Doctors perform organ transplant surgery at
Military Hospital No.103 - Photo sggp.org.vn
Starting
from 2017, lung transplants will become a common practice in Việt Nam, said top
local organ transplant surgeons.
Deputy
Head of the Tuberculosis and Pulmonology Department under Military Hospital
103, Tạ Bá Thắng, has recently voiced his forecast on the outlook of lung
transplants in Việt Nam in the near future.
According
to Thắng, ever-developing technology and modern science as well as the mastery
of Vietnamese doctors in other organ transplant techniques including heart,
liver and kidney, together with increasing organ donations will form the
foundation for the first regular lung transplant to be performed next year.
Worldwide,
the number of lung transplants has been on the rise through the years.
Those
with chronic obstructive pulmonary disease (COPD), idiopathic pulmonary
fibrosis, bronchiectasis and early stage lung cancer are all amenable to lung
transplants.
Patients
receiving lung transplants had demonstrated improved quality of life and higher
longevity, Thắng said.
Currently,
there are two types of lung transplant based on donor source: lungs from
brain-dead patients and those from living donors.
In the
case of living donors, there are two main techniques: taking two lower lobes
from two separate donors to transplant into the recipient, or using the lower
lobe from a donor.
As per Dr
Thắng’s analysis, living lung transplants offer many advantages over the
cadaver alternative, hence its rising popularity.
First,
the sources for living lobar transplants are more available. The patient’s
biological parents, siblings, cousins, and blood relatives are encouraged to
donate their lung’s lobes.
Second,
lobectomy, or the removal of the lower lobe, won’t affect the donor’s long-term
health or quality of life despite a reduction in lung volume. The donor’s
optimal age is between 20 and 60 years old.
Third,
with living donors, the surgery is elective, and medical examinations or
surgery can be more proactively arranged when the conditions are favourable.
Fourth,
in Việt Nam, where it is much harder to persuade people to donate organs from
relatives who are clinically dead, living donation is the more viable alternative.
Fifth and
last, the ischemic time (cold time) during surgery is shorter, causing less
damage to the tissue. Complications in living transplant cases are also less
likely than the cadaver options, with a lower risk of infection or primary
graft dysfunction (PGD).
However,
live lobe transplant surgery is relatively more complicated; the risk of
complications to the donors is minimal, but cannot be dismissed. There’s also
the need for pre-op and post-op psychological counselling for both donors and
recipients.
“Similar
to other types of organ transplant, lung transplant patients may suffer from
organ rejection, PGD, among other conditions, leading to dyspnea, respiratory
failure, and potentially, death. Survival rates still vary depending on the
type of the disease, its severity or stage, and transplant indication”, Thắng
said.
“Thus,
the screening and evaluation of donors and patients are of the utmost
importance.”
According
to Nguyễn Tiến Quyết, former Director of the Việt Nam-Germany Hospital and a
leading expert on organ transplant, by the end of 2015, Vienamese doctors have
performed 1,500 kidney transplants, 50 liver transplants, 13 heart transplants
and 1 lung transplant.
Last
year, there was a case of a heart-lung transplant performed in Huế Central
Hospital, however, the donated lungs had already severely deteriorated, and the
40-year-old male patient unfortunately passed away five days after surgery,
even with best efforts from local and foreign experts.
Lung
transplants will open up new opportunities for treating patients with early
stage lung cancer or COPD – an increasingly common condition in Việt Nam,
because of heavy smoking or environmental pollution, Quyết said.
On the
bright side, with remarkable progress in recent years, the success rate of
transplants is increasing, bringing a better life for patients.
No comments:
Post a Comment