A gift that will leave a lasting legacy
An expert in organ and tissue donation explains the power of transplants
‘To leave a lasting legacy is probably one of the most deep-seated human desires. Hence, giving part of oneself through organ and tissue donation is a gift that never ceases to yield rewards. Unlike a gift voucher that eventually gets used up, this is a gift that becomes part of another person’s life.” This is the opinion of Cleo Ndhlovu, manager of the Tshwane University of Technology’s Centre for Tissue Engineering (CTE) in Pretoria.
With a focus on August as Organ Donor Month, the Mail & Guardian talked to Ndhlovu about the importance of organ and tissue donation, as well as the amazing work done at the CTE, which celebrates its 14th anniversary this year. Her love for this challenging sector of the health industry is clear when she talks about the life-changing difference the transplant of tissue — such as a cornea, a bone allograft or the treatment of serious burn wounds through the use of cadaveric skin — can make.
What is the Centre for Tissue Engineering?
The CTE was established in September 2002. Prof Daniel du Toit, the current director of the CTE, explained that this followed his discussions with Martina Lutz, managing director of Bone SA, while he was head of the department of biomedical sciences at TUT. Prof JJ Pieterse and Prof Mariëtte Lowes, then dean of the faculty of health sciences, were involved in drawing up the agreement signed by Lutz and Du Toit. Prof du Toit added that the gift of life is the most altruistic deed that one person can do for another. “The dedication with which Cleo Ndhluvo and her team go about their work to enhance the quality of life of many South Africans makes me proud to be associated with CTE”.
The CTE was established to make more bone tissue available in the country for transplants, but it soon developed into a mature, multi-tissue bank with a strong professional reputation, both locally and internationally. Located at the CSIR in the East of Pretoria, the CTE operates in all provinces throughout South Africa to procure human tissue from cadaveric donors. It provides tissue allografts to private and state hospitals, clinics and surgeons.
According to Ndhlovu, it was initially quite challenging to establish the CTE as a role player in the industry. However, by 2005, and under the directorship of Professor Danie du Toit and Dr Nicolaas Duneas, the CTE gained substantial support and donor numbers have since increased steadily.
“Although the CTE’s primary focus is on the retrieval, processing and storage of bone, cartilage, tendons, corneas, skin and cardiovascular tissue for implant, transplant and therapeutic purposes, human tissue research and development functions are also provided for internal role players, as well as external industry partners. The CTE is the only true multi-disciplinary tissue bank in the country,” says Ndhlovu.
Why would people become donors?
Ndhlovu explains that, although there is little awareness about tissue donation, tissue transplants play a vital role in improving the quality of life for ordinary South Africans. This includes healing opportunities for patients who suffer from skeletal conditions, repairing the sight of people who may otherwise suffer permanent blindness, saving the lives of burn victims and providing treatment options for people with congenital heart defects.
“Donors come from all walks of life, but unfortunately only a small segment of the South African population are currently registered as donors. This may be due to cultural and religious factors, but I strongly suspect it is more due to a lack of information. In addition to the CTE’s own efforts to educate the public on the responsibility of becoming donors, we have always worked closely with the Organ Donor Foundation (ODF), to reach people of all communities and to provide them with information to understand the benefits of donation.”
She explains that a formal partnership agreement signed between the cadaveric tissue banks of CTE, Bone SA and ODF in July 2016 will go a long way towards increasing marketing opportunities and resources to escalate the general awareness about all forms of donation.
“We are excited about the agreement, which will allow for more integrated and centralised marketing and advertising campaigns to create awareness of the vital services all these organisations offer. In addition, the logistics of liaising with donor families, referring potential donors, as well as registering to become a donor, will be centralised in one database in future. This means that whether people register on www.tissuedonation.org.za or on www.odf.org.za, all these registrations will go to a central database.”
How do you ensure adherence to ethical standards, and what are some of the challenges the CTE has to deal with?
“Because of the nature of our business, we have to be very aware of our conduct at all times, says Ndhlovu.
“Confidentiality is of the utmost importance. We often deal with sensitive information and it is vital that we follow the correct protocols when families and potential donors share such information with us. We always act within the law — we treat the body of every donor with utmost respect — as if it were a member of our own family.
“We are sensitive to the rules of
Tear of Hope
Taking hands with the glass experts at TUT’s faculty of the arts, the Tear of Hope, which has pretty much become our signature, was created as a reminder to donor families of their wonderful gifts to mankind. Every donor family receives an exquisite, hand-crafted, solid glass teardrop to say thank you, and to demonstrate the hope and new life that was made possible through their sacrifice of tears. other organisations or companies who assist us in the cause of organ and tissue donation. We value the health and lives of recipients and will never compromise on quality and safety.
“As far as the retrieval of tissue is concerned, our retrieval officers are compelled to adhere to very strict locally and internationally recognised procedures, against which they are continually evaluated.
“The major challenge we face is inadequate financial resources for marketing the importance of organ and tissue donation to the general public. Only about 200 000 people, from the total South African population of about 54 million, are currently registered as organ and tissue donors. We have a massive task ahead of us in educating people about the topic.
“At a national level, there is legislation that guides our work, but there is no official policy on organ donation, nor is there a national system that facilitates the donation process. The result is that when a registered donor passes away, we are often not aware of the fact, which can result in the tissue being lost.
“The partnership agreement between CTE and the ODF, which I alluded to earlier, is aimed at addressing and alleviating these issues.”
In addition to being organ donor month, August is Women’s Month. What is your message to the young women of this country?
“Women face many challenges and
To register as an organ and tissue donor please visit or
or call the toll-free number at 0800 22 66 11
have to juggle their professional, family and social lives, as well as other aspects of daily life. My advice is to surround yourself with supportive, like-minded people who understand where you are heading and who can provide the support you need to succeed. In this way the battle is already half won.
“Another very useful practice in my own life is to find mentors for different areas of my life. To have someone to talk to and to use as a soundboard is invaluable for providing guidance, both professionally and in your personal life,” says Ndhlovu.
What are some of the CTE’s milestones?
“Over the past five years, the CTE has been inundated with pleas from surgeons and burn units around the country to assist with the banking of skin for the treatment of burn victims. The majority of patients who require skin are state patients, who are more often than not the victims of shack fires that frequently result in life threatening burns. Although there are no financial advantages to be gained through skin procurement and distribution, the CTE and Bone SA felt morally obliged to make a financial commitment and take on the challenge to help these ordinary South Africans,” says Ndhlovu.
“The launch of the first skin banking programme in South Africa in April 2016 was probably one of the most notable highlights for the CTE. The programme is aimed at alleviating the dire need for skin to treat burn victims and prevent the death of victims. These deaths occur not only because of the severity of the burns, but because there are no effective, affordable synthetic treatment options available to patients in state hospitals.”
The best solution to this problem is cadaveric human skin. Only a few strips from the very top layer of skin can be procured from organ and tissue donors, which can then be used very effectively on burn victims.
Although there are a number of transplant centres, as well as eye and tissue banks around South Africa, there has never been a successful long-term skin-banking program.
The treatment of burns with cadaveric skin has a number of advantages for the recipient. The treatment process is far less traumatic and painful than treatment with synthetic dressings, less scarring occurs and the cost saving is massive.
“One of the biggest challenges in providing skin in adequate quantities is the shortage of organ and tissue donors. Every person in South Africa can make a difference, and we appeal to the public to make a decision in favour of donation after their death,” says Ndhlovu.
Early in 2015 cardiovascular tissue procurement was added to the CTE profile, following an agreement with Netcells, which does the actual cryopreservation of the valves.
“We are extremely proud of the progress the CTE has made in 14 years and take courage from the TUT slogan ‘We Empower People’. Looking at the work of the CTE, this slogan rings true in every sense of the word,” concludes Ndhlovu.