SOUTH AFRICA: Cape Town surgeon pioneers organ transplants for HIV positive patients

Record ID: 402391

  • Title: SOUTH AFRICA: Cape Town surgeon pioneers organ transplants for HIV positive patients
  • Date: 5th April 2012
  • Summary: VARIOUS ARTICLES ON DR. ELMI MULLER PINNED TO WALL
  • Embargoed: 20th April 2012 13:00
  • Keywords:
  • Location: South Africa, South Africa
  • Country: South Africa
  • Topics: Science
  • Reuters ID: LVABV93WEZ3A1JSHV3Y2A76U2DRZ
  • Story Text: A Cape Town doctor has pioneered a technique to transplant kidneys between HIV-positive donors and recipients.
    Her procedures are highlighted in the prestigious New England Journal of Medicine earning her global attention and acclaim for her innovation.
    In 2008, Dr Elmi Muller and her team became the first in the world to transplant a kidney from an HIV-positive donor to an HIV-positive patient. Since then she has performed fourteen surgical procedures at the world renowned Groote Schuur Hospital, where Professor Chris Barnard led the team which performed the first human-to-human heart transplantation operation in 1967.
    Muller says kidney failure is prevalent among HIV-positive people because kidney function is adversely affected both by the virus itself and prolonged use of medication to keep the virus under control.
    HIV-positive patients with end-stage kidney failure have never qualified for dialysis or transplants in the South African state sector.
    "In South Africa when I started the programme for HIV positive patients, the patients didn't actually qualify for dialysis in the state sector at all, the patients were sent home to die, they didn't have the option of dialysis, they didn't get a transplant and we offered them no treatment," said Muller.
    Muller realized kidneys of donors whose blood samples showed they were HIV-positive were not used for transplants. So she decided to investigate the option of transplanting these kidneys into the bodies of other HIV-positive patient group.
    After the first operation Muller received a number of referrals for HIV-positive patients who were in need of kidney transplants.
    "The reason we can do it is that we have such low resistance rates in South Africa of HIV resistance so it's a fairly safe thing in the South African context. We got anti-retroviral therapy quite late and that means everybody started on triple therapy straight away, if you look at resistance patterns it develops mostly when you start one ARV and not the second one or you don't start triple therapy straight away. In South Africa we started all our patients on triple therapy which means we don't have that high rejections rates," added Muller.
    Nomakhaya Plaatjie was diagnosed with HIV in 2002. She found out five years later she had kidney failure and needed a transplant.
    The 34-year old mother of two from Khayalitsha township said she had lost hope and thought she would never see her son go to school. She was introduced to Muller through her counsellor and put on the waiting list to receive a kidney transplant.
    "I would like to encourage organ donors to come forward because there are a lot of people that are very sick and need them, this will give them a chance to a new life. People should donate their organs with an open heart because they are not only helping the doctor but also giving someone a chance to raise their children," said Plaatjie, two years after the transplant surgery.
    Muller says a lot of support is given to the patients after surgery.
    One patient, Bulelwa Nxusani, is HIV positive and has also received a kidney transplant. She was admitted to hospital because of complications with her anti-retroviral treatment. But doctors said she would be released soon.
    "The kidney transplant has made a big difference in my life, I couldn't do anything for myself but now I can do whatever I like," she said.
    The donors don't have to be HIV positive, but Muller says the waiting period for the HIV positive donors and kidney transplants is shorter. Most of the kidneys come from HIV positive patients who are brain dead or people who have suffered from trauma and whose families have consented to the procedure.
    Muller has an active interest in promoting organ donation and transplantation and is currently the International Transplantation Society's councillor for the Middle East and Africa region as well as the president of the Southern African Transplantation Society.
    She has been involved in transplant-related outreach and educational programmes for the public and medical profession through the Organ Donor Foundation of South Africa.
    Her project recently received a major boost when she obtained funding from the Roche Organ Transplantation Fund (ROTRF) to conduct further research into the virology, pharmacology and immunology of these transplants.
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