Burn victims unable to get life-changing treatment

First published by GroundUp

Not a single patient who needed a skin transplant for serious burns could receive this treatment for weeks. This was revealed at a press conference at the Red Cross War Memorial Children’s Hospital in Cape Town on Friday.

“As soon as the skin and bone is banked, it goes out,” said Ana Sterrenberg, marketing manager from Bone SA.

But for two months no skin has been donated and the tissue bank is empty.

“We have a very desperate need,” she said. “Last year was the first time ever we had to import skin from America, because we did not have enough.”

Sterrenberg said too few people donate. The chances that an adult will currently receive donated skin are slim because in most cases a single donation could help two to three children. A panel of experts, not involved on the treatment of the recipients, makes this decision.

She said people are unaware that one can donate skin and bone, along with other organs such as the heart, lungs, liver, kidneys and pancreas.

Bone SA is a non-profit organisation which works in co-operation with the Centre for Tissue Engineering at the Tshwane University of Technology where the tissue bank is situated.

Dr Gary Dos Passos, head of the hospital’s Burn’s Unit, said there are five children at the hospital who urgently need skin transplants. “With a major open wound the only way to do a reconstruction is to use the patient’s own skin, which creates another wound. That puts massive stress on the body. But if there are huge burns, it is not possible to do.”

The best option is to use donated skin from organ donors. The donated skin takes on the role of your own skin. He said one’s body eventually rejects the transplanted skin, but by that time significant healing has happened.

“There is a huge difference in healing between patients who receive donor skin and those who don’t. It is a far better life saving intervention than any other available method, and one adult donor can save three children. You really have nothing to lose by doing this,” Dos Passos said.

Sandra Venter, public relations officer of the Centre for Tissue Engineering in Pretoria, said: “I am compelled to say something about the [donor] shortage in South Africa. In many other countries one is automatically a donor and have to request not to be one, not here. There are 300,000 organ donors in the country who have to provide for the needs of 58 million.”

The Centre for Tissue Engineering sources, processes and supplies human tissue for implant, transplant and therapeutic purpose. This includes skin, bone, cornea, tendons and heart valves.

“We need definite support from the government about possible donor referrals at all hospitals. This will give all families the opportunity to make a decision. But to do this we will need a moral and political will to drive organ donation,” Venter said.

The way in which donation takes place is also surrounded by myths and misunderstandings. The body is treated with respect and one can still have on open casket funeral. When the skin is taken “there is no blood, an instrument is used to shave off the very top layer of the epidermis. Only from the arms, legs and the back. Afterwards it looks like sunburn, or white.”

“We have to adhere to international ethical standards. With any donation the body is closed up again, and treated respectfully,” she said.

Dr Peter Nourse, pediatric nephrologist, said there are 20 children at the hospital in need of a kidney transplant. They will eventually need dialysis to survive. “Most importantly, children who wait for organ transplants don’t grow and develop like other children,” he said.

Natalie Hendricks from Mitchells Plain, said her son Nathaniel, 14, went to the shop “for a moment” last year when he was shot dead. When she arrived at Groote Schuur Hospital, she was informed about the process of organ donation.

She said the nurse (organ donation coordinator) at the hospital promised that she would be with Hendrick’s son in theatre when they removed his organs, and she was. She “saluted me as a mother because his blood was clean, [drug free] and they don’t see many 14-year-olds these days with clean blood.”

“All I know is that I had to do it … My son got to save others. He saved the lives of five other children. Their mothers can hold them, like I held mine,” said Hendricks.

To create awareness for organ donation, Normie Eckhard (Spinnekop) is running from Lüderitz to the Red Cross Childrens’s Hospital, with is friends Erik Nerf who will be hand pedaling a bike, and AJ van der Walt as a backup. Their journey ends this week in Cape Agulhas. Children who were recipients of organs or skin saw them off on their journey. DM