Joburg woman becomes SA's 'first' Covid-19 lung transplant patient after giving birth

When Mbali Mbatha went into a coma, it was still 2020 and doctors at Johannesburg's Netcare Milpark Hospital had just removed her baby Kuhle after only 30 weeks of pregnancy through an emergency C-section operation.

But for her to hold her daughter for the first time, doctors would have to perform what was likely SA and Africa’s first Covid-19 lung transplant.

By December 1, when she and her obstetrician made the call for the operation to happen, the 27-year-old mother had been ill at Netcare Park Lane Hospital for seven days.

“I was shocked when the doctor told me that he needed to prepare for a C-section and operate immediately. When I realised that I would not be able to carry full-term, I was devastated. I phoned my husband Sizwe, who calmed me down and said I must let them take the baby out as it would be best for us,” Mbatha was quoted as saying in a Netcare statement.

“All I remember is the cold, it was terribly cold in the operating theatre. I felt so alone — my husband could not be with me. It was a very distressing experience, as I did not even see the baby ... I gave birth to my little girl and I passed out.”

According to Netcare Milpark Hospital pulmonologist intensivist Dr Paul Williams, Mbatha was rushed by ambulance to the hospital shortly after she had her baby.

“She was in serious danger as both her lungs were affected from top to bottom with pneumonia and she was not extracting oxygen from the air. We immediately had to escalate her treatment to a more sophisticated form of care than what would generally be needed by most patients with Covid-pneumonia,” he said.

Cardiothoracic surgeon Dr Martin Sussman said Mbatha was in “extremis” (in extreme circumstances, especially at the point of death) and was taken straight from the ambulance into theatre where she was placed on extracorporeal membrane oxygenation (ECMO), which artificially maintains a supply of oxygen to the brain and other vital organs for patients who require either or both respiratory and cardiac support.

“ECMO is essentially an artificial lung. The circuit does the work of the lungs and that is how we kept Mbali alive while she had Covid-pneumonia,” said Sussman.

He said that while Mbatha eventually recovered from Covid-19, her lungs did not.

“One of the complications of Covid-19 is that it sometimes damages the lungs extensively. In Mbali’s case the damage was irreversible. Her only chance of survival was to receive a donor lung,” said Sussman.

The doctors believe the transplant for a Covid-19 affected patient was a first in SA medicine.

According to Sussman and Williams, who both led the transplant team, lung transplantation is a rare procedure for patients with established lung disease such as cystic fibrosis and other conditions and is done only after all other treatments for lung failure are unsuccessful.

“Covid-19 is a new one for us though. We have had no experience in transplantation with this virus and we are fairly sure that we are the first team in SA to do it — perhaps we are even the first team on the African continent. Throughout the world there have been only around 100 lung transplants performed so far for Covid-19 pneumonia at a handful of facilities,” said Williams.

“To be able to do a transplant on this young woman who is also a mother, was really something special. We did it for her and her baby. Being part of this remarkable team that can make this kind of difference is an immense honour.”

When Mbatha eventually awoke from her coma in early February, she was told that she had been in a coma for two months and had undergone a lung transplant.

“Some time after I woke up, I was told that I had been in a coma for two months and that I had a lung transplant. In fact, it seemed that there was very little hope I would survive. Had it not been for the exceptional medical care I received and for the lung transplant, I would not be here today,” she said.

“The staff [at the hospital] are very warm and caring. They ended up feeling like family. The encouragement that the nursing staff and doctors gave me on a daily basis really carried me through. They made me feel like everything was going to be OK,” said Mbatha.

“I am so thankful to be here today and that I have been given an opportunity to raise my daughter. I am grateful to the doctors and staff of Netcare Park Lane Hospital and Netcare Milpark Hospital.

“I am particularly grateful to the donor and the brave family for the gift of life, which ensured that I was given this second chance.”

She also thanked her husband for his moral support and encouragement and her mother, Christine, for looking after her baby, Kuhle, while she was in hospital.

“[Sizwe] only ever had positive things to say. He was a constant source of inspiration throughout my recovery, and he kept telling me that I would walk out of the hospital.

“While I am sad that I missed out on so much time with her, I am eternally thankful that my mother was there to care for her [Kuhle]. More than anything, I thank God for saving my life and giving me a second chance at life,” said Mbatha, who lives in Winchester Hills, Joburg.

Netcare Milpark Hospital general manager Marc van Heerden said Mbatha’s discharge from the hospital, to the applause of hospital staff, was a proud moment for them.

“We are very grateful to the doctors, the nurses, the staff and the donor for giving this family a new chance in life,” he said.