In a first, HIV-positive mother donates liver to save her child's life

Sunday, October 07, 2018

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JOHANNESBURG, South Africa (AFP) — Faced with the only chance to save a child's life, doctors in South Africa have performed a medical first — transplanting part of the liver from an HIV-positive mother into her HIV-negative child, it was announced last Thursday.

The doctors at University of the Witwatersrand in Johannesburg revealed that one year after the operation, the child may not have caught the virus from her new liver.

The child had a terminal liver disease and would have died without the transplant.

Medication given to the child “may have prevented the transmission of HIV. However, we will only know this conclusively over time”, said Jean Botha, chief surgeon at the university.

The team of doctors at the Wits Donald Gordon Medical Centre performed what it said was the first liver transplant from a mother living with HIV to her HIV-negative child, who was close to death after waiting six months for a donor.

They said that the mother and child, who have not been identified, have fully recovered and are in good health. After a transplant, liver remaining in the donor is able to regenerate rapidly.

The mother, who is being successfully treated with antiretroviral (ART) medication, had repeatedly asked to donate her liver to save her child's life — posing a major ethical debate for doctors due to the risk of HIV transmission.

“The transplant team faced the dilemma of saving the child's life whilst at the same time knowing that the child might end up HIV- positive,” the university added. “The actual chance of transmitting HIV was unknown.”

South Africa has the world's largest HIV treatment programme with 7.1 million people living with HIV, an 18.9 per cent adult prevalence rate.

About 3.7 million people in the country receive treatment for HIV, so the use of HIV-positive donors could help tackle the severe shortage of donators.

In 2017, 14 children waiting for liver transplants in Johannesburg died before having the operation.

“We hope that this ground-breaking operation will be the first of many like it and will contribute towards promoting justice and equity in liver transplantation,” June Fabian, research director at the university's medical centre, said in a press release.

A paper detailing the case was published last Thursday in the peer-reviewed AIDS medical journal.

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