Doctors in South Africa had a wrenching dilemma: A baby in desperate need of a liver had been on the organ-donor waiting list for 181 days and wouldn't live much longer. The child's mother pleaded with doctors to take a portion of her own liver for a transplant, but one big issue stood in the way: The mother has HIV. Finally, surgeons at the Wits Donald Gordon Medical Centre decided they had no choice and performed what is believed to be the world's first transplant from an HIV-positive donor, per a university release. The surgery itself went well, and, more significantly, the child is HIV negative one year later. It's too early to say whether that will hold true permanently, but the news is being hailed as a potentially big development, especially in countries such as South Africa where HIV is prevalent.
"This operation could be a game changer for South Africa," write three officials from the University of Witwatersrand (affiliated with the hospital) in the Conversation. "The country has a large pool of virally suppressed HIV-positive people who have previously not been considered for living liver donation." The piece details the ethical quandaries the hospital faced, including whether it would be right to deny the mother a chance to save her baby, even with the risk of HIV infection. The story is drawing international attention, and in the US, Anthony Fauci of the National Institutes of Health says doctors made the right choice—even if the child had emerged with HIV. "If it is a choice between death and living reasonably well with a treatable infection, I think they made a quite reasonable choice," he tells the AP. (A canceled HIV test resulted in a huge payout for one patient.)