Local resident, Yvette Viljoen recently shared her gripping journey of receiving a kidney transplant with Delaine Hazelhurst, CEO of the Hospicare Dialysis Centre.
On January 6, this brave woman and aspiring mother was gifted a kidney by her brother, Jacques Botha, a pharmacist, husband, and father of two toddlers who lives in Cape Town.
Her voice is joyful as she speaks of new-found hope, allowing her to dream of motherhood and of being outdoors again. She wants to participate in the World Transplant Games – yes, it is a real thing. She is in recovery, full of energy and tells her story to encourage sufferers of kidney disease and their families never to give up.
Yvette, the youngest of four siblings, had a happy and outdoorsy childhood. Born in Johannesburg and raised on a smallholding in Randfontein with chickens, cows, sheep, dogs, birds, and horses everywhere, and being part of a loving circle of family and friends, she felt lucky. At the age of eight, she was diagnosed with Type 1 diabetes.
Despite this, Yvette was relatively healthy. She qualified as a nutritionist, obtained two BSc degrees from the University of Potchefstroom (NWU), and completed various international qualifications. She learnt to play the violin and became a front-running advisor on nutritional sciences for humans and domestic animals. She has written various articles online and for magazines like Canine Zone and Get It, and has appeared in various television productions.
Little did she know how her young adult life was destined to become a roller coaster ride of extreme highs and lows. She had to learn to ‘hurry slower’ and focus her energy on actively fighting for her life.
Yvette’s fateful journey had begun. Her well-being and survival were now at the mercy of, and dependent on, modern medicine. Medication that was intended to control sugar and improve health in her pancreas, toxified her liver and gradually caused her heart and kidneys to fail. Cross-deterioration of organs happens to many patients, and one of the possible causes, according to Yvette, is how different drugs interact with each other.
There can be changes in the way a drug acts in the body when taken with certain other drugs, foods, or supplements, or when taken whilst having certain medical conditions. This can only be fully eliminated if patients educate themselves and actively participate in checking the effects of prescribed medication.
“Medical professionals are also just people, they are busy, and they make mistakes. However, there are times when ‘a slip twixt the cup and the lip’ can cost you your life,” Yvette said.
The ‘slips’ made during Yvette’s journey give one the shivers, but she bravely pushed it aside. Yvette survived a toxic liver, a heart attack from the wrong anaesthesia, a hip that was shattered in three places in a hospital, more than 200 days in ICU, a couple of weeks in a coma, and uncontrollable epileptic fits. She was resuscitated six times after almost dying.
However, the miracles on Yvette’s journey leave one warm and hopeful. Her mother’s intuition saved her life when she raised the alarm while Yvette lay in ‘recovery’ after a small procedure, her skin turning blue while she was on the brink of death. An empathetic yet strict doctor and qualified dietician walked the road with her. She had a vision of what Heaven looks like and whilst under anaesthesia she dreamt of giving birth to twins.
She married the love of her life at 28 – the same year she learnt that her kidneys had failed irreparably. She had to come to terms with undergoing dialysis (artificially replacing the function of the kidneys) three times a week, with three to four-hour intervals, which is a lifestyle not easy to adapt to. And then one more miracle – her brother announcing his commitment to giving her one of his healthy kidneys.
Dr MR Moosa wrote in his research article, The state of kidney transplantation in South Africa (SAMJ Research, April 2019, Vol 109, No.4) that kidney transplants have been performed in South Africa since 1966, initially only in the public sector before entering the private sector. Approximately 34% of all kidney transplants in South Africa are performed in Johannesburg, with a growth trend in the private and a declining trend in the public sector.
Charlotte Maxeke Johannesburg Academic Hospital (still not functional after the fire last year in April) has been the only public transplant hospital in Johannesburg since 1994, with Wits University Donald Gordon Medical Centre, Netcare and Life Healthcare private hospitals offering private sector transplants.
Yvette was subsequently accepted on the transplant list at Donald Gordon in 2016. She speaks highly of the transplant team, especially the transplant coordinator and team of nephrologists, who continuously educated and kept Yvette and her brother informed and prepared them for their difficult but legendary transplant journeys.
She expressed gratitude for the support and encouragement she received from her extended healthcare team at Hospicare Dialysis Centre in Roodepoort, who made sure that she remained fully compliant with the standards required for a patient to qualify for the operation. She was overjoyed when she received the green light after waiting for five years.
The kidney transplant process
A date is set by the professional transplant team. On the same day and in the same hospital, the donor is admitted earlier and separately from the receiver. Two medical teams are dedicated to the procedures, working in two separate theatres. The receiver is prepped and ready to receive the donor kidney within 40 minutes after its removal. Both patients are admitted to ICU under high care whilst their bodies adapt and start the healing process.
Jacques spent five days in hospital where he was monitored by a nephrologist and put on a Keto diet for a month. Yvette was encouraged to intimately get to know and ‘befriend’ her initial dosage of 30 pills a day, which would gradually be decreased.
Yvette, however, is considered lucky. Many others are not as fortunate and the road to finding a willing donor can be daunting and even impossible. In South Africa, organs are allocated on a point system, with the time a patient is wait-listed as the main determinant. Other factors include age, previous sensitisation and comorbid conditions. In Johannesburg, kidneys are allocated one each to the private and public sectors, irrespective of their source.
On average, deceased-donor transplants exceed living-donor transplants. However, future projections suggest that living-donor transplants are fast becoming the dominant source.
South Africa is a signatory of the Istanbul Declaration in which all and any form of commerce in organ transplantation are illegal. With all these challenges facing kidney transplant patients, the obvious road to the highest success is for family members and close friends to volunteer as donors to those they love.
Jacques believed it was his calling to help his sister get her life back. For five years, he committed to dedicating his physical well-being to reach and maintain a state where he would be a ‘good kidney donor’. This commitment did not come without cost. He willingly subjected himself to rigorous testing, cross-matching, and lifestyle changes.
He lost 20kg in the process which, amongst other things such as Covid, became a ‘hurry up, stop and go’ roller coaster. His wife, a medical doctor, supported this quest, despite having a busy life and two small children. His employer, DSV, also applauded and supported this family goal. It is well known that a sibling donating a matching kidney significantly reduces the risk of rejection.
This does not mean that the option of other family members or friends becoming donors is out of the question. Being a donor remains a hero’s journey and it undoubtedly is one of the most noble and selfless human sacrifices. Jacques’s one kidney is now functioning inside Yvette and his body is adapting well to metaphorically running on one engine in the kidney department.
Yvette finally has her life back. She has lots of energy, three extra days a week not having to go for dialysis, no more grafts, fistulae, and needle-poking. She feels empowered and, despite the healing process ahead, is praying to meet the twins she dreamed about. She wants to show them how beautiful nature is and how many things there are to live for in our beautiful country. She will be dedicating the rest of her professional life to medical research to help others. And yes, she will be spending a lot of time outdoors.
She now encourages kidney-failure victims who qualify to get a transplant, to be brave and to do everything possible to fight for a chance to get the transplant. It is a rough and emotional road of sacrifice, accountability, self-discipline, and perseverance, and 90% of the work lies with you as the patient. The medical team does the rest.
If you decided to donate your organs in South Africa, it is critical to know that wearing the donor bracelet or putting it in your living will is not enough. According to Stella de Kock, MD of Transplant Education of Living Legacies (TELL) there are many hidden obstacles in our donor process. Ultimately, the decision will be made by your closest family members while they are coming to terms with your passing. Therefore, they must be aware that donating your organs is your choice, and that you want them to carry out your final wishes.
