South Africa: From Split Livers to Machine Perfusion - the 20-Year Evolution of Liver Transplants in South Africa

South Africa has a rich history in organ transplants, with the world's first heart transplant performed in the country during the 1960s. Over the decades, there have been significant advancements in various transplant procedures. The Wits Donald Gordon Medical Centre has marked a milestone by completing 1,000 liver transplants since initiating its program in 2004. The center's head of transplant surgery, Jerome Loveland, discusses the current state and future of liver transplantation in South Africa.

The transplant landscape in South Africa has evolved from a single center in the 1980s to a high-volume transplant center today. Split liver transplants allowed for optimal use of available livers, while living donor transplants and transplants across the blood group barrier have expanded the options. The most recent advancement is machine perfusion of the liver, which has enabled the resuscitation and storage of donor organs for extended periods, increasing the number of livers transplanted.

Despite these advancements, challenges remain, primarily due to the limited availability of deceased donor organs. South Africa has over 4,000 people waiting for organ transplants, and the demand for liver transplants has increased over the last 20 years. This increase is driven by broader eligibility criteria for patients and improved awareness among physicians and patients. Jerome Loveland emphasizes the importance of organ donation, stating that by donating one's organs, individuals can save seven lives.