According to information from the Vietnam - Germany Friendship Hospital, heart - lung transplantation is an advanced medical technique in which both the patient's heart and two lungs are simultaneously replaced with a healthy heart and two lungs from a suitable organ donor.
This is the final treatment for patients with simultaneous heart disease and end-stage lung disease, when all other treatments are no longer effective.
The surgery requires high techniques, coordination with many specialties and a special resuscitation and post-operative care system. In the world, heart - lung transplantation is performed very rarely due to rare organ sources, complex surgical procedures and high risk of complications; It is indicated for cases of simultaneous heart and lung disease in the final stage when all other treatments are no longer effective.
Common situations include: complex congenital heart disease with Eisenmenger-style pulmonary hypertension; severe pulmonary hypertension that causes irreversible right heart failure; or end-stage lung disease with irreversible left heart disease.
Due to the rare organ requirement and extremely complex techniques, each year the whole world only performs about 100 transplants of this type.
The first patient to successfully receive a simultaneous heart-longitude transplant in Vietnam was patient Tran Nhu Q (38 years old) with a history of operation of the airport - severe acute coronary artery hypertension at Hanoi Heart Hospital in 2011, not being monitored regularly, having only used the drug for 1 year, the patient had no history of cerebral aneurysm.
The patient was admitted to the hospital and was diagnosed with eisenmenger syndrome - left-sided recessive failure - severe tricuspid regurgitation/ history of acidosis, daily mortality, indicated for heart and lung transplants, and even if not promptly treated for malnutrition and lungs, the donor had the infection with Acinetor baummani and the recipient's chest was larger.
"If there were no suitable organ donors and the organ transplant was not successful, then this could be the last time this patient was hospitalized. The patient has now stood up, eaten, and started walking. The past 21 days, are the days when we, the doctors, have made efforts, tried for the patient's life. We have returned a mother to a 13-year-old boy, a child of an elderly mother, a relative in the family..." - Mr. Duong Duc Hung, Director of Viet Duc Friendship Hospital, emotionally said at the press briefing on the morning of August 13.
Improved heart - lung transplant techniques have been performed in interdisciplinary coordination: Thoracic and cardiovascular diseases, anesthesia - resuscitation, adenoids, rehabilitation, nutrition... with a surgery time of 7 hours.
Experts must temporarily use an extracorporal circulation to temporarily replace the heart and lungs within 7 hours; Ensure that the heart is functioning well but avoid truyenting many fluids that cause lung edema, use less anesthesia and include in the most advanced blood monitoring devices; Cut the lungs on both sides to moderate, connect the two main bronchi instead of connecting the air ducts according to the classic to better blood connection, analyze the mouth of the bronchi in surgery to assess the 2 mouths connecting the main bronchi.
After lung transplantation, patients need to use strong immunosuppressants but are very susceptible to infection because they are available from the outside and the lungs are infected with A. Baummani is resistant to multiple resistance, so it is necessary to balance the dosage of immunosuppressants (because it is a drug that reduces resistance); Super filtering blood to treat renal failure due to many reasons, the team consulted to stop renal toxic antibiotics and control the concentration of immunosuppressants to reduce kidney toxicity and recover after 2 weeks; Increase vein and digestion nutrition, clean the lungs by opening the tracheal, suction and recovering for function. The patient continues to be monitored for resuscitation after the transplant.
The success of the heart-long transplant not only marked a remarkable step forward in organ transplant capacity, especially multi-organ transplantation, but also affirmed the professional qualifications of the Vietnamese medical team in the field of surgery. This achievement opens up opportunities for survival and new treatment directions for patients with end-stage heart and lung disease.
Success rate at major centers around the world
Thanks to advances in surgery, resuscitation and post-transplant care, the results of heart - lung transplantation have improved significantly.
In the UK, the survival rate after 90 days is about 85% and after 1 year is 72%.
In the US, some leading centers such as Stanford Health Care recorded a 1-year survival rate of nearly 90%, higher than the national average.
Many international reports show that the 5-year survival rate after the transplant is now about 60%, proving the effectiveness of this method in prolonging and improving the quality of life for patients.
