For 56-year-old Fanie Swart, sitting down to a Christmas lunch with his family this year will be nothing short of a miracle. He is the 100th patient to have received a lung transplant at Netcare Milpark Hospital’s highly specialised transplant unit.
“For me, it is a miracle that I will be able to spend Christmas at home with my wife, children and grandchildren. I never thought that I would make it through this year, but God has a plan for me,” Fanie said a few days prior to being discharged from hospital.
Fanie was in need of a double lung transplant because he suffered from interstitial lung disease with pulmonary hypertension, meaning that the blood pressure in his lungs was too high and they were not functioning normally due to inflammation and scarring of the lung tissue.
Fanie has never been a smoker but had been in very poor health for around eight years. He was dependant on an oxygen tank, which he says restricted his freedom, making him feel “like a dog on a leash”.
“When we saw him at the beginning of this year, Mr Swart was very, very ill and very short of breath. He had put on a lot of weight because of all the medication he was on, and due to his condition he was short of breath and couldn’t do much exercise,” says pulmonologist Dr Paul Williams.
Fanie needed to lose weight and increase his fitness level in order for his body to be ready for the transplant operation if a pair of matching donor lungs became available.
“We got him started on an exercise programme, doing as much as he could given the fact that he was reliant on supplemental oxygen. Mr Swart was extremely enthusiastic; he lost weight rapidly and regained his strength,” Dr Williams notes.
“A few months later, Mr Swart came for a check up and we realised that it was time for the transplant, conditions were ideal, and it was really just a matter of waiting until the right donor organ became available.”
In South Africa there is a critical shortage of organ donors, with approximately 4 300 South Africans on the waiting list for transplants, according to the Organ Donor Foundation. Fanie was extremely lucky because just a few days after being declared fit for surgery, a suitable matching donor organ became available and he received a double lung.
Mande Toubkin, Netcare’s general manager: emergency, trauma, transplant and corporate social investment says that the shortage of organ donors means that many people in need of organ transplants are not as fortunate as Swart. “Tragically, many people on the waiting list for donor organs die before suitable matching organs becomes available,” she explains.
“There is a limited window of opportunity, as only patients who have reached a certain stage of severity in their illness qualify to be placed on the national donor organ waiting list but, as was the case with Mr Swart, their bodies need to be fit and well enough to be able to survive surgery.”
The transplant team involved in the transplant at Netcare Milpark Hospital comprised Dr Williams, cardiothoracic surgeons, Dr Agneta Geldenhuys and Dr Martin Sussman, cardiothoracic surgery registrar, Dr Siya Mahlangu, anaesthetist, Dr Ronet Steyn and perfusionist, Deon Van Der Berg, while Sr Marlize Frauendorf served as the transplant co-ordinator. Netcare’s holistic transplant service also includes support from psychologists and dieticians through the different phases of the transplant process.
Dr Geldenhuys explains that Netcare Milpark Hospital’s lung transplant programme has access to extra corporeal membrane oxygenation (ECMO) technology, a life support system that is used to maintain the oxygen supply to the brain and other vital organs.
“ECMO technology has recently been introduced as an extremely helpful tool in our lung transplant programme. This is particularly beneficial because it reduces the need for blood thinning medication, thereby reducing the chance of certain complications during the operation,” Dr Geldenhuys says.
“Pre-operatively we place the patient on ECMO, so that the blood is artificially oxygenated before being returned to the body. Essentially, the ECMO machine does the work of the lungs while we perform the transplant, then slowly and gently ventilates the new lungs,” Dr Geldenhuys explains.
Dr Williams adds: “Mr Swart was placed on a ECMO machine in intensive care after the transplant. He has had a relatively routine course following the operation, but no transplant case can be described as ‘easy’, and no two are quite the same.
“All transplant patients encounter certain complications, but fortunately Mr Swart has had very few of these and things have been pretty much plain sailing. We gradually adjusted his medication and his immune suppression, which is necessary to prevent the patient’s body from rejecting the donor organs, and we are getting Mr Swart back on his feet again. He is up and ready, and very keen to go home,” Dr Williams noted.
None were more gratified with Fanie’s progress than his wife, Naomi, who recalls: “Before the transplant, we could never go out because Fanie was reliant on an oxygen tank, and now we will be able to.
“Fanie and I went through some difficult times together. He has now had this opportunity to receive lungs and it is wonderful; a miracle from God. If it hadn’t been for the support of our children and grandchildren, we wouldn’t have made it this far. As a special Christmas treat, I am going to make roast leg of lamb, which Fanie has really been looking forward to. Having my husband home is the best Christmas present I could dream of; I love him very much,” Naomi says.
“I just want to thank the transplant team, the doctors and everyone who was involved. I also want to pay tribute to the donor and the donor’s family, who gave us this opportunity.”
Fanie adds that he has written a letter expressing his thanks to the family of the donor, who must remain anonymous in terms of the strict ethical protocols for organ donation.
“I am very thankful to the donor and their family, to God and to everyone who were involved in my surgery and care. Now I can walk outside, play with my grandchildren, and that is a huge gift. I never thought that I would make it through this year,” Fanie notes.
Fanie’s children say that the thought of losing one of the most important role models in their lives was frightening. “We are so grateful for the second chance God gave our dad. Our wish for him was to wake up and just have that feeling of being able to breathe without having to feel like he is suffocating. Our wish has come true and we are overjoyed that we will be able to spend Christmas with him as a family.”
Toubkin says that, like all transplant patients, Fanie and his family will continue to receive support following his discharge from hospital. “We wish Mr Swart and his family all the very best over the festive season, into the New Year, and beyond. This would not have been possible if not for the donor and their family, and therefore we appeal to the public to consider registering as organ donors, as this truly is the gift of life,” she concludes.
Register as an organ donor to pass on ‘the gift of life’ to others
Each organ donor has the potential to save up to seven lives after their own death, as the heart, liver, pancreas, kidneys and lungs may help others in need of organ transplants. Remember that when you register as an organ donor, you can decide which organs or tissues you are willing to donate.
To register as an organ donor or for more information contact the Organ Donor Foundation on their toll free number, 0800 22 66 11, or visit https://www.odf.org.za.
Registering as an organ donor is free of charge and the donor and their family do not incur any costs in the organ donation process. If you wish to donate your organs when you die, discuss your wishes with your family, as they will need to give the final permission – even if you are a registered organ donor.
The process of removing donor organs can only begin after two independent doctors have pronounced the donor brain dead. The removal of organs is done with the utmost care and respect, and the process does not affect the appearance of the body. Once the organs have been removed for transplantation, the donor’s body is returned to their family for burial or cremation.
Issued by: Martina Nicholson Associates (MNA) on behalf of Netcare Transplant Division
Contact : Martina Nicholson, Graeme Swinney, Meggan Saville and Pieter Roussouw
Telephone: (011) 469 3016
Email: [email protected], [email protected], [email protected] and