18% of donated organs cannot be transplanted due to 'poor resuscitation'

"Brain-dead people have a rapidly progressing condition. If we do not resuscitate them in time and optimize the donor source, organ function will deteriorate and they may not be able to be used, which means we will miss the opportunity to save the lives of many patients waiting for transplants," said Prof. Dr. Nguyen Quoc Kinh, President of the Vietnam Association of Anesthesia and Resuscitation, at a training session on organ donation and transplantation from brain-dead people on November 15.

Brain dead people will have dysfunction of the nervous system, hypothalamus-pituitary axis, causing heart damage, reduced circulatory volume, low blood pressure, leading to reduced blood flow to organs such as the heart, lungs, liver, kidneys, pancreas. When organs fail, doctors cannot take them for transplant to other patients.

"Brain death affects the cardiovascular system and reduces organ perfusion. Therefore, resuscitation of brain-dead patients helps increase the quantity and quality of transplanted organs," Professor Kinh said, adding that to resuscitate and avoid multiple organ failure, doctors need to resuscitate circulation, respiration, and metabolism. Treat anemia, blood clotting disorders, and hypothermia to ensure a good source of transplanted organs.

Associate Professor Dong Van He, Director of the National Organ Transplant Coordination Center, also said that not all donated organs are medically qualified for transplantation due to some infectious diseases, cancers; organ failure before or after brain death. Therefore, organ resuscitation after brain death is very important. For a successful transplant, to survive in the recipient, the removed organ must be in good condition. Therefore, from the moment the patient is transferred to the hospital, he or she must be well resuscitated by the outpatient emergency system and 115 emergency.

In addition, in the process of receiving organs from deceased donors, the most urgent thing is time. Each organ has a different "life" period outside the body, from 4 to 36 hours. This is the "threshold" of the organs to withstand anemia. If this "golden" period is missed, all efforts to revive life will become worthless.

The first organ transplant from a brain-dead donor in Vietnam was performed in May 2010. As of November 2024, after 32 years of organ transplants and 14 years of organ retrieval from brain-dead donors, the country recorded 183 cases of brain-dead organ donation. The number of brain-dead people donating organs has increased recently, but the number of brain-dead people donating organs in Vietnam is still among the lowest in the world. Of which, the rate of organ transplants from brain-dead donors accounts for only 6%, the rest are transplants from living donors. This reality goes against the world trend, because in many countries, organs donated from brain-dead people account for the majority. Compared to Spain and the US, the rate of brain-dead organ donation is 300 times higher than in our country.

Organ transplantation is one of the most important achievements of human medicine since the 20th century. Since the first kidney transplant in 1992, the country has had 9,000 organ transplants performed. Of these, the majority were kidney transplants with more than 8,000 cases; liver transplants 650; heart transplants 90; lung transplants 11; and some other intestinal and organ transplants.

At the training session, Mr. Nguyen Trong Dien, Director of the Quang Ninh Department of Health, said that the province is preparing human resources and materials to move towards organ transplantation in 2025. Currently, doctors from the two provincial general hospitals and the Vietnam - Sweden Uong Bi hospital are studying transplant techniques at Viet Duc Hospital. Currently, the Ministry of Health has licensed 29 hospitals to perform this technique.