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Liver transplant from HIV+ mother a success - Mom begged doctors to save her child

Doctors at Wits University in Johannesburg have conducted the country's first HIV-positive organ transplant to an HIV-negative recipient.
Doctors at Wits University in Johannesburg have conducted the country's first HIV-positive organ transplant to an HIV-negative recipient.

An HIV-positive mother begged her 13-month-old child's doctors to use her liver to save the terminally ill toddler even though it was expected the child would become HIV positive.

But, a year later, doctors say there is no concrete sign of HIV existing in the child's DNA.

A team of medical doctors from the Wits Donald Gordon Medical Centre in Parktown, Johannesburg, revealed this yesterday when they published their paper in the peer-reviewed journal Aids.

The transplant, which was done last year, is believed to be the world's first intentional liver transplant from a mother with HIV to her critically ill child with end-stage liver disease but HIV negative.

"The mother asked a number of times for the opportunity to save her child's life by donating a segment of her liver," said Dr Harriet Etheredge, who oversees ethics and regulatory issues at the Wits Donald Gordon Medical Centre.

Etheredge said the child had been on the waiting list for liver donation and would have died without the procedure.

She said the child was put on pre-exposure prophylaxis in preparation for the surgery, and the mother had a suppressed viral load.

Professor Jean Botha, who was the transplant surgeon in the case, said the decision to do the transplant was taken with the knowledge that the child would become HIV positive.

"In the weeks after the transplant, we thought that the child was HIV positive because we detected HIV antibodies," said Botha.

However, HIV experts that were brought in from the National Institute for Communicable Diseases could not find any active HIV infection in the bloodstream of the child.

According to Botha, between 20% and 25% of children who need organ donors in SA will die while waiting for a deceased donor transplant. Last year, 14 children died while waiting for a liver transplant in Johannesburg. "The situation is dire. This is what forced us to do this surgery which was very risky," he said.

Health minister Dr Aaron Motsoaledi said this success will open policy discussions on HIV-positive people being organ donors in SA.

Motsoaledi said this success meant that people living with controlled HIV may be a new group of potential donors needed to relieve the transplant crisis in the country.

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