South African doctors can now perform transplants across blood group barriers and use Africa’s first liver perfusion machine, yet the country records fewer than 1.4 dead organ donors per million people, leaving thousands waiting for potentially life-saving transplants.
Image: IOL Graphics / Canva
Organ donation is one of the last gifts an individual can give to make a difference in the world.
One dead donor can save up to seven lives, and tissue donation can improve the lives of more than 70 others.
According to Transplant Education for Living Legacies (TELL), a South African non-profit organisation founded by transplant recipients to educate the public, patients and healthcare professionals about organ and tissue donation, South Africa’s transplant medicine is advancing fast, but its donor rate is not.
“South African transplant teams are now performing procedures that were impossible a decade ago, including transplants across blood group barriers and, since June 2026, with Africa’s first liver perfusion machine.
“Yet the country’s organ donation rate remains among the lowest in the world, at fewer than 1.4 deceased donors per million people, leaving thousands of patients, including children, waiting for transplants that may never come,” TELL told IOL.
Mohamed Zayd Khota is thriving after a kidney transplant in July 2025.
Image: Supplied
In South Africa, surgeons can now transplant kidneys and livers across blood group barriers that would once have ruled a donor out entirely. A kidney exchange programme matches two incompatible donor-recipient pairs with each other, so both patients receive a compatible kidney in simultaneous surgery.
And the new liver perfusion machine keeps a donor liver viable for longer outside the body, letting surgeons assess and even improve it before transplant, sometimes allowing a single liver to be split between a child and an adult.
TELL co-founder and double lung recipient Fawn Kruger said transplantation is achieving things that would have seemed impossible a decade ago.
“South African patients now have access to world-class transplant expertise and innovative treatments. But every breakthrough still depends on the generosity of donors and their families,” Kruger said.
TELL explains how far transplants have come.
Image: TELL / Supplied
One such patient is Mohamed Zayd Khota, an eight-year-old from Lenasia in Gauteng.
For more than six years, his nights were spent connected to a dialysis machine while other children slept. Then, after years of hope, prayers, and an ABO-incompatible living donor transplant from a relative, everything changed in July 2025.
An ABO-incompatible kidney transplantation is a surgical procedure where a patient receives a kidney from a living donor who has a different and normally mismatched blood type.
According to the bubbly Grade 1 learner, he was on the transplant waiting list for five years.
“I was on dialysis for six and a half years from the time I was one year and nine months old. My mum did my dialysis every day at home. I had to make sure I was always home for dialysis and couldn’t go to school. My dialysis would last 16 hours overnight, and I had one extra two-hour session during the day. I had to keep myself very clean and away from germs to prevent infections,” Khota explained.
He couldn’t travel or play around like other children his age and, at the time, had to take 21 medications daily while on dialysis.
“I had weekly injections as well. My days were spent like clockwork for over six years,” he said.
Khota said he was both excited and scared when he found out he had a donor.
“My family was also very excited. It was an answered prayer after a long time of waiting. We couldn’t believe it was finally happening,” he said.
According to the eight-year-old, he now has a new lease on life.
“I can go to school now, and I’m able to drink as much water as I want without worrying about restrictions. I can swim and play with friends and no longer sit and watch while everyone has fun around me. I’m also allowed to enjoy time away from home and go on holidays. It really is a wonderful gift. We are thankful to God every day for this blessing,” Khota said.
The young fighter also urged patients on the transplant waiting list to “stay positive” and “remain in prayer”.
“Never give up and always try to spread awareness as much as you can,” Khota said, adding that he thinks the shortage of donors in South Africa stems from a lack of awareness and education.
“Living donation is something that very few people know about because, while we were looking, we had to explain that you can live a perfectly healthy life with one kidney and recover fully after donating part of your liver. We need to educate our youth on this important issue so that we have more living donors,” Khota said.
So, as he continues to grow, the eight-year-old is now leading a healthy, normal life with love and laughter, as every child is supposed to.
According to TELL, patients with blood group O wait 12 to 15 years on average for a kidney, and many die before a match is found. It is a stark position for the country that performed the world’s first human heart transplant in 1967, nearly 60 years ago. Spain, the global leader, has more than 40 donors per million through sustained public education, government backing and a transplant co-ordinator in every ICU.
South Africa has just 23 transplant co-ordinators in total.
Stella de Kock, managing director of Tell, who herself has been on the kidney transplant waiting list for 14 years, said a machine cannot fix a system that doesn’t refer potential donors in time, or a family that’s never had the conversation, or a myth that stops someone from saying yes.
Organ donation is a big deal, and it is advised that individuals speak to their families about this option.
Those wishing to become organ donors can register online on the Organ Donor Foundation of SA website.
More information about becoming a donor and the steps to take once a loved one has died can be obtained from the Organ Donor Foundation of SA’s toll-free number at 0800 22 66 11.
IOL
