Vietnam carries out world’s first limb transplant from living donor

Monday, 2020-02-24 15:13:26
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Vietnamese doctors have successfully performed the world’s first hand transplant with the donor hand comes from a living donor. (Photo courtesy of the 108 Military Hospital)
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NDO – Vietnam medical sector has marked a new milestone as local doctors have successfully carried out the world’s first hand transplant with the donor hand coming from a living donor.

After four years from losing his hand in a labour accident, a 31-year-old male patient now has a new hand transplanted from a living donor. The Hanoi-based 108 Military Central Hospital on February 24 announced that it has successfully performed the historic limb transplantation, which is the first hand transplant in Southeast Asia, and also the first hand transplant in the world with the donor hand taken from a living donor.

Pham Van Vuong, 31, from Hanoi’s Thanh Tri district, had one third of his lower left forearm and the whole of his left hand completely damaged and deformed during a sudden labour accident in 2016. Because the crushed wound was so severe and completely incapable of preserving his arm, doctors at the hospital were forced to amputate a third under his left forearm.

Vuong was discharged from the hospital after two weeks of treatment, but the mental pain of losing his hand kept the young man depressed. His life has been difficult ever since.

On January 3, 2020, the hospital received a severe and complicated injured case, with one third of the patient’s left arm from upper forearm to the armpit severely damaged during a work accident. Doctors strived in their efforts during three operations for three weeks to save the patient's arm but the necrosis of the elbow and muscle, combined with infection, did not help, threatening the patient’s life.

Through careful consultations, doctors had to make a decision to give the patient an amputation equal to one third of the upper arm. When examining the injury, doctors also found that the excess part of the amputated limb (one third below the forearm to the hand) is relatively normal and can be used to transplant to other patients with their limbs amputated in the corresponding parts. The patient and family members agreed to voluntarily "donate" a part of the limb to Vuong as an extremely noble humanitarian intention.

In the face of high risk of secondary infection for the hand from the living donor, after careful consideration of all the possible risks, the Board of Directors of the hospital and surgical team has reached a decision after a special pre-surgery consultation as they decided to immediately carry out the "new hand transplant" for Vuong.

The transplant was conducted directly by Prof. Nguyen The Hoang, Deputy Director of the hospital, and doctors from of the hospital’s Upper Limb Surgery and Microsurgery Department. After eight hours, the "new forearm and hand transplant" from a living donor for Vuong was successful.

All anatomical structures have recovered and the transplanted hand is fully perfused like Vuong’s normal right hand. Immediately after the operation, Vuong was able to move the new fingers. So far, just over a month after the transplant, he has been able to use the transplanted hand to handle some rough objects.

The transplant is a success as the recipient is now able to handle objects. (Photo courtesy of the 108 Military Hospital)

Prof., Dr. Mai Hong Bang, the hospital’s director, said that limb grafting to salvage a severed or damaged limb is a technique performed regularly from the 1980s and up until now, the hospital is a leading medical centre in this field that has successfully performed tens of thousands of cases. The broken arms, forearms, hands and fingers can be resumed within 5-8 hours with convenient functional results if the patient is transferred to the hospital in time.

Replanting the broken limb by applying microsurgical technique is a difficult and complex technique, which is the culmination of plastic and micro nerve vascular surgery. Self-reconstruction of the severed limb using micro-surgical technique has been transferred to many other hospitals across the country by the 108 Military Hospital and so far, many local hospitals are capable of performing this kind of surgery.

Hoang said that the limb self-reimplant surgery is technically difficult and complicated, but that the limb transplant surgery is much more difficult. So far, although there have been tens of thousands of cases of self-replanting the disjointed limb successfully performed in the world, the limb transplant is not the same. It is a complex technique that requires donor and recipient that must be compatible in both the blood type and the immune system. The post-transplant also requires appropriate anti-rejection medication to be used much more cautiously than in many other organ transplants.

Since 1998, only about 89 limb transplants have been carried out in the world. In Southeast Asia, up until now, there has not been a single case of a limb transplant announced. For that reason, it is the first hand transplant in Southeast Asia, and also the first hand transplant from a living donor in the world to be carried out right at the 108 Military Hospital.