In a historic milestone for African medicine, the Wits Donald Gordon Medical Centre (WDGMC) has officially launched the continent’s first liver perfusion unit. The arrival of the R2.7 million machine, manufactured by XVIVO, marks a paradigm shift in how donor organs are preserved, evaluated, and resuscitated, offering a lifeline to thousands of patients awaiting transplants across sub-Saharan Africa.
Historically, harvested donor livers have been packed statically on ice, a traditional method that limits an organ’s viability to a strict ten hour window. Under this intense time pressure, clinicians often have to make difficult, high stakes decisions based on limited data, frequently leading them to discard borderline or “marginal” organs that carry questionable risk profiles.
The introduction of machine perfusion completely alters this clinical reality. Rather than freezing metabolic processes on ice, the perfusion machine mimics the human body by continuously circulating cold, oxygenated fluids, nutrients, and essential medications directly through the liver cells. This process effectively resuscitates the organ, flushes out harmful metabolic toxins, and allows the surgical team to observe the liver’s functionality in real time before it is ever placed inside a recipient.
For South Africa, where organ donation rates sit among the lowest globally at just one to two donors per million people, maximizing the utility of every single available organ is a matter of life and death.
“Too many patients in South Africa deteriorate while waiting for a transplant because there are simply not enough donor organs available,” explains Dr. Bilal Bobat, a Specialist Gastroenterologist and Transplant Hepatologist at WDGMC. “Anything that helps us safely expand organ utilisation has the potential to directly impact survival and quality of life for patients and families facing end stage liver disease.”
The machine’s ability to provide a comprehensive metabolic profile of the organ before surgery removes much of the guesswork that has long plagued transplant medicine
“This technology changes the level of information we have available before transplantation,” notes Dr. Sharan Rambarran, a Transplant Surgeon at the facility.
“Traditionally, organs are preserved on ice and assessment is limited. Machine perfusion allows us to monitor how the liver is functioning outside the body. Beyond the valuable information it provides, the machine has the ability to resuscitate the liver by delivering oxygen to the liver cells, creating the best metabolic environment outside the body.”
The acquisition of this state of the art technology was made possible through a distinct three year collaborative effort between WDGMC, the non profit organization Surgeons for Little Lives, local distributor Coligo Medical, and corporate sponsor Weelee. Crucially, the hospital has ensured that the technology will be equally accessible to all patients on the transplant waiting list, seamlessly bridging the gap between the private and public healthcare sectors.
Beyond immediate survival rates, the clinical implementation of the machine is expected to increase local liver utilization by 10% to 15%. This surge in usable organs carries a powerful knock-on benefit for pediatric care. By using perfusion technology to salvage and stabilize borderline adult organs that would previously have been thrown away, pristine, optimal donor organs can be freed up, split, and utilized to save multiple critically ill children.
“As a transplant programme, our responsibility extends far beyond the operating theatre,” states Professor Jerome Loveland, Head of Solid Organ Transplantation at WDGMC. “This technology will help us better assess donor organs and increase the number of livers that can safely be transplanted, whilst simultaneously improving results. In a country where every donor organ matters, this will have a significant impact on organ utility and patient outcomes.”
While the medical community celebrates this technological leap, clinicians stress that machine perfusion is an optimization tool, not a cure all. Raising public awareness around the critical importance of voluntary organ donation remains the ultimate frontier in resolving the region’s healthcare deficit. However, as WDGMC prepares to conduct its first surgeries using the new unit, the future of African transplantation medicine looks remarkably brighter.
