Liver transplant is a procedure where a dysfunctional liver of a patient is replaced by a healthy one of a donor’s. The human liver regenerates quickly once a portion is cut from it surgically. Thus, a donor can either be deceased or alive. Liver transplant is the only treatment option for patients who have the last stage of chronic liver disease.
Liver transplant has almost become a common practice in highly developed countries. According to a study published in the Liver Transplantation Journal, 7000 liver transplants are performed each year in the United States alone. China and Brazil were second and third on the list.
Developing countries have also started to catch up. The most recent example in this regard is India. Another study reveals that 1200 liver transplants were performed in India in 2014 alone.
Pakistan’s health sector has just started the practice of liver transplant and some of the best hospitals in Karachi, Lahore, and Islamabad have conducted transplants at their facilities. Recently, some Pakistani and Iranian surgeons also celebrated a week of success at Sindh Institute of Urology and Transplant (SUIT).
A report by Dawn reveals that seven successful liver transplant surgeries were performed during this week. The report also shows that a total of 15 transplant surgeries with living donors have been performed at SUIT. The progress is indeed promising but there are still a lot of areas that need improvement.
In this article, we analyze the possible causes of the slow progression of liver transplants in Pakistan.
1. Lack of infrastructure
Lack of appropriate infrastructure is one of the key reasons that liver transplants are not frequently performed in Pakistan. There is no official organ harvesting agency. Some of the private medical services are harvesting organs however they unable to meet the demand.
There are also no rules for the selection of recipients and doctor’s themselves decide if the patient is worthy of a donation or not.
Lack of any code of conduct when it comes to transplants has rendered a lot of efforts useless. People still do not trust a Pakistani health facility for a liver transplant. It is thus the duty of the government to establish a proper and enforce it in all public hospitals.
Corruption is another cause of failure of projects related to liver transplant in Pakistan. The governments have usually been generous regarding funds but unfortunately, this money is not used effectively.
Former Chief Justice of Pakistan, Mian Saqib Nisar while conducting the hearing of a suo moto case last year also questioned Punjab government which has already spent Rs. 34 million but has failed to create a liver transplant facility for the public.
Accountability in health projects is thus crucial for their success. A liver transplant facility in a public hospital could have set this procedure on its course in the country but till now the rampant corruption never let it happen.
Propaganda against transplant facilities is another reason that they are not succeeding. Many projects are in their development phases but there is a serious hindrance created by the lobbyists who carry various political and professional jealousies.
Sometimes, opposition parties also try to block important projects by the ruling party while on other occasions, medical professionals involved in these projects turn against their colleagues.
4. Lack of Doctors
Lack of trained medical professionals is another reason that the liver transplant in Pakistan has not gained expected success. One way this could be tackled is to hire international doctors who can train the locals so that they can perform transplants on their own.
5. Lack of Donors
Another key reason for the lack of liver transplants in Pakistan is a lack of donors. Due to religious reasons, many people hesitate to become a donor after death.
Living donors are also very rare. People are usually unaware and think that it is highly dangerous to donate a portion of their liver. The fear is so real that even close family members are hesitant in donating to their blood relatives.
The government should start awareness campaigns to clear out confusions regarding liver donations. An official organ harvesting agency can also be helpful in getting the trust of donors.
Pakistan’s health sector has recently stepped into the arena of liver transplants. Although funds are available and many projects are in progress, the progression of liver transplant in Pakistan is very slow in the country.
If the government and professional bodies pay attention to training workshops and awareness campaigns, we can have an excellent network of liver transplant surgeons in Lahore, Karachi, Islamabad, and other leading cities of the country.
Unless there is a decent influx of professional doctors, people will be at the mercy of quacks and dangerous practices in the market.