On March 14, when brought to Vinmec, baby BLC (27 months old) was in a state of end-stage liver failure, multiple biliary tract infections and sepsis, and constant fever. The baby weighed only 10 kg but his abdomen contained more than 1.3 liters of ascites causing difficulty breathing, compression of the diaphragm, bleeding, and rupture of esophageal veins due to increased portal vein pressure.
Previously, LC had congenital biliary atresia and underwent Kasai surgery to connect the bile and intestines at 3 months of age. The progress one year after surgery showed that the baby was unfortunately one of the cases of congenital biliary atresia and did not achieve effective results after surgery.
The baby's bile duct system inside and outside the liver is not circulating, causing cholestasis leading to fibrosis and eventually liver failure with many serious complications such as ruptured esophageal veins causing gastrointestinal bleeding and ascites. That means, baby LC must have a liver transplant, otherwise his life will be in danger.
Mrs. HTL - BLC's grandmother (far left) recovered quickly and was discharged from the hospital just 5 days after liver donation surgery.
However, the results of the examination and evaluation of the liver anatomy of both LC's parents showed inconsistent results. The child's cirrhosis condition was getting worse, not responding to treatment and severe malnutrition, the child's life expectancy could only be calculated in days or weeks. Fortunately, the child's grandmother - Mrs. HTL (Vinh Bao district, Hai Phong) was qualified to donate a liver to her granddaughter after being tested and passing 3 strict rounds of examination.
Immediately, the Vinmec medical team urgently consulted and prepared carefully before successfully performing the complicated major surgery. The transplant not only aimed to completely solve the problem of liver failure, but also to solve the root cause of complications of the dangerous congenital biliary atresia for baby LC.
Baby LC had pain relief surgery by Vinmec medical team using ESP method which is safe and has no side effects.
With the careful care of the doctors in the surgical team during and after the surgery, LC's health improved rapidly after the surgery. Her skin was no longer yellow, her belly was slimmer, she ate well and started to gain weight.
The indicators show that the graft function has stabilized. According to the doctors, next, just using anti-rejection drugs, the baby can completely return to normal life.
In addition, the baby's grandmother also recovered and was discharged from the hospital just 5 days after the liver donation surgery.
Seeing both her daughter and mother safe and recovering very positively, Ms. PTL - LC's mother emotionally shared: "With a part of her body given to her by her grandmother and the wholehearted treatment of Vinmec doctors, my child feels like she has been born a second time. As her mother, there is no greater happiness for me than this moment."
Completely master complex "general" surgery
The 8-hour surgery for a patient weighing only 10 kg with liver failure was a real challenge. To be able to create blood vessels precisely, matching the blood vessels of adults, which are 3 times larger in diameter than those of children, the surgeon's technique had to be very high.
At the same time, the entire anesthesia process as well as intensive care and post-operative care requires smooth coordination between many specialties, following strict professional procedures to avoid possible complications.
Dr. Dao Duc Dung - the main surgeon of the surgery, has more than 10 years of experience in the fields of Digestion, Hepatobiliary - Pancreatic and Gastrointestinal Surgery.
With careful preparation and experience performing many pediatric liver transplants with Korean and Japanese experts, including a case of a patient weighing only 7kg, Vinmec's liver transplant team completely mastered LC's surgery.
Immediately after completing the surgery, the anesthesia team removed the endotracheal tube to allow the baby to breathe on his own, helping to reduce pressure in the chest, increase the quality of the newly transplanted liver, and avoid the risk of pneumonia for the patient.
“The Vinmec anesthesia team continuously tested and adjusted the necessary blood and urine parameters, paying attention to every small detail throughout the surgery. The patient received pain relief using ESP (erector spinae plane) anesthesia, which is safe and has no side effects.
Thanks to that, as soon as the surgery ended, the child was extubated and awake, to the boundless joy of his parents" - Master, Doctor Vu Tuan Viet, Head of Anesthesia Department, Vinmec Times City International General Hospital shared about the surgery.
Associate Professor, Dr. Pham Duc Huan - Director of Vinmec Digestive - Hepatobiliary - Urology Center, said that successes in liver transplantation in children can bring about long-term, meaningful changes in the lives of patients.
Biliary atresia is a common disease in young children, many of whom are waiting for transplants. Therefore, successful surgeries like LC’s give hope to families whose children are battling this disease.
"In the coming time, Vinmec will also promote pediatric liver transplants, along with developing liver transplant techniques in adults today," he said.
To date, Vinmec is also one of the few hospitals in Vietnam that routinely performs liver transplants for both children and adults and is the first hospital in Vietnam to be able to remove the endotracheal tube immediately after liver transplant surgery.
Over the years, Vinmec has shared its experience in liver transplant anesthesia and resuscitation with many domestic and foreign colleagues, contributing to improving the quality of liver transplants in Vietnam.
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