Alive in me

Madimo Mokgosi (24), a teacher’s assistant at a prep school in Sandton, Johannesburg, is for once feeling her age. She is recovering from a recent liver transplant and has never felt better. “I have so much energy, I feel like I am back in the world after a long absence,” she says.

After being diagnosed with hepatitis autoimmune disease in her matric year, at age 18, Madimo felt tired all the time and constantly cold. “I couldn’t go out or work, I had jaundice and blood clots were visible through the skin on my neck,” she says.

In autoimmune hepatitis, the liver becomes inflamed as a result of an attack by the immune system. Although the exact cause of the illness isn’t known, some other diseases, toxins and drugs may trigger it in susceptible people, especially women. Untreated it can lead to scarring of the liver (cirrhosis) and eventually liver failure.

Madimo was treated with medicine for two years, but she couldn’t continue due to financial problems. “I thought things were under control, but I realised later that although the symptoms were ‘in hiding’ the condition of my liver was worsening.”

Her situation became critical in April 2013. “I was in and out of hospital and I was told my only chance was a new liver. But I was aware that many people die waiting for organs. ”

In South Africa, the waiting list for donated organs is extremely long, with the demand far greater than the availability. Around 4 000 people are awaiting all types of organs at any given time, with only 500 receiving transplants per year.

Hope arrived in the form of Dr Jean Botha, head of liver transplantation at the Wits Donald Gordon Medical Centre, where Madimo is being treated. “Dr Botha looked at my dad and said: Two things are going to happen - it’s either we get your daughter a liver or we buy her a coffin. And I am going to make sure that we don’t put her in that coffin. I broke down and so did my dad,” recalls Madimo.

Dr Botha is known for novel techniques in which he splits the liver of a patient’s family member in order to transplant a portion into the patient. Because the liver can regenerate, after surgery both the donor’s liver and the transplanted portion inside the recipient grow to full size.

Due to his weight, age and medical history, Madimo’s father was not an appropriate donor. She lost her mom when she was 10, and so a sibling was the next logical option. “My younger brother, Barnard, is too young as he is under 21, but my sister, Tsholofelo, seemed the perfect candidate,” says Madimo.

Tsholofelo immediately agreed to donate part of her liver to save her sister, notwithstanding the risks and the fact that she has a five-year-old daughter to care for. Authorisation for the procedure, and Discovery’s approval to pay all of Tsholofelo’s medical costs, was received within days.

But it wasn’t to be. During routine tests, doctors discovered that Tsholofelo was anaemic and couldn’t make the donation after all. Both women were devastated.

Madimo’s condition continued to worsen and she seemed to be out of options.

Then, 10 days later, on 25 October 2013, Madimo received a phone call. “I will never forget those words. The voice on the other end said: ‘We have found a liver for you and you need to be at the hospital as soon as possible.’ A friend came to collect me and I was at the hospital in less than 10 minutes. I was sent straight into ICU to complete compatibility testing.”

“A nurse came to us and said: ‘Have you heard the good news? The liver is yours and we are operating in 30 minutes!’ The procedure took six hours and Madimo has been recovering in the weeks since the operation. “I am feeling so well and I am so grateful for the donation of the liver that saved my life, and for the love and support of my partner Prince and his family.”

Just two months before her surgery Madimo was made permanent by her employers and joined Discovery Health. “They were there for me from the first day till now, and without Discovery I probably wouldn’t be alive,” she says. Madimo also does not have to worry about paying for the expensive medication she has to take every month to stop her body from rejecting her new liver.

“In some black cultures there is a saying: ‘We want to bury our person in full.’ This deters many people from becoming an organ donor, but we need more donors to save more lives. I was saved by someone I will never get to know, but I know that person lives on, as he is living in me.”