Medical news September 27: Organ transplant marks a turning point at Duc Giang Hospital
Duc Giang General Hospital has officially put its name on the Vietnamese organ transplant map by successfully performing the first kidney transplant on a female patient in Tuyen Quang.
A turning point in organ transplants at a capital hospital
On September 8, the Hospital officially put its name on the Vietnamese organ transplant map by successfully performing the first kidney transplant for Ms. NTBH (26 years old, Tuyen Quang) with a kidney donated from her biological mother.
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| Duc Giang General Hospital has officially put its name on the Vietnamese organ transplant map by successfully performing the first kidney transplant on a female patient in Tuyen Quang. |
Dr. Nguyen Van Thuong, Director of Duc Giang General Hospital, congratulated patient H. and said that the patient's health has recovered very well and he will be discharged next week.
A new life is coming is the story of Ms. NTBH, 26 years old, Tuyen Quang after a successful kidney transplant, with a kidney donated from her biological mother.
Ms. NTBH was diagnosed with end-stage chronic kidney failure in early 2022 and has had to undergo dialysis 3 times a week since March 2022, with the desire to have a kidney transplant at Duc Giang General Hospital and the hope that she will not have to go to the hospital for dialysis 3 times a week regardless of rain or shine, holidays or Tet.
Therefore, under the direction of the hospital's leadership, all members of the hospital's kidney transplant selection, anesthesia, and kidney transplant team, after a period of screening and pre-transplant treatment, the patient was successfully transplanted by surgeons of Duc Giang General Hospital, under the supervision of experts of Military Hospital 103.
What is special about this transplant is that the mother is relatively older and physically smaller than the recipient, so the risk of the transplanted kidney function not being as expected is high.
For a successful transplant, it is necessary to carefully prepare human resources and logistics and to anticipate all possible post-transplant scenarios because the possibility of graft rejection in this patient is relatively high.
With careful preparation of human resources and equipment, the patient's kidney transplant surgery proceeded as planned. After the transplant, the health of both the donor and recipient was completely stable, the transplanted kidney function and paraclinical indicators were within normal limits and they quickly recovered, returning to normal life.
The mother was discharged from the hospital 1 week after surgery, with stable health. Ms. NTBH is compatible with the new kidney and is functioning well, the test results of the transplanted kidney are within normal limits and she continues to receive post-transplant maintenance treatment, with regular check-ups as scheduled by the doctor.
Upon discharge from the hospital, Ms. NTBH shared that she was very moved by the affection of her family members and the dedication of the doctors and medical staff of Duc Giang General Hospital.
I don't know what to say other than my sincere thanks to my family and the doctors and nurses who have given me all their love.
As for Mr. LBC, 19 years old, in Quang Xuong district, Thanh Hoa, last April, LBC showed signs of fatigue, dizziness, frequent rashes, and had to be hospitalized.
After examination, the doctor concluded that he had end-stage renal failure. At this time, LBC was working as a leather shoe worker in Le Mon industrial park.
From a healthy young working man, he lost weight rapidly and fell into a state of anxiety, fatigue, and panic because there was no greater misfortune than knowing that he had an incurable disease, and that his life would be tied to the hospital and a dialysis machine. His family also took LBC to several hospitals across the country for treatment in the hope that his health would improve.
However, the miracle did not come, he was diagnosed with end-stage chronic kidney failure and had to undergo dialysis 3 times a week.
Doctors at Duc Giang General Hospital advised him on kidney replacement therapy methods, of which kidney transplantation is the most suitable and best treatment method for him at this time.
After screening kidney donors who were family members, doctors concluded that the mother's kidney was suitable for transplantation to LBC.
On September 11, the kidney transplant team of Duc Giang General Hospital performed kidney transplant surgery for the mother and son pair. After more than 6 hours of surgery, the transplant was successful beyond expectations. After the transplant, the health of both LBC and his mother improved.
LBC shared that he was very happy to have had a successful kidney transplant. Now he no longer has to be tired from dialysis or waste money, energy, and health. The successful surgery has given him hope for a new life.
Dr. Nguyen Van Tuyen, Head of the Department of Nephrology and Urology, said that in order to maintain life, patients must go to the hospital for dialysis once every other day and in addition to the health insurance costs, patients still have to spend a considerable amount of money every year such as travel and vehicle costs and what is more difficult is that they and their accompanying family members cannot earn their own income.
And despite regular dialysis, the patients’ health can only do light work, try to take care of themselves, and participating in labor, work, and study is very difficult. For these patients, if they receive a kidney transplant, they will have the opportunity to live a healthy life, live and work normally.
Organ transplantation is one of the greatest inventions of mankind in the 20th century, the most miraculous achievement of Vietnamese medicine and also the only way to save the lives of terminally ill patients. This is the best opportunity for patients with chronic, fatal diseases due to impaired function of tissues and organs that cannot be restored.
Donating tissues and organs to people with organ failure is a priceless gift, a miracle of life that helps patients who seem to have lost hope have another chance to live a normal life, to continue their unfinished dreams.
Currently, the Department of Nephrology and Urology of Duc Giang General Hospital has nearly 170 patients, each day there are 80 patients on dialysis divided into 3 shifts undergoing periodic dialysis.
Hemodialysis makes patients and their families tired, requires frequent travel and is expensive. Therefore, maintaining, developing and mastering kidney transplant techniques at Duc Giang General Hospital will contribute to improving the quality of life for patients.
Teenage birth rate remains high
According to the Population Department, the birth rate among adolescents (aged 15-19) is still high, nationwide at 42 live births per 1,000 women, highest in the Northern Midlands and Mountains and the Central Highlands, where ethnic minorities are concentrated.
Mr. Le Thanh Dung, Director of the Department of Population, Ministry of Health, said that according to the General Statistics Office, Vietnam's population increases by nearly 1 million people each year. The number of women of childbearing age (15-49) is about 25 million people, and it is forecasted that the number of women of childbearing age will continue to increase, and the demand for contraceptives will continue to increase.
Although the quality of family planning services has gradually improved, there is still an issue of concern.
The total unmet need for family planning has not decreased but continues to increase, from 6.1% (2014) to 10.2% (2021) among women who are currently married or living together, especially among sexually active women who are not currently married or living together, the rate is up to 40.7%.
The birth rate among adolescents (aged 15-19) is still high, nationwide at 42 live births per 1,000 women, highest in the Northern Midlands and Mountains (115) and the Central Highlands (76), where ethnic minorities are concentrated,” said Mr. Dung.
Therefore, in the coming time, implementing family planning goals will continue to be an important content of population work.
Resolution No. 21-NQ/TW, the 6th Conference of the 12th Party Central Committee clearly stated that "Continue to shift the focus of population policy from family planning to Population and Development", which does not mean that family planning will not be implemented but will continue to be implemented more effectively to achieve the goal set out in Resolution 21: "All women of childbearing age have convenient access to modern contraceptive methods; reduce by 2/3 the number of adolescents and young people with unwanted pregnancies".
The theme of World Contraception Day 26/9/2024 in Vietnam is “Young people should take responsibility for safe sex and proactive contraception for their own happiness and for the future of the country”. The theme aims to arouse the responsibility of young people for safe sex and proactive contraception for their own benefit and happiness.
According to Mr. Le Thanh Dung, the Department of Health of provinces and cities should coordinate with relevant departments, branches and sectors to continue to pay attention to and advise competent authorities to effectively implement the Party and State's guidelines, policies and solutions on population work in the new situation, contributing to the completion of the goals of Resolution 21-NQ/TW of the Party and the Vietnam Population Strategy to 2030.
Direct the synchronous implementation of tasks and solutions to gradually overcome the situation of pregnancy and childbirth among minors; prioritize promoting peak communication campaigns integrated with providing population and reproductive health services friendly to minors and young people.
It is necessary to ensure that all women of childbearing age in the area have access to convenient, safe and quality family planning information and services; implement population education and reproductive health activities for adolescents and young people appropriate to each age group; characteristics and actual situation of each locality.
How dangerous is May-Thurner syndrome?
Ms. Dinh, 68 years old, had pain and swelling in her left leg due to pelvic vein thrombosis. Medication did not help and she needed surgery to remove the clot and dilate the narrowed area.
A month earlier, Ms. Dinh (Phu Yen) had pain and swelling in her left leg. She went to the hospital for examination and was diagnosed with thrombosis of the popliteal vein and left iliac vein. The doctor prescribed anticoagulants for her. After taking them for two weeks, the pain and swelling in her leg decreased, but did not go away completely.
A week later, despite following the medication, Mrs. Dinh's left leg became more swollen, painful to the touch, and felt tense and tight, especially when sitting or lying down for a long time. Continuing to take the medication as prescribed, she felt that her condition did not improve but became worse, and her leg ached a lot. She went to Tam Anh Hospital in Ho Chi Minh City for a check-up.
Dr. Tran Quoc Hoai, Department of Cardiovascular and Thoracic Surgery, Cardiovascular Center, Tam Anh General Hospital, Ho Chi Minh City, said that through clinical examination, the patient had symptoms of pelvic vein thrombosis with swollen legs, severe skin edema from the foot up to the left thigh, pain when pressed, and spider veins on the skin. Ms. Dinh had a venous ultrasound and a CT scan, which detected severe left iliac vein stenosis due to May-Thurner syndrome.
May-Thurner syndrome is a rare cause of iliofemoral deep vein thrombosis, accounting for 2-5% of all cases of deep vein thrombosis.
The condition occurs when the right iliac artery crosses and compresses the left iliac vein, slowing the flow of blood from the legs back to the heart. This condition increases the risk of deep vein thrombosis at the site of the compressed iliac vein.
The clot can break off and travel to other arteries, causing a life-threatening pulmonary embolism. In the long term, deep vein thrombosis can recur or cause post-thrombotic syndrome, affecting the patient's quality of life.
MSc. Dr. Pham Ngoc Minh Thuy, Department of Cardiovascular and Thoracic Surgery, Cardiovascular Center, Tam Anh General Hospital, Ho Chi Minh City, shared that in the past, for patients with deep vein thrombosis, doctors often treated them with anticoagulants and compression stockings.
This helps to partially improve symptoms, preventing the formation of new blood clots in the early stages. But after a while, the disease is likely to recur, as in Ms. Dinh's case, with more blood clots making the symptoms worse.
In May-Thurner syndrome, the cause of thrombosis and recurrence is due to compression of the pelvic veins. Therefore, in addition to drug treatment, a more effective method is to use thrombolytic drugs to soften the blood clot, remove the blood clot, then place a pelvic vein stent to clear the vein. This is a minimally invasive method, helping to almost completely resolve the venous stenosis, with a low chance of recurrence.
Ms. Dinh underwent a two-hour procedure. First, the doctor used a small balloon to expand the left iliac vein, then inserted a specialized instrument to suck out the blood clot in the vein. Finally, the doctor placed a stent in the vein to expand the vein, allowing blood to circulate normally.
The procedure went smoothly, without complications. The patient was discharged after one day, her leg swelling had significantly reduced, and she was prescribed anticoagulants for the first few months to prevent recurrence of blood clots. At a follow-up visit two weeks later, Ms. Dinh’s left leg had returned to its original size, and the pain had completely disappeared.
Doctor Hoai informed that May-Thurner syndrome is not a genetic disease and can occur in any subject. The disease has three stages: Stage I is asymptomatic, stage II is long-term compression of the veins causing damage to the blood vessels, stage III has formed blood clots in the blood vessels.
People at risk of blood clots are women over 50 years old, women who have just given birth, women with two or more children, women taking birth control pills, people who have to lie still for long periods of time, and people with diseases that increase the risk of blood clots such as cancer.
To reduce the risk of May-Thurner syndrome, it is advisable to maintain activities that keep the veins circulating normally: exercise regularly, do not smoke, do not stand or sit in one place for too long, avoid wearing tight clothing, and maintain weight within normal limits.
If you have early symptoms of the disease (swollen, heavy, painful legs, non-healing ulcers, varicose veins) or signs of suspected deep vein thrombosis (severe leg swelling, cramps, red or purple discoloration of the skin of the legs, feeling warm to the touch), you should see a doctor soon.
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