Lung transplant numbers still low in Việt Nam

Doctors perform a lung transplant on a female patient on February 8 at the National Lung Hospital in Hà Nội. VNA/VNS Photo

 HÀ NỘI — Việt Nam has conducted over 8,000 organ transplants so far, but among these, only 11 have been lung transplants.

Associate Professor Đồng Văn Hệ, director of the National Organ Transplant Coordination Centre said that several factors contributed to the low number of lung transplants in the country in Việt Nam.

“Firstly, lung transplantation is one of the most complex organ transplant procedures,” he said.

“Secondly, lungs for transplantation must come from brain-dead donors, as live lung donations are technically challenging and risky.

“Therefore, the practice of using living donors for lung transplants is not recommended worldwide, the preference is for donations from brain-dead or deceased cardiac donors,” he added.

Hệ also said that in Việt Nam, the rate of brain-dead organ donors was already low.

When a brain-dead person is able to donate kidneys, liver and heart, only about 20 per cent of such donors could provide usable lungs.

“This is due to the more complex techniques required for resuscitating and preserving lungs compared to other organs,” he said.

Additionally, the incidence of chronic lung diseases was increasing.

He once visited a specialist lung hospital where doctors reported that around 200 patients were undergoing treatment for lung conditions, but there were no available donor lungs for transplantation.

He also noted that another issue was the high cost of a lung transplant.

Regarding organ coordination, he said there were situations where patients passed away while waiting for lung transplants or when lungs were available, there were no suitable recipients.

“This is indeed a concern for us,” he said.

Dương Đức Hùng, director of the Việt Nam – Germany Hospital, said at a recent workshop held by the hospital, that since the first successful lung transplant 30 years ago, lung transplantation had rapidly become a standard procedure for treating end-stage lung disease in eligible patients.

Advancements in lung preservation, surgical techniques and immunosuppressive regimens had made lung transplants more routine worldwide with broader indications.

Nevertheless, the shortage of donors and the prevalence of chronic obstructive pulmonary disease remained significant challenges in realising the full potential of lung transplants.

“Lung transplantation is a challenging procedure for medical centres worldwide,” he said.

The preservation and storage solutions for lungs were entirely different from those for the heart or kidneys.

“Furthermore, lung transplantation requires meticulous preparation. If a patient is not properly prepared, the donated lung may not be viable for transplantation,” he said.

Although the Việt Nam – Germany Hospital successfully performed its first lung transplant on 12 December 2018 and the patient remains in good health, the hospital has only carried out half of the total 11 lung transplants performed nationwide.

In contrast, the hospital conducts three to four kidney transplants each week.

Former director of the hospital Nguyễn Tiến Quyết said that lung transplantation not only involved the most complex technical aspects among organ transplants but also presented challenges in post-transplant care, which differed significantly from the care required for other types of organ transplants.

Reflecting on the first lung transplant at the hospital, Quyết recalled a patient with severe and end-stage chronic obstructive pulmonary disease.

“At that time, lung transplantation is the last resort to save the patient’s life,” he said.

The transplant procedure itself was not overly difficult but post-operative care was extremely challenging.

The medical team had to provide continuous care around the clock for several months, he said, emphasising that the challenges remained unchanged in lung transplant procedures.

Quyết said that Vietnamese doctors’ organ transplant expertise was on par with international standards and they should try to increase lung transplant numbers in the future.

“This would not only save more lives but also enhance the reputation of Việt Nam’s healthcare sector, as lung transplantation is one of the most difficult transplant procedures,” he said.— VNS