In medicine first, an HIV-positive mother gives her liver to her uninfected baby

Doctors at Donald Gordon's Wits Medical Center in Johannesburg announced last week that they had performed a liver transplant from an HIV-positive live donor to an uninfected patient, the first in the world.

The operation of the woman and her daughter with end-stage liver disease took place last year, when the girl was 13 months old.

Although HIV-positive people can donate organs in South Africa, they are not considered potential donors in the hospital's transplant program, in order to reduce the risk of transmission, said Jean Botha, director of the hospital's transplant program. program.

While the baby's condition continued to deteriorate after three months on the waiting list of an organ, the doctors said that they had to take into consideration the desperate demands of the mother .

Ethical decision

"We were faced with a difficult decision," said Botha, the chief surgeon of the case.

"We had to choose between the death of the child and the acceptance of an infected organ to save it." The mother continued to push and almost challenged us to possibly discriminate against her. HIV-positive people live in good health, we had to seize the opportunity, "he added.

"We were also facing the risk for this child, having a child too young to tell us if they were willing to assume that risk," Etheredge said, adding that an investigation was underway to determine the status HIV of the girl.

The baby received three antiretroviral drugs the night before the procedure to prevent HIV transmission. An anti-inflammatory was administered during the operation.

The mother and the child are doing well and the baby remains HIV-negative, the doctors said, but they will continue to follow up.

"The tests on the baby have yielded interesting results too, we can not present them for the moment," said Botha.

& # 39; Single deal & # 39;

Organ transplants have already been performed between HIV-positive patients.

Doctors from Johns Hopkins University performed the first kidney and liver transplants on HIV-positive patients in 2016. The donor had been living with HIV for 30 years and the recipient had been carrying the virus for 25 years.

South Africa has also been successful in transplants between HIV-positive people.

But two things made this case unique, doctors said: it is the first liver donation of a living donor living with HIV in the country; donors in previous cases had died. It is also the first liver transplant from an infected donor to an HIV-negative recipient, with the intention of reducing transmission in the recipient.

The addition of HIV-positive patients to the donor pool helps countries facing a shortage of appropriate donors and offers South Africa, with its high burden of HIV, more opportunities to cope with HIV. offer transplant services to save more lives, said Mee.

"The shortage of appropriate organ donors for people in need of a transplant is a major problem worldwide.This problem is even worse in countries like South Africa where the rate of HIV is high and where infected people would normally be considered ineligible donors because of the risk of infection for the recipient, "said Mee

"We are facing a severe shortage of organs, which forces us to look for alternatives for transplanting our patients," said Botha.