In a remarkable example of team collaboration at The Alfred, paediatric lung transplant patient Thuong Mai returned home to Queensland last week, with a newfound dream of becoming a nurse.
The 15-year-old from northern Vietnam received a double lung transplant, a kidney from her mother and record-levels of blood products among many other medical interventions.
It wasn’t long after Thuong arrived in Australia with her family in March 2018 that she became increasingly out of breath. She was diagnosed with pulmonary arterial hypertension, restricting blood flow to her lungs.
In late 2018 she was placed in a coma at Queensland Children's Hospital and connected to Extracorporeal Membrane Oxygenation (ECMO), which did the work of her heart and lungs.
Belinda Bourne, Paediatric Lung Transplant Coordinator, was part of the team who flew to Queensland to assess Thuong and transfer her to The Alfred.
“We put out a nationwide urgent call for organs once we had established she was appropriate for transplant and that it was her only option for survival,” said Ms Bourne.
The gift of life came a week later, when another family’s tragedy made it possible for Thuong to receive a lung transplant.
Cardiothoracic surgeon Mr Julian Gooi led the team who performed the transplant, which he describes as the most complex case they can be faced with.
“It takes a large team of staff who are dedicated to doing very complex surgery – involving theatre staff, anaesthetic staff, a perfusion team, and many others, to operate on a patient like Thuong, who is airlifted on ECMO, horribly sick,” said Mr Gooi.
Thuong’s case was difficult and over the next three days she remained unstable, with more surgical teams called to help, and record amounts of blood products needed to keep her alive.
Recovery was slow, her kidneys had failed
A/Prof Basu Gopal, medical lead for kidney transplant at The Alfred, said Thuong’s kidneys were damaged from multiple assaults, including her initial and heart and lung problems, followed by many operations.
“It’s likely that Thuong would have remained on dialysis and her chance of survival was not great without a new kidney,” said Dr Gopal.
“The waiting list for a kidney from a deceased donor can be three years. Thuong didn’t have that much time.”
Thuong’s mother Lan Tran was a match, and after extensive consultation, Dr Gopal and the renal team confirmed that Ms Tran could donate a kidney to her daughter.
“I was willing to give anything that I have that’s needed to save my daughter, I wasn’t scared.” said Ms Tran.
A/Prof Gopal said there was a lot of work done by the Allied Health team to get Thuong to the point of another transplant surgery.
“Operating on a child, who’s had ECMO, is not easy and we had a capable doctor, Sharmila Chandran, who did the transplant. It was technically challenging – and what her situation shows is that The Alfred is ready to take on a challenge.”
An unimaginable recovery
Thuong now looks forward to returning to year 11 on the Sunshine Coast after what Mr Gooi describes as an unimaginable recovery.
“It highlights that our cardiothoracic and transplant unit is ready for complex cases.” said Mr Gooi. “The reward I get is to see a patient live their life. There is immense pride to see Thuong Mai walking out of the hospital – it’s a great feeling.”
Thuong says she is grateful to her lung donor and family, along with everyone at The Alfred, for giving her a second chance.
“The medical staff, the nurses who helped me, have done a wonderful job and I appreciate their devotion to helping me.”
Teams and specialities involved in Thuong’s care include: anaesthetics, perfusion, respiratory, ICU, renal, dialysis, Blood Bank, occupational therapists, physiotherapists, dietitians, cardiothoracic surgeons and language services.