- Gallery: Manto Tshabalala-Msimang
By Noor-Jehan Yoro Badat and Kanina Foss
A week ago former health minister Manto Tshabalala-Msimang's name was put on a liver transplant list for the second time.
After she had spent about a month in two different hospitals, undergoing a battery of tests and with an expert committee reviewing her case, doctors agreed that Tshabalala-Msimang should have a second liver transplant.
Her name was placed on the Wits University Donald Gordon Medical Centre list and her doctors watched closely for a donor whose blood group, tissue typing and body and organ size were compatible with those of their patient.
But a match was not found. Yesterday, Tshabalala-Msimang died at 14.27pm at the medical centre.
She was 69.
She had been sick for more than a month and had been admitted to the Charlotte Maxeke Johannesburg Academic Hospital in mid-November, said her physician Professor Jeff Wing.
At the time, Wing, the clinical head for the department of medicine at the hospital, said Tshabalala-Msimang's illness was related to her liver.
In the following weeks Tshabalala-Msimang had several diagnostic tests to determine whether the transplanted liver was being rejected by her body, to establish the cause of the liver problem, and to exclude the possibility of complications arising from the previous operation.
According to Wing, the former health minister was on lifelong immuno-suppressants, but despite this, "transplant complications did occur... It's not unknown for (a transplant) to cause problems".
On Monday, Tshabalala-Msimang was transferred, in a convoy of three cars, from the academic hospital to the medical centre.
But despite every effort by the medical team, "Dr Msimang died from complications arising from a liver transplant she received in March 2007", a statement said.
Speaking on behalf of the family, Sue Tager, the Academic Medical Director of the centre, said: "Dr Msimang's family would like to record their heartfelt appreciation for the extraordinary attention devoted to Dr Msimang at both Charlotte Maxeke Hospital and the Wits Donald Gordon Medical Centre."
Tager said: "Tshabalala-Msimang required another transplant because she was rejecting the liver she had, and this is an unfortunate complication of transplantation which we are sometimes unable to control with medication.
"We assessed her as any other patient.
"Age was not a factor - the oldest patient in our unit that we've transplanted is 72.
"The answer was that (Tshabalala-Msimang) needed another transplant and indications for this is end-stage liver disease.
"(During) the time she was relisted, there wasn't another organ available."
Several minutes after Tshabalala-Msimang died, members of the media began arriving at the medical centre. Her family, arriving at the hospital, refused to comment, and later left the hospital using a back entrance. About an hour after she died, a black hearse drove out with Tshabalala-Msimang's body.
Security personnel who had been guarding the former health minister's ICU room to prevent members of the media and public from entering, said some hospital staff members and patients had wept when they heard the news.
Two years ago, Tshabalala-Msimang had a five-hour liver transplant.
At the time there was widespread speculation that she had jumped the waiting list for organs.
But this was denied by Wing and a team of specialists.
Wing said the then-minister's "tissue typing rendered her a universal recipient".
"In this country there is no long waiting list as such for livers," he said.
"In fact, when it comes to liver transplants, we have more donors than recipients."
Dr Russell Britz, a chief transplant surgeon at the Wits Donald Gordon Medical Centre, said Tshabalala- Msimang "scored the highest points" to be a recipient.
At the time, Tager said that according to the waiting list at the Donald Gordon centre, the minister "qualified as the person who was most in need of a liver in terms of severity of condition and size match compatibility".
Wing was also quoted as saying before, during and after the then-minister's transplant that her liver problems had nothing to do with alcohol, but were caused by hepatitis.