Annatjie and Paul Nel each donated a kidney to their two daughters, becoming living donors and saving their lives; TELL is celebrating living donors this “Orgust”, and this is everything you need to know about the selfless act.
South Africa (07 August 2024) – August is Organ Donor Awareness Month, and TELL (Transplant Education for Living Legacies) is dedicated to raising awareness about the critical importance of organ donation. This month, we aim to educate the public about the life-saving potential of living donations.
There are two types of donors: living donors and deceased donors. A living donor can only donate a kidney or part of a liver and has to be in excellent health, whereas the deceased donor’s suitability will be assessed at the time of death to determine which organs and tissue can be donated.
The Nel family were rocked when both their daughters were diagnosed with rare diseases affecting their kidneys, which will go on to affect their livers in years to come. Parents Annatjie and Paul Nel were each able to become living donors for their daughters Mia and Tanya.
Tanya had been on dialysis for three years, after a year of testing and making certain, Paul Nel was able to donate his kidney to Tanya in 2021. Just a few years later in 2024, Mia got her new kidney from mom Annatjie just before she was due to start dialysis.
Tanya and Mia were saved years of waiting, thanks to the living donation from their parents.
Living organ donation
You can donate a kidney or part of the liver to a patient on the waiting list, this may be someone you know or a stranger. Donating to a stranger is called an altruistic donation. Donating to someone you know, either a family member or friend, is known as a related (RLD) or non-related donation (NRLD).
A living donor needs to be in excellent health to withstand the operation and also to lead a normal life after donation. To be listed for a transplant, the recipient goes through a variety of tests and is assessed on an ongoing basis by their specialist. Only once the recipient has been cleared to be listed for a transplant, will the assessment of the living donor start. The work-up process for the donor is done in phases and can be stopped at any time if the donor changes his or her mind or if it comes to light that the donor has a medical condition that will prevent a transplant.
The World Health Organisation (WHO) defines donor selection:
“Live donations are acceptable when the donor’s informed and voluntary consent is obtained, when professional care of donor is ensured and follow-up is well organised, and when selection criteria for donors are scrupulously applied and monitored.”
Financial incentives for living donation are prohibited by the Declaration of Istanbul, which South Africa is a signatory, and also by law in South Africa.
Testing Process for Kidney and Liver Patients Awaiting a Transplant
For patients awaiting a kidney/liver transplant, the testing process involves several crucial steps:
- Evaluation: Comprehensive medical evaluation, including physical examinations, medical history review, and psychosocial assessment.
- Blood Tests: Blood type and tissue typing to ensure compatibility with potential donors.
- Imaging Tests: Chest X-Rays and ultrasounds, to assess the current state of overall health.
- Functional Tests (liver recipient): Liver function tests, including bilirubin, albumin, and clotting factor levels, are crucial.
- Infection Screening: Testing for infections such as HIV, hepatitis, and other transmissible diseases.
Cardiovascular Assessment: Ensuring the heart and blood vessels are in good condition to handle surgery.
General: Pap smear, Mammogram, BMI, dental health.
*some of these tests will be repeated annually or as requested by the transplant coordinator.
Tests for Living Donors for Kidney/Liver Transplants Living kidney/liver donors undergo a rigorous screening process to ensure they are healthy and suitable for donation:
- Initial Evaluation: Detailed medical history, physical examination, and psychosocial assessment to determine overall health and motivation.
- Blood Tests: Blood type and cross-matching to confirm compatibility with the recipient. Kidney donor: tests for kidney function (creatinine, eGFR). Liver donor: tests for liver function (ALT, AST, bilirubin).
- Imaging Studies: CT scans to assess the anatomical structure and function of the donor’s kidneys/liver. A liver biopsy might be performed.
- Cardiac Evaluation: Stress tests, echocardiograms, and other cardiovascular assessments to ensure the donor’s heart can withstand surgery.
- Infection Screening: Testing for infectious diseases like HIV, hepatitis B and C, and other transmissible infections.
- Psychological Assessment: Evaluating the donor’s mental and emotional well-being to ensure they understand the risks and benefits of donation.
Once all the tests are completed, the case will be presented to the transplant panel and once they approve the case will be referred to the Department of Health advisory committee for approval for a non-related living donation or altruistic donation. Only directly blood-related donors are not required to get approval from the Department of Health.
Who Can Be a Donor:
Living donors can be family members, friends, or even altruistic donors who volunteer to donate to someone they do not know. Key criteria include:
- Age: Typically 18 or older.
- Good Health: Donors must have good overall health without significant medical conditions that could complicate surgery or recovery.
- Compatibility: Blood type and tissue matching with the recipient.
- Informed Consent: Donors must fully understand the risks and benefits and voluntarily consent to the procedure.
During Organ Donor Awareness Month, TELL encourages individuals to learn more about living donation and consider becoming a donor. By stepping forward, you can give someone a second chance at life.
Who is TELL?
Life is the best gift you can give. That’s why TELL (Transplant Education for Living Legacies) helps educate South Africans about organ and tissue donation. TELL was created with a heart for hearts (and other organs). Two of the three founders received lifesaving lung transplants, which not only gave them a second chance at life but also put them in the unique position to make a difference in the transplant community. The other members of the team have also received an organ transplant or are currently waiting for an organ. Through years of working in the field, various barriers to organ transplantation have been identified and TELL is on a mission to solve as many of these problems as possible. Through awareness campaigns and education initiatives, they aim to lead the conversation surrounding organ and tissue donation in South Africa.
They are a registered Non-Profit Organisation (#219-134NPO) and a Public Benefit Organisation (930069136).
For more information about organ and tissue donation, please visit TELL’s social media pages @tellorgza, website at www.tell.org.za or e-mail: info@tell.org.za
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