At least 32 young children have died since 2000 after failing to receive a heart transplant – a sign of South Africa’s faltering organ donation and transplantation programmes.
In one hospital in a five-year period from 2010 to 2014, two children received heart transplants while 10 died while wait-listed for a transplant.
These figures are directly linked to government policy, the nation’s poor commitment to organ donation generally and the difficulty of matching a young recipient to a small donor heart.
Only 80 children have received a heart transplant in this country in the 40 years that programmes have been operating, an average of two procedures a year.
According to figures presented by cardiothoracic surgeon Dr Susan Vosloo of the Christiaan Barnard Memorial Hospital at the Heart Transplant Society congress in Gordon’s Bay last week, the transplant programme for children started at Red Cross Children’s Hospital in association with Groote Schuur Hospital in Cape Town in 1980.
In the first two decades, this government-funded programme completed 28 children’s transplants. However, with the new democratic government’s policy change towards primary healthcare, funding for the state transplant programme dwindled radically.
As a result, from 2000 to August this year, only four paediatric heart transplants were performed in the government hospital complex in Cape Town.
Meanwhile, the private sector started performing heart transplants on children from 1995 as well, picking up the load from the government sector. To date, Christiaan Barnard Memorial Hospital in Cape Town has transplanted 28 young hearts.
Durban private hospitals, which started a programme in about 2000, have transplanted 18 hearts and Johannesburg private have performed five transplants since 2010.
In addition, Vosloo said six heart assist pumps had been inserted into children in the past four years.
But, as life-affirming as these figures are, Vosloo presented a chilling dissection of the deaths of paediatric and congenital heart disease patients while waiting for heart transplant procedures.
In her own hospital, from 1995-1999, 12 children were placed on the transplant waiting list and nine received donor organs.
However, from 2010 to 2014, 10 died while waitlisted for a transplant.
Vosloo said congenital heart disease (CHD) would increase exponentially in Africa.
As more children born with CHD survive, it presented a later challenge as more adults who had experienced congenital heart disease were presenting for heart transplantation.
She suggested that healthcare professionals should assert the best interests of their patients in the face of state bureaucratic and commercial dominance.
– RAY HARTLE