World’s first successful liver transplant from an HIV positive mother to a critically ill HIV negative child
PARKTOWN – A world's first surgery was successfully conducted at the Wits Donald Gordon Medical Centre last year.
Wits University announced on 4 October that they conducted the world’s first successful liver transplant from an HIV positive mother to an HIV negative child, at the Wits Donald Gordon Medical Centre in Parktown last year.
The child, whose identity was not revealed at the announcement, was critically ill with an end-stage liver disease at the time.
Transplant surgeon and principal investigator Professor Jean Botha said, “Bearing in mind that the patient was becoming increasingly ill and without a transplant, they would most surely have died, we opened up this possibility to the child’s mother,” said Botha.
The medical bioethicist at the centre, Dr Harriet Etheredge explained that the procedure was not conducted without looking at the opportunity from every possible angle.
Due to the fact that there was no knowledge about the risk of contracting HIV and the child was too young to make a decision (13 months old), it was left to their mother to decide.
Etheredge explained that it was because of a brave set of parents who made a difficult decision that this surgery has opened up many options for HIV research.
Botha said, “Two aspects of this case are unique. Firstly, it involved the intentional donation of a [portion] of an organ from a living HIV positive individual.
Secondly, pre-exposure prophylaxis [medication to protect individuals from contracting the HI virus] in the child who received the organ may have prevented the transmission of HIV.
However, we will only know this conclusively over time,” adding that doctors do not know whether the child is not HIV positive.
Health Minister Aaron Motsoaledi applauded the team for being trailblazers and having unity in this procedure.
“We often undermine ourselves as South Africans and have forgotten that we conducted the first-ever heart transplant here. To me, what has happened today is the coming together of maturing systems,” said Motsoaledi.
He added that only a decade ago, HIV was a death sentence, but because of the maturing ARV treatment, the mother was virally suppressed when the procedure was conducted.
The second maturing system he referred to was the successful prevention of mother to child transmission programme which ensured that the child was born HIV negative.
“In 2004, 70 000 babies were born HIV positive, now we have reduced that to less than 4 000 babies,” he said.
“This operation has opened up new policy discussions regarding the question of whether HIV positive people can become organ donors.”
