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A cross-border effort rekindling hope among liver patients in Pakistan has run against a hurdle after Indian surgeons refused to continue with their surgery schedule in Lahore until drastic improvements in post-operation care to minimise the possibility of infection.
A team of Indian surgeons has been collaborating with their Pakistani counterparts in liver transplantation for five months from the summer of 2013.
But the Indians have postponed surgeries scheduled for December after the death of liver recipient Nazar Mohammad of Gujranwala during post-operation care in November last, according to a doctor close to the administration of the hospital where the transplantation had been carried out. The cause of the death was an infection.
The Indian doctors have linked their next visit to the Pakistani side meeting required standards for highly sensitive surgeries.
Liver transplants surgeries in Lahore began under a memorandum of understanding (MoU) signed on July 20, 2013, between the Surgery Centre for Liver and Biliary Sciences, New Delhi, and the Centre for Liver Disease and Liver Transplant, Shaikh Zayed Postgraduate Medical Institute, Lahore. The New Delhi centre is an autonomous institute set up by the government whereas the Lahore hospital is overseen by the Punjab government.
This first instance of public sector cooperation between India and Pakistan came after an exchange of positive overtures and limited-scale joint ventures over the past many years between doctors in the two countries in the private sector.
Under the programme, Indian doctors have conducted 22 successful liver transplant procedures in Lahore and have been paid $30,000.
A senior doctor at the Shaikh Zayed Hospital told Dawn that during their last visit in November 2013 the Indian surgeons had identified serious deficiencies at the centre and asked the administration and the doctors for improvements. Under the MoU, he said, the two sides were to share human resource development through training of doctors, nurses and technicians and ensure quality control and good clinical outcome of hepato-pancreatio-biliary and liver transplant surgery at the SZH.
Another purpose of the MoU is the exchange of consultants, registrars, nurses and technicians to help either side expand and improve its services.
The two sides have agreed that services and activities in pursuance of the MoU would be in accordance with the Transplantation of Human Organ and Tissues Act, 2010.
According to the agreement the receiving party will pay for the international air travel cost, inland travel expanses, professional charges and expenses on other host facilities.
According to studies, liver diseases are highly prevalent in Pakistan and account for 37 per cent of deaths due to different causes. A large number of liver patients ultimately develop end-stage liver disease for which the only treatment option is liver transplantation.
An SZH doctor says currently there are about 10,000 potential candidates for liver transplantation in the country which lacks the facilities for the procedure. The only option for those requiring liver transplant is to go abroad for the procedure. It is not only highly expensive but also impractical for most of the patients because of visa and logistic issues. As a result, hardly five per cent of them are able to avail this option.
The joint programme with India, apart from providing relief to patients now, can help Pakistan develop better facilities under the charge of experienced doctors from within the country.
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