Liver Transplant Across Vietnam Saves a Child’s Life

Assoc. Prof. Dr. Ho Huu Thien visits the patient before discharge

"My child has been born again"

The pediatric patient is baby V.Q.H., currently 17 months old, from Ba Don, Quang Binh. Previously, the child was diagnosed with congenital biliary atresia - a rare and dangerous condition that affects liver function and can be life-threatening. At just 3 months old, the patient underwent a Kasai procedure (removal of the blocked bile ducts in the liver and using part of the infant’s small intestine to create a new pathway for bile drainage), but it was unsuccessful. With a Child-Pugh score of B and a PELD Score of 24, the baby was indicated for a liver transplant.

The baby’s parents had planned to donate part of their liver to their child, but unfortunately, their compatibility indicators did not match. After more than a year on the liver transplant waiting list and two missed transplant opportunities due to objective reasons, this time, luck finally smiled on the little boy.

During the transplant procedure, there were several technical challenges involving blood vessels and some postoperative complications, but the doctors managed to handle them successfully.

For Mr. V.Q.C. and his wife, since the day their child got sick, Mr. C. gave up his job as an electrician to accompany his wife in and out of the hospital to care for their child. When their child underwent the liver transplant, the couple went through some of the most unforgettable moments of their lives.

The lengthy surgery left everyone stressful, knowing that organ transplantation is unpredictable. “That whole night waiting felt like sitting on a bed of fire - no one said a word to each other, we could only silently pray,” shared a family member of the patient.

In the first days after the transplant, seeing the baby healthy made the family very happy. But later, the situation worsened due to a severe infection… “The doctors said at that point they thought he wouldn’t make it. When I heard the words “critical condition,” I felt like my soul left my body  - the family had to mentally prepare for the worst,” recalled Ms. Pham T.T., the baby’s mother, about her child’s life-or-death moment.

Thanks to intensive care, the baby pulled through. Three weeks later, Ms. T. was finally able to see her child. “When he saw me, he pouted and burst into tears as if he were hurt and lonely, and I cried with him. He had to be away from his mother’s arms, facing so many difficulties and pain alone to fight the illness,” the young mother recalled through tears. Few people know that she also spent more than 20 nights silently crying out of love and worry for her little son, who had to endure such a harsh medical ordeal in the earliest days of his life.

Up to this point, baby H. is more alert, the skin has started to return to normal, eyes are bright, active and quick in movements, eating well, and the body is absorbing nutrients properly. At the same time as receiving the good news of being discharged from the hospital, the boy also "got promoted" to become a big brother amid the family's joy.

Baby V.Q.H. sleeps soundly in his mother's arms after being examined

Baby V.Q.H.’s mother was moved: “To have what we have today, my family sincerely thanks the organ donor’s family for giving my child the chance to be born again, to live like any other child. We also thank the team of doctors and nurses who cared for my baby day and night as if he were their child, encouraging our family to overcome this difficult and challenging time.”

“Keep holding on until the very end”

On March 19th, after receiving a liver donation from a brain-dead donor at Thong Nhat Hospital (Ho Chi Minh City), with coordination by the National Coordinating Center for Human Organ Transplantation, one lobe of the liver was sent to Hue Central Hospital. The donated liver was divided into two parts: the left lobe and the right lobe. The left lobe was transplanted to baby H., as mentioned above.

Traveling nearly 1,000 km, the donated organ was rushed from Thong Nhat Hospital in Ho Chi Minh City to the airport, with support from traffic police, to catch the 7:30 PM flight back to Hue on the same day.

Dr. Ho Van Linh, Ph.D., Deputy Head of the General Surgery Department and Head of the Referral Coordination Office  - the person who went to receive the donated organ  - shared: “The donor’s liver had abnormalities in the artery and bile ducts. The transplanted liver segment had two bile duct branches with diameters of only 2 mm and 0.5 mm, with a distance of nearly 10 mm between the two branches. The left hepatic artery was damaged internally and had to be sutured at the site where the left hepatic artery divides  - the segmental artery  - during liver division, with a diameter of only about 1 mm. These posed significant technical challenges for the transplant team.”

Prof., Dr. Pham Nhu Hiep, Director of Hue Central Hospital, chatted with the patient and her mother through the window of the intensive care unit

The transplant procedure was supported by Associate Professor, Dr. Le Van Thanh from 108 Central Military Hospital. The most difficult part of this transplant was the grafting of the hepatic artery.

Assoc. Prof., Dr. Ho Huu Thien, Deputy Head of the Pediatric Surgery  -  Emergency Abdominal Department, said: “After nearly 4 hours of vascular anastomosis surgery and 30 minutes of bile duct connection, the transplant was successfully completed. After the transplant, ultrasound examination showed that the blood vessels were flowing properly. The entire surgical team was overjoyed and ecstatic. The most advanced resuscitation techniques were used to ensure the survival and liver function of the fragile infant.”

In the first 10 days, the child made very good progress; however, afterward, signs of infection and multi-drug-resistant pneumonia appeared, leading to a complicated clinical situation with a high risk of death. The doctors had to monitor every second and every clinical change closely, applying all their medical expertise, mobilizing full interdepartmental cooperation, and making the most of the modern medical equipment system.

A doctor shared that the child’s health was monitored and updated continuously. Every time they heard the baby cry, everyone felt deeply moved; looking into the child’s clear, innocent eyes, they all reminded themselves to give their all and "fight to the very end" to save the patient.

After more than 80 days of intensive treatment, the patient made a remarkable recovery and was discharged from the hospital amid the joy of both the family and the medical team.

According to Prof. Dr. Pham Nhu Hiep – Director of Hue Central Hospital – alongside heart and kidney transplants, the hospital has made steady progress in performing the trio of organ transplants. Liver transplantation is a technique that requires coordination among many specialties, from internal medicine, diagnostic imaging, and functional exploration to surgery, anesthesia-resuscitation, and post-transplant care. “In recent times, we have made very thorough and proactive preparations in all areas supporting liver transplantation, so that when it is performed, we are well-equipped to handle any situation and gradually master the technique. As of now, it can be said that Hue Central Hospital is capable of routinely performing liver transplants for both children and adults,” affirmed Prof. Hiep.