Thirty-one-year-old Zama Thobeka Mthembu from Witbank was the picture of happiness as she waited to be discharged from a Netcare Milpark Hospital in Johannesburg recently. She became the first person in the history of South African medicine to have a combined heart and kidney transplant.
Zama’s relief and joy following the lifesaving operation was palpable: “Previously I was always exhausted and could hardly walk; now I already feel that I have my life back and can live my dreams.
“I am so grateful to the transplant teams, and everyone who have provided me with support over this time, including my relatives and members of my church. Most of all I would like to thank the family of the donor, who were so compassionate at what must have been a time of great hardship for them, for making this miracle possible,” she added.
Cardiologist, Dr Graham Cassel, who is a member of the transplant programme at Netcare Milpark Hospital and who was part of Zama’s transplantation team, says: “Ms Mthembu’s operation is a landmark procedure in South African medicine and demonstrates the new levels of maturity that transplantation programmes in this country have attained.
“Worldwide, simultaneous heart and kidney transplantations are undertaken only rarely. We are delighted and gratified at the positive outcome that has been achieved in this case. Ms Mthembu, who has suffered numerous health problems throughout her life, has recovered well and is in good health and spirits after the procedure.
“Most South Africans are probably not aware of just how active our transplant programmes are in South Africa. This combined heart and kidney transplantation was made possible by the cooperation between the heart transplantation unit at Netcare Milpark Hospital and the kidney transplantation team at Wits Donald Gordon Medical Centre, both of which brought their expertise to this particular case.”
According to Marlize Frauendorf, transplant recipient coordinator at the Netcare transplant division, the team were most concerned when Zama cried continually after her operation. “When we asked Zama what was wrong, she said that she was crying tears of joy. She was overwhelmed at her good fortune in receiving donor organs, and the positive impact it will have on her life going forward.”
According to Frauendorf, Zama suffered from tuberculosis (TB) at an early age, which damaged her bones to such an extent that she had to have a hip replacement operation. She suffered renal failure six years ago and had to have one of her kidneys surgically removed. Zama has been on dialysis ever since then whilst waiting for a new kidney after being placed on the transplant list. To add to Zama’s health problems, two years ago she was also found to be suffering from cardiomyopathy, a chronic disease of the heart muscle.
“It became clear that Ms Mthembu required both a heart and kidney transplantation, but there was no matching donor available. Nevertheless, she was placed on the donor list for both organs,” adds Dr Cassel. “Then, in a rather remarkable set of circumstances, a donor match for both organs became available recently, enabling the dual transplantation to go ahead.”
The transplant team who performed the transplantations at Netcare Milpark Hospital included Dr Cassel; cardiothoracic surgeons, Dr Martin Sussman and Dr Agneta Geldenhuys; transplant surgeon, Dr Bernd Ströbele; transplant fellow Dr Sharan Rambarran; surgery registrar, Dr S Mahlangu; nephrologist, Dr Peter Hsu; anaesthetist, Dr Rudolf Monoyane; perfusionist, Alvin Naidoo; and the theatre staff. Also involved in the process were psychologist, Tascha Meredith; transplant recipient coordinators Thalukanyo Nelwamondo, Penny Eales and Marlize Frauendorf, as well as the organ donor harvesting team and nursing staff.
Jacques du Plessis, managing director of the Netcare hospital division, affirms that Zama’s transplant was an immense cooperative effort: “Heart-lung transplantations are undertaken from time to time by Netcare’s transplantation programme, but this is the first dual heart-kidney procedure. Ms Mthembu’s case brings new hope to those patients who may require such a dual transplantation in the future.
“We would like to congratulate and thank all members of the transplant teams who brought this initiative to fruition,” adds Du Plessis.
Nephrologist, Dr Peter Hsu, says the heart transplant was undertaken first, followed by the kidney transplant, with the combined operations taking a total of some 10 hours. “Both went off without a hitch although Ms Mthembu’s blood did start becoming worryingly toxic at one point and we had to undertake a therapeutic plasma exchange, which is a process used to filter toxic substances out of a patient’s blood. If all goes well she will no longer require dialysis.”
Mande Toubkin, Netcare general manager: transplant, says that approximately 4 300 people in South Africa are waiting for a lifesaving organ or cornea transplant but, due to a lack of donors, only about 600 transplants are performed each year.
“Tragically, this shortfall in organ donors in South Africa sometimes results in loss of life. We therefore encourage people to step forward to register as an organ donor with the Organ Donor Foundation,” pointed out Toubkin.
Issued by: Martina Nicholson Associates (MNA) on behalf of Netcare
Contact : Martina Nicholson, Graeme Swinney, Meggan Saville and Pieter Rossouw
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