Increase the rate of organ transplants from brain-dead donors.

At the seminar "Lung Transplantation from Brain-Dead Donors – Current Situation and Solutions" held on August 9th, Viet Duc Friendship Hospital clearly stated its determination to increase the rate of organ transplants from brain-dead donors.

Currently, Vietnam is the only ASEAN country performing over 1,000 organ transplants per year, with organs from brain-dead donors accounting for 6% and organs from living donors accounting for 94%. The demand for organ transplants is very high; however, very few people register to donate organs after brain death.

Doctors during a lung transplant surgery for a patient.

However, in recent times, due to adjustments in transplantation techniques and campaigns to encourage organ donation, along with the support of the National Organ Transplant Coordination Center and the internal medicine systems of hospitals, the number of organ transplants from brain-dead donors has increased. In 2024, Viet Duc Friendship Hospital strives to achieve a significant breakthrough in the number of organ transplants from brain-dead donors.

According to experts, in the field of organ transplantation, the potential and opportunities to save patients' lives are enormous. With the support and involvement of the Government, the attention of the Ministry of Health and all levels of government, and a change in public awareness, the leadership of Viet Duc Friendship Hospital believes that in the coming period there will be a breakthrough in organ transplantation from brain-dead donors.

According to Dr. Duong Duc Hung, Director of Viet Duc Friendship Hospital, lung transplantation remains a challenge among organ transplant techniques. In particular, the specialized technical procedures for lung transplantation are very different from those of many other organs.

Furthermore, unlike heart transplants, lung transplantation requires very early preparation. To complete the lung transplant process, close collaboration between the recipient's medical team and the donor's medical team is essential. If a brain-dead patient donates lungs and no unit is ready to perform the transplant, those lungs will have to be discarded.

Because of the aforementioned difficulties, lung transplantation in Vietnam remains sporadic, individualized, and limited to a few cases. Meanwhile, if lung transplantation is to become a treatment method for end-stage chronic lung disease patients, there is no other way than to reorganize lung transplantation work and ensure close collaboration between different specialties.

It is known that lung disease is currently the leading cause of disability and death worldwide . In Vietnam, according to the Respiratory Department of the National Lung Hospital, approximately 6.7% of patients suffer from chronic obstructive pulmonary disease (COPD), and 6-7% suffer from interstitial lung disease, requiring lifelong treatment. Many cases only have a chance of survival through lung transplantation.

However, heart-lung transplantation is currently the most difficult technique, and cardiopulmonary resuscitation from a donor also presents many challenges.

It is known that, on average, Viet Duc Friendship Hospital can perform about 200-300 organ transplants per year. In addition, the hospital also sees about 300 deaths from traumatic brain injury each year, which is a very large number.

A brain-dead donor can save the lives of eight other people by donating organs, and a brain-dead donor can improve the lives of 75-100 others. In the future, Viet Duc Friendship Hospital will also implement new organ transplant techniques such as pancreas transplantation, heart-lung transplantation, and heart valve transplantation…

To date, Vietnam has successfully performed 9 lung transplants, including 1 at Hue Central Hospital, 1 at Military Hospital 103, 4 at Military Central Hospital 108, and 3 at Viet Duc Friendship Hospital. Of these, 2 lung transplant recipients are still alive: 1 at Military Hospital 103 and 1 at Military Central Hospital 108.

The most successful lung transplant to date was for a patient with end-stage pulmonary fibrosis. Specifically, in 2020, the National Lung Hospital, in collaboration with the Central Military Hospital 108, successfully performed a lung transplant on Mr. NXT (from Thanh Hoa province) who suffered from end-stage pulmonary fibrosis.

The surgery was performed meticulously and systematically according to international standard procedures at the UCSF Lung Transplant Center – one of the nine largest and most reputable lung transplant centers in the United States.

The entire process, from preparing the brain-dead donor to the lung transplant recipient, involved rigorous assessment, diagnosis, and treatment according to the standards of the UCSF Heart-Lung Transplant Centre. This was the most comprehensively successful lung transplant, achieving the highest level of success at UCSF.

Nearly three years after undergoing a lung transplant, the patient has recovered well and is completely healthy, with stable respiratory function. This surgery is considered by experts to be the most successful to date, given that Vietnam has performed many lung transplants from brain-dead donors, but the success rate has not been high, and the survival time of recipients after lung transplantation has not been long.

The most recent major successful lung transplant was performed on the afternoon of the 30th day of the Lunar New Year. To carry out the transplant, the National Lung Hospital mobilized approximately 80 hospital staff members to directly participate (with many others ready to be deployed and working remotely), and also received coordination and support from the National Organ Transplant Coordination Center, Hospital 108, Hospital E, Friendship Hospital, Hanoi Heart Hospital, etc.

After consulting with Professor Jasleen, Director of the UCSF Lung Transplant Center (the largest and most prestigious medical center in the Western United States), Professor Dr. Le Ngoc Thanh (President of the Vietnam Society of Cardiovascular and Thoracic Surgery), and Dr. Nguyen Cong Huu (Director of E Hospital), it was decided to proceed with this lung transplant.

The surgery was performed on February 9, 2024 (the 30th day of the Lunar New Year), lasting 12 hours (from 10:00 AM to 10:00 PM) by Assoc. Prof. Dr. Dinh Van Luong, Director of the National Lung Hospital, along with other doctors and experts from the National Lung Hospital, in collaboration with Prof. Dr. Le Ngoc Thanh, Rector of the University of Medicine and Pharmacy - Vietnam National University, Hanoi, and doctors and experts from E Hospital. The transplant was a resounding success, meeting the highest standards of UCSF.

Globally, lung transplants are mostly performed in developed countries due to the difficulty and high cost of the procedure. However, at the National Lung Hospital, this transplant was successfully performed on a poor patient from the mountainous region of Bac Kan.

The successful transplant is a major milestone, marking the remarkable progress of the doctors at the National Lung Hospital, thanks to the guidance and special attention of the Ministry of Health's Department of Medical Examination and Treatment Management.

According to Dr. Dinh Van Luong, Director of the Central Lung Hospital, the burden of lung diseases has increased significantly, especially after the Covid-19 pandemic, making the need for developing advanced and effective techniques more urgent than ever to meet the needs of the people.

Therefore, the Director of the Central Lung Hospital hopes that the Ministry of Health will approve the proposals on technical procedures for lung transplantation and regenerative medicine, so that health insurance will cover lung transplant cases, allowing more and more organ transplant patients to benefit.

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