Liver Disease, Liver Transplantation and the Challenge of Scarcity: Africa's Silent Burden
Are we doing the best with what we have? A frank, panel-led discussion on liver transplantation in South Africa.
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About This Webinar
Liver transplantation remains the only definitive treatment for many patients with end-stage liver disease, yet in South Africa access remains profoundly constrained. With just two adult transplant centres serving a population of over 60 million, a donor pool that remains well below its potential, and a referral landscape only beginning to be properly mapped, the gap between need and access is stark.
The challenge is not only one of resources. The pattern of liver disease we manage in sub-Saharan Africa — dominated by HBV-related pathology, affecting younger patients, and shaped by a pharmacogenomic profile that diverges significantly from the populations in which global transplant protocols were developed — does not always fit neatly into the frameworks we have inherited. Established paradigms such as the Milan criteria and MELD-based allocation systems were built in very different epidemiological and systemic contexts. In our setting, each of these warrants careful scrutiny rather than automatic acceptance.
Which raises a central question that runs through this discussion: are we doing enough with what we already have? This session brings together the heads of department of South Africa's two main transplant centres alongside a critical care specialist with both South African and international transplant experience, for a direct, panel-led conversation about what is working, where the gaps are, and what it would actually take to expand access so that more patients have a realistic chance at liver transplantation in South Africa.
This session is now available to watch on demand. Originally broadcast as a live interactive panel on 18 June 2026, the recording captures the full multidisciplinary dialogue — designed to generate the kind of cross-speciality conversation that changes practice not just in the transplant unit, but in outpatient clinics, ICUs and consulting rooms across the country where the pathway either opens or closes.
- Describe the current liver transplant landscape in South Africa, including the scope and structure of the two main adult transplant programmes and the burden of liver disease driving demand.
- Understand the unique profile of sub-Saharan African liver disease, and how that profile — including HBV-driven pathology and CYP3A5 pharmacogenomics — impacts the transplant landscape and clinical decision-making.
- Critically evaluate the application of established allocation and eligibility tools — including MELD scoring, Milan Criteria, and the six-month rule — to the South African patient population.
- Identify the key barriers to donor pool optimisation, including organ utilisation and discard practices, and assess the potential contribution of marginal donors and emerging preservation technologies.
- Articulate practical steps that non-transplant clinicians can take to improve transplant referral, patient preparation, and post-transplant support within their own clinical settings.
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Non-alcoholic fatty liver disease in Africa: a hidden danger.
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Liver transplant for nonresectable colorectal cancer liver metastases in South Africa: A single-center case series.
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Meet the Expert Panel
Four specialists, one shared mission: expanding liver transplantation access in sub-Saharan Africa. Click any card to read the full biography.
