Children’s Hospital 2 has performed 24 liver transplants in the past two years, double the number of cases in the previous 15 years, and is expected to accelerate in the coming time because this is the only solution to save the lives of children with liver failure and end-stage cirrhosis.
On July 10, Dr. Pham Ngoc Thach, Deputy Director of Children’s Hospital 2, said that this place performed 3 consecutive liver transplants, after being recognized by the Ministry of Health as qualified to perform organ transplants at the hospital instead of depending on other places, since April. Previously, the hospital had to rely on the support of transfer and the presence of units (that were qualified for transplants) such as Cho Ray Hospital, Ho Chi Minh City University of Medicine and Pharmacy Hospital or experts from abroad.
According to Dr. Thach, the hospital has been performing liver transplants since 2005. By 2020, the hospital had performed 15 cases, with the support of experts from Belgium. This is a very small number compared to the waiting list for transplants, which is always hundreds of cases, increasing every year. Obstacles come from scarce organ sources, high transplant costs, and complex transplant techniques. Each liver transplant surgery usually lasts 10-14 hours, requiring very strict professional qualifications.
Doctor performs liver transplant surgery at Children’s Hospital 2. Photo: Hospital provided
At the end of 2020, the Hospital established the Hepatobiliary Pancreas and Liver Transplant Department, focusing on investing in developing this area. At the same time, due to the impact of Covid-19, foreign experts could not come. Some children who could not wait for liver transplants passed away, and the doctors were determined to do it themselves. At the end of 2021, the doctors were completely autonomous in their techniques for the first time, without the support of foreign countries.
At the end of 2022, the hospital had to postpone organ transplants for children due to lack of operating rooms and the transplant plan had not been approved. Many families brought their children to Hanoi for transplants, while other parents who did not have the conditions had to bring their children home, threatening the children’s lives. After that, the hospital quickly added conditions and restarted organ transplants in June 2023.
The number of recent transplants has increased rapidly, currently reaching 36. Notably, in the past 13 months, the hospital has performed 12 transplants, or one a month, instead of one a year as before. “This represents a breakthrough in the number of transplants, aiming to speed up the saving of more children,” said Dr. Thach, adding that the facility is striving to reach the milestone of 50 transplants on the occasion of the inauguration of the organ transplant center and the celebration of April 30 next year.
Not only have the numbers increased, the doctors have also mastered many techniques and expanded the indications for transplantation. Most of the previous liver transplants were on children with congenital biliary atresia leading to cirrhosis and liver failure. Last week, the hospital performed its first liver transplant on a child with liver failure caused by vascular abnormalities, with much more complex requirements. In the near future, this place plans to perform liver transplants on children with liver cancer or cases of acute liver failure requiring emergency transplants.
Dr. Tran Thanh Tri, Head of the Department of Hepatobiliary Pancreas and Liver Transplantation, said that although the number of transplants has increased, it is still very small compared to centers that have performed thousands of transplants around the world. Therefore, the hospital’s liver transplants are considered “just beginning, with much more work to be done in the future.”
With kidney failure, patients who have not had a kidney transplant can prolong their lives through hemodialysis or peritoneal dialysis. For patients with liver failure or end-stage cirrhosis, a liver transplant is the only solution for children to escape the risk of death. Patients waiting for a liver transplant only have a golden period of time, requiring efforts to race against time to save the child in time.
Child patient after liver transplant surgery at Children’s Hospital 2. Photo: Hospital provided
According to Dr. Tri, each year, hospitals in the South perform about 100 operations for congenital biliary atresia. Most of the children then require liver transplants, so the number of children needing transplants is gradually increasing every year. Meanwhile, Nhi Dong 2 is the only facility in the South that performs organ transplants for children. The hospital continues to send doctors and nurses abroad for training, coordinates with domestic and foreign experts to handle complicated cases, and improve professional skills.
To increase the number of transplants and meet the needs of pediatric patients, doctors hope that Vietnam will soon allow humanitarian organ donation in brain-dead children under 18 years old, like many countries in the world. Most of the organ sources in many countries come from brain-dead donors, while in Vietnam, on the contrary, mainly from living donors. In addition, Vietnam needs to soon have an organ transplant fund to help poor families, and a policy to exempt expenses for testing and hospitalization for organ donors. The cost of a liver transplant at Nhi Dong 2 is about 600-700 million VND, excluding the amount paid by health insurance, the family spends about 300-400 million VND.