Initial Results on Lung Transplantation in a Vietnamese Hospital

Abstract

Purpose Lung transplantation (LTx) is a complex technique of organ transplant, both organizational, technical, postoperative as well as the poor long-term outcome. In the world, the first LTx was in 1963, but it has only developed strongly in the last 15 years (annual quantity about 70% of heart transplant). In Vietnam, LTx was first performed in February 2017 (bi-lung transplant for children from 2 living donors). Up to now, there are a total of 8 LTx across the country, of which 5 have been performed in Viet Duc university hospital. This report aims to present some of the baseline results for these 5 LTx. Methods Retrospective descriptive study for all cases of LTx in Viet Duc hospital with the general results, since December 2018 to October 2020. Results The main disease of 5 recipients was following: lung Langerhans's; congenital bronchiectasis; Eisenmenger syndrome due to congenital heart disease; Progressive acute respiratory distress syndrome (ARDS) due to complications of influenza H1.N1; and interstitial lung disease. All LTx received multiple organs harvesting (≥ 5 organs) and all transplants then are doing at the same time in Viet Duc hospital according to a unified procedure, the donated lungs are protected and treated in accordance with the recipient in each case. Transplant time range from 10 to 16 hours, which depends heavily on the adhesion of diseased lungs to the chest wall. Two-lung transplant technique is done according to the procedure with the support of ECMO, through Clamshell opening, 2nd time of closure of the incision, and tracheostomy are the main technical characteristics of our LTx group. Postoperative care is complex, mainly related to airway problems, with the shortest hospital stay of 2 months, the longest 10 months in 4/5 patients living after the transplant. One case was death in third week after LTx (H1.N1) caused by very severe infection lasted 2 months before surgery. Life of patients after discharge, if there is no special sequelae (3 cases), it is very positive, the monitoring and treatment is not too complicated compared to heart transplant. Conclusion The initial success of LTx at Viet Duc Hospital in the past two years will make an important contribution to the development of LTx - which is classified as this complex, in the future in Vietnam.