Why not take living lungs for 'patient 91'?
To transplant lungs into an adult, the donated lung must have a large enough volume, which would render the donor disabled.
Associate Professor Nguyen Huu Uoc, Head of the Department of Cardiovascular and Thoracic Surgery, Viet Duc Hospital, explained on May 19 that there are two sources of donated organs for lung transplants for a person. The first source is from a brain-dead person, depending on the patient's condition, one or both lungs can be taken from the donor. This type of whole organ transplant is simpler.
The second, more difficult case is a lung transplant from a living donor. This option is only suitable for children.
In Vietnam, the first child to receive a lung transplant from a living donor was a 7-year-old boy in Ha Giang in February 2017. The boy's entire lung was damaged due to bronchiectasis and had to be removed. Doctors at Military Hospital 103 took a lung lobe from his father and a lobe from his uncle to transplant to the boy. After the transplant, the boy's lungs gradually expanded.
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| Lung transplant for a child patient from a living donor, at Military Hospital 103. Photo: Provided by the hospital. |
"For adults, in principle, it is possible to transplant lungs from living donors, but adult lungs are large in size and have a large donor mass, so the donor will turn from a normal person to a disabled person," Associate Professor Uoc explained. Therefore, lung transplants from living donors to adults are usually not performed.
In the case of a small section being removed, the donor's lung function is not much affected. However, they cannot do heavy work or play strenuous sports afterwards.
If an adult lung transplant is performed from a living donor, at least three to four donors will be needed. Even if successful, post-transplant care, especially in terms of immunity, will be extremely difficult.
Therefore, adult patients can only receive lung transplants from brain-dead donors.
When transplanting lungs from a brain-dead donor, the volume of the donor's lungs must be equal to that of the recipient's lungs, with no difference of more than 30%. The transplant source must also meet immune conditions and many other compatibility indicators.
Viet Duc Hospital has so far performed 5 lung transplants, all from brain-dead donors. Before the transplant, doctors had to measure the size of the lungs to match the recipient and the donor. In 4 of the 5 cases, doctors had to remove some of the donor's lungs.
Dr. Uoc estimates the success rate of lung transplants at 85-90%, however, the patient's long-term survival rate is only 50% compared to heart transplants. 50% of lung transplant patients live for more than 5 years, while the rate for heart transplants is more than 10 years.
"Patient 91", a 43-year-old British pilot, weighing 100 kg and 1.81 m tall, is the most severe Covid-19 patient to date. The patient is dependent on the ECMO system, has a blood clotting disorder, an immune system overreaction syndrome, and has solidified lungs with only 10-20% remaining. The Ministry of Health has ordered a lung transplant from brain-dead donors. More than 40 people living in Vietnam have expressed their desire to donate part of their lungs to save the patient.
