Kidney transplantation was first successfully performed in Vietnam in June 1992. Cho Ray Hospital initiated its transplant program in December 1992. This study aims to provide a comprehensive overview of the 30-year experience of kidney transplantation at Cho Ray Hospital—the largest kidney transplant center in southern Vietnam.

We conducted a retrospective descriptive study of all kidney transplants performed at Cho Ray Hospital from December 1992 to December 2022.

A total of 1,126 kidney transplants were performed, including 15 second transplants. The mean age of recipients was 34.4 years (range: 16–69), and that of donors was 50.0 years (range: 19–72). Living donors accounted for 94.2% of cases, while brain-dead and non-heart-beating donors contributed 5.4% and 0.4%, respectively. Left kidney retrieval was performed in 78.9% of living donors; single-artery kidneys represented 70.1%. Surgical techniques evolved from open nephrectomy (10%) to laparoscopic transperitoneal (24%), retroperitoneal (62%), and robot-assisted donor nephrectomy (4%) since 2018. All laparoscopic cases were completed successfully, with two requiring reoperation for postoperative bleeding. Most grafts were placed in the right iliac fossa (98.2%), and dialysis was performed pre-transplant in nearly all cases. Innovations included preemptive transplantation, ABO-incompatible transplantation, paired exchanges, and the use of expanded criteria donors and recipients. The average hospital stay was 7 days. Immediate graft function was observed in most cases. Long-term graft and patient survival rates were comparable to regional and international benchmarks.

Kidney transplantation remains a highly effective renal replacement therapy. Long-term success depends on donor type, recipient age, immunological compatibility, and optimal immunosuppression. Continued development of deceased donation—both brain-dead and circulatory—is essential and requires broader societal and policy engagement.