient. This is humanity" - Dr. Ha Anh Duc said.

According to Mr. Duc, the success of the doctors at Viet Duc Friendship Hospital has not only given the mother back a daughter, but also given two relatives in the family a younger sister and an older sister, and at the same time we have also given the small family with a 13-year-old son back a healthy mother. This is a great achievement not only for Viet Duc Friendship Hospital but also for the Vietnamese medical sector.

"We have continued to make Vietnam's healthcare industry famous, on par with developed countries with incomes dozens of times higher than ours," Dr. Duc proudly said...

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Source: https://baolaocai.vn/them-ky-tich-cua-nganh-y-viet-nam-lan-dau-tien-ghep-thanh-cong-dong-thoi-tim-phoi-cho-nguoi-benh-suy-da-tang-post879457.html