Celebrating a decade of HIV-positive transplants

Nombuyiselo Skafu, who was a recipient of a kidney transplant at Groote Schuur Hospital in 2015.

Groote Schuur Hospital celebrated a decade of doing HIV-positive to HIV-positive kidney transplants, last Friday.

Doctors and nurses attended the event, held on the eve of World Aids Day (December 1), along with recipients of the unique procedure.

Nombuyiselo Skafu, 36, from Port Elizabeth, had the surgery in 2015 and said it had improved her quality of life.

Apart from still being able to enjoy running, it had allowed her to speak to people at hospitals, clinics and churches in PE about kidney illness.

“I just want people to know that the HIV-positive to HIV-positive transplant has made me healthy again. People must go for this operation. It is good for people who have HIV; they get a kidney from a donor who has HIV. I am on treatment, and the kidney from that person was on treatment,” said Ms Skafu.

Since 2008, there have been 51 such transplants at the hospital, while a few have been done for private patients at the adjoining UCT Private Academic Hospital.

Professor Elmi Muller, Groote Schuur’s head of surgery, performed the first operation in 2008. “It was a time when HIV-positive patients were not considered eligible for dialysis or transplantation,” she said.

“It was difficult to navigate all those issues. The surgery was no more difficult than any other transplant, but the political situation was tricky.”

It had been a challenge managing interactions between the patients’ antiretrovirals and the transplant-related drugs but one that had become easier over time, she said

“The policies have changed; there is much more buy-in from the hospital managers. People got to know the results as they are good. They knew that they were not signing up for something that is unsafe. We have also increased the scientific work,” she said.

Fiona McCurdie, the transplant co-ordinator at Groote Schuur, has the tough job of finding donors.

“In many cases, when we find a donor, we deal with the families. We are not sure whether the donor is HIV-positive or negative. We would send the donor organs for testing and only at that point we find out whether it is HIV-positive or negative,” she said.

The main difference with the HIV-positive transplants was the way the patient’s post-operative medication was managed, she said.

Another patient from Cape Town, who underwent this surgery in 2012 but prefers not to be named, said she had named her new kidney Isipho, which means gift.

“I thank the team and everybody involved for making this possible,” she said.

Professor Muller said: “We are committed to transplantation and committed to the HIV-positive patients that will require them.”

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