Recipients of all ages can take part in the World Transplant Games. South Africa has placed third in the last two Games
Transplants for the treatment of end-stage organ failure have been one of the major medical advances of the last 50 years in South Africa. The success of this form of treatment has improved dramatically, with better understanding of the rejection process and introduction of more effective immunosuppressive regimens.
After a debilitating illness of some sort, all people experience loss of muscle, a degree of mental depression and in many cases difficulty in re-entering the community around them, both socially and economically. Organ transplant recipients are a particularly vulnerable category. In this context sport – or some sort of physical exercise after transplantation – is not a luxury, it is a necessity — a vital vehicle to full integration physically, mentally, socially and economically.
Benefits of physical and sports activities after transplantation
According to studies by Wall, Slapak and Johnson, physical and sports activities after transplant can reduce weight, improve dietary habits, control blood pressure and reduce bowel disturbance. Activity also increases endurance, strength and capacity.
Psychological benefits of taking part in sports activities include giving the recipients a sense of achievement, a feeling of being part of a group of “winners”, enhanced self-esteem and discipline, and is also a way of saying thank you to the donors and donor families.
Healthcare professionals monitoring transplanted athletes indicated they felt a joint feeling of pride in their achievements and use these sporting accomplishments to encourage other recipients to follow suit. In themselves these accomplishments promote organ donation and transplant among the public.
Transplanted athletes show a great depth of courage. A 40-year-old mother said: “Just months after receiving a liver transplant I was strong enough to start swimming. After completing a swim of 50m I experienced an overwhelming sense of exhilaration and achievement. I am making the most of my second chance [at life]!”
The World Transplant Games Federation (WTGF) and World Transplant Games (WTG)
The purpose of the WTGF is to visibly demonstrate through the Games the benefits of successful organ transplantation, work to increase public awareness and increase organ donation rates, as well as promote the wellbeing of participants. In 2009 the WTGF was recognised by the International Olympic Committee.
The World Transplant Games (WTG) is the largest organ donor awareness event in the world.
Summer World Transplant Games are held every two years, with over 1 500 athletes representing 69 countries competing at an extraordinarily high level in 13 sporting disciplines. The first WTG were held in Portsmouth, England in 1978 with 99 athletes. Since then these games have been hosted all over the world; in 2013 South Africa hosted the WTG in Durban. Winter World Transplant Games, which were first held in Tignes, France in 1994, take place in the intervening years, providing an opportunity for athletes to compete on the ski slopes.
Why do recipients participate in the WTG?
Slapak sums it up by saying: “A regaining of physical strength, a return to the ability to compete successfully and for that success to be recognised by the award of a medal is clearly a very positive step. When there is the addition of the companionship of peers, the confidence of seeing and meeting hundreds of people who have triumphed over similar adversity and the embracing warmth of belonging to a worldwide club, a truly remarkable benefit becomes obvious to all those present. It is this palpable feeling which gives the WTG its unique flavour.”
The South African Transplant Sports Association (Satsa)
The Transplant Games Association of South Africa (TGASA) was established in April 1994 by a small group of organ recipients. In September 2006 the association’s name was changed to South African Transplant Sports Association. The non-profit organisation Satsa is a member of the WTGF, is recognised by the department of sport and recreation in South Africa, and is an affiliated member of the South African Sports Confederation.
Satsa is a purpose-driven sports organisation, striving to optimise the quality of life of organ transplant recipients and promote organ donation and transplantation through sports and other physical activities.
Satsa’s membership profile
Satsa represents transplant recipients and their families, donor families and healthcare professionals involved in organ donation and transplantation. The majority of the transplanted athletes reside in Gauteng, the Western Cape and KwaZulu-Natal, where most transplant units are based. Smaller numbers are located in the other provinces. Sixty-eight percent have received a kidney transplant, with heart transplants in second place at 13%. Seventy percent of members received their transplants in the last 10 years, while three members received their transplants more than 30 years ago.
SATSA and the WTG
The South African Transplant Team has participated successfully in every WTG since 1995. It has been a goal to increase junior participation (6-17 years) since 2011, and the association has increased the numbers to 16%. Most of the athletes (51%) are between 40 and 69 years of age.
South African Transplant Team’s performance at WTG
National Transplant Games are organised every two years to give athletes the opportunity to participate in sports activities, show their gratitude to donors and celebrate their new life. This is also an opportunity to be considered for the team participating in the WTG.
Since 1995, the team has performed so exceptionally that it was placed third overall at the 2013 and 2015 WTG.
When the phrase “peak performance” is used in the normal sports arena, it simply means the best. In transplant sports it involves optimising physical functioning within the constraints imposed by previous or current medical concerns. For one recipient it means daily walking, for another participating at local level, and for a third winning a medal at the WTG. Organ recipients should challenge themselves to make exercise a part of their post-transplant life.
For more information about transplant sports and Satsa visit: www.transplantsports.org.za
Written by Dr Heilie Uys
Why not compensate the families of deceased organ donors?
South Africa needs a discussion about compensating the families of deceased organ donors.
There are at present about 4 300 South Africans awaiting organ and cornea transplants. From the earliest days of organ transplantation, there has been a shortage of organs. It has often been proposed that compensation for donation may rectify this severe problem. However, our law prohibits compensation in order to prevent the trafficking of human body parts. This and the perceived difficulties in implementing such a system is why one cannot receive any form of compensation for being an organ donor in South Africa.
The debate over compensation for organ transplantation is often deeply divided, because the stakes are indeed high. Barriers to willingness to donate include education, access, social, economic, religious and cultural factors. Resolving this issue has extensive legal, social and health ramifications. Re-evaluation of our laws could make compensation the appropriate remedy; it provides an incentive for donation by acknowledging the donor’s efforts and providing them or their family with some sort of remuneration. It is also important to remember that family members have the final say in the organ donation process after the death of a loved one.
There is no denying that compensation may be a vital tool to increase donor numbers. The ethical debate surrounding compensation is increasingly relevant to ensure that compensation bypasses illegal organ trading and the undermining of religious and sociocultural beliefs. The dire need for donor organs makes the need for discussion and debate all the more significant.
Written by Natasha Coleman and Professor Jonathan Klaaren