'Breakthrough in science' - Motsoaledi on first ever HIV/liver transplant

2018-10-04 17:56
Aaron Motsoaledi. (Supplied)

Aaron Motsoaledi. (Supplied)

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A successful liver transplant from an HIV-positive mother to her critically ill HIV-negative child could unlock a whole pool of new donors.

At a press conference on Thursday, Minister of Health Dr Aaron Motsoaledi said the success of the procedure would open up policy discussions on whether an HIV-positive person could donate organs.

Motsoaledi called the operation an "amazing breakthrough in science".

Wits University wrote in a statement on Thursday: "In 2017, doctors from the transplant unit at the Wits Donald Gordon Medical Centre performed what is believed to be the world's first intentional liver transplant from a mother living with HIV to her critically ill HIV-negative child, who had end-stage liver disease."

The team of doctors included Professor Jean Botha, Dr Francesca Conradie, Dr Harriet Etheredge, Dr June Fabian and Professor Caroline Tiemessen.

Although doctors are unsure of the HIV status of the child a year on, they are excited about the success of the transplant.

"Two aspects of this case are unique. Firstly, it involved the intentional donation of an organ from a living HIV-positive individual. Secondly, pre-exposure prophylaxis (medication to protect at-risk 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," Botha, the transplant surgeon said.

The transplant of the mother's liver to her child, who had been on the waiting list for a deceased donor for 180 days, was approved by the human research ethics committee (medical) at Wits University.

"Transplanting HIV-positive organs is not illegal in South Africa. However, it is not considered best practice internationally because of the risk of HIV transmission to the recipient. To minimise risk to donors and recipients, this operation is offered only under exceptional circumstances," said Etheredge, a medical bioethicist.

The mother asked the team several times to be given an opportunity to save her child's life after the child had been waiting longer than the normal 45-day period. In this case, " quantifying the risk was simpler for the transplant team".

Conradie, an HIV clinician, noted that " when considering an HIV-positive parent, it is important that they have an undetectable viral load. This means that they know they are HIV-positive and that they have been taking their antiretroviral medication properly for at least six months.

According to Wits University, " the Wits Donald Gordon Medical Centre is the only transplant programme doing living donor liver transplantation in southern Africa".

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