Vietnam marks milestone in first split liver transplant

Friday, 2019-03-15 17:02:01
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An adult patient following a liver transplant undergoing postoperative care. (Photo: NDO/Trung Hieu)
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NDO – For the first time in Vietnam, doctors from the Hanoi-based Vietnam-Germany Friendship Hospital have been successful in performing a split liver transplant, dividing a donor’s liver and transplanting it into one adult and one child patient.

The hospital on March 15 announced that organs donated from a 30-year-old brain dead man have been transplanted into five patients, including two kidney and two liver transplant recipients, as well as one heart transplant. In addition, blood vessels have been sent to a tissue preservation bank for transplanting to other patients.

Ass. Prof., Dr. Nguyen Quang Nghia, Head of the Organ Transplantation Centre under the hospital, said that the most complex aspect of the liver transplant was that the medical staff had to split the donor liver and then transplant it to one child at the age of eight, who was suffering liver failure - hepatic coma due to decompensated cirrhosis, as well as copper metabolism disorder and congenital biliary atresia), and a 49-year-old adult with liver cancer.

A simultaneous dividing and transplantation surgery was performed during 16 hours for the split liver transplant, witnessing a combination of leading experts from multiple specialties. Six days after the transplantations, all five patients have recovered well, in which the two with the liver transplant are now capable of self-breathing with consciousness and the new livers’ function has been restored and harmonised with the recipients.

According to Prof. Tran Binh Giang, Director of Vietnam-Germany Friendship Hospital, the success of the split liver transplant has affirmed the profession of the local medical staff and offered a new opportunity for patients waiting for liver transplants. At present, the source of livers for transplants remain limited, mainly from brain dead donors, but with the split liver transplantation, from one donated liver, two patients will be transplanted, instead of only one as before.

The split liver transplantation was first carried out in 1988 but it is difficult to implement due to the lack of understanding on the anatomy of the donor liver before dividing, while the transplant for two patients at the same time also requires huge technical crews that can perform the liver transplant in emergency conditions with complex techniques. For that reasons, split liver transplant is still not popular in the world.

The liver transplant programme at the hospital began in the early years of the 21st century. The first adult liver transplant was successfully performed on November 28, 2007. On April 15, 2010, the hospital also successfully carried out the first liver transplant from a brain death donor in Vietnam. Currently, the facility is active in most liver transplant techniques, including full transplant from brain dead donors, partial liver transplantation from living donors and split liver transplantation from brain death donors.

The biggest difficulty of liver transplantation is the scarcity of organ resources, making the number of liver transplant only meets about 10-15% of demand. Therefore, the hospital has advocated maximising the ability of liver transplantation for patients, in which its Organ Transplantation Centre has been assigned to research and implement the split liver transplantation technique.