Vietnam saves kidney patient with first incompatible transplant

The transplant was performed at Cho Ray, a leading hospital in southern Vietnam.

The recipient is Vi Van Biet, 54, and the donor is his wife, Tran Thi Hanh, 51. Biet has blood type A and Hanh, type B.

Biet had had to rely on dialysis since December 2020 as he reached the end stage of renal failure.

For almost two years, Biet had to undergo the process three days a week in HCMC. For the procedure, he had to leave home in Ben Tre Province in the Mekong Delta to take a bus at 5 a.m. and return home in the evening.

Traveling and dining out cost him VND10 million ($440) per month.

"Whenever returning home from dialysis, I always felt exhausted. I had to spend almost the entire next day resting and couldn't do anything," he said.

Biet's older brother, who has the same blood type, wanted to donate a kidney, but health examination shows he was not qualified.

His wife, Hanh, has the same wish, but their blood type did not match.

"Our son is just 16 so I really wish for his father to live on and be there for him."

Thai Minh Sam, head of the Department of Urology, said around 300 patients register for kidney transplants every year but the hospital could not cure 100 because of different reasons, with one of them being the lack of donors with the same blood type.

Sam said the process to transplant kidneys between recipients and donors with incompatible blood types has occurred in several countries.

"To perform incompatible organ transplant, it requests meticulous preparation and calculation or the recipient could suffer anaphylaxis and die shortly after the operation," said doctor Sam.

"Over the years, the hospital has sent doctors abroad to study and coordinate with dialysis units and blood transfusion centers to develop detailed plans," he said.

To transplant a kidney with different blood types, doctors must first stop the production of antibodies in the blood to avoid rejection. The patient is then subjected to the maximum removal of circulating antibodies by plasmapheresis, a term used to refer to a broad range of procedures in which extra corporeal separation of blood components results in a filtered plasma product.

Eventually, the hospital and Biet’s family reached an agreement for his wife to give him a kidney.

For the unprecedented kidney transplant in Vietnam, Biet and Hanh had to be hospitalized two weeks instead of two days before the operation.

Nguyen Minh Tuan, head of the Department of Artificial Nephrology at Cho Ray, said the goal of plasmapheresis is to remove antibodies from the patient's body.

"Fortunately, in this case, the patient has low antibody levels, so only three filtrations are needed," said Tuan.

The operation took place on Dec. 29 last year and the recipient could urinate right away.

The next day, he could eat and drink normally. His health has kept improving day by day.

"I’m feeling a lot better now. From now on, I no longer have to go through dialysis. My wife has recovered speedily after the operation," he told VnExpress on Jan. 21.

Biet has since been discharged from hospital.

The cost of the operation is thrice higher than normal but thanks to health insurance, Biet’s family only had to pay VND100 million ($4,400), similar to a normal kidney transplant.

Nguyen Tri Thuc, director of Cho Ray, said: "This initial success is a great signal that opens up a lot of opportunities for kidney patients."

In Vietnam, where organ donation is considered taboo as many believe one should die wholly prepared for the afterlife, black market kidney transactions are common.

In most cases, those with kidney failure have to register to wait in line for a legal kidney, which normally takes several months or even more due to a serious donor shortage. This has prompted many kidney patients to gradually lose hope and turn to the black market. In many cases, donors and receivers have no information on each other.