Pakistan’s first liver transplantation unit, inaugurated by the Punjab Chief Minister on Feb 25, in Shaikh Zaid Hospital (SZH), lack facilities as even a single liver transplantation could not be performed since its inauguration.
According to sources, 1.2 million patients in the country need liver transplantation while 150 patients are on the waiting list of the liver transplant unit but the unavailability of required facilities including an operation theatre, CT scan, high dependency units and at least six medical officers for back-up treatment in the ward after transplantation have made it useless.
Only a ten-bed ward is available for the patients who need transplantation. Only two surgeons are working in the department, including Associate Prof Dr Tariq Bangash and Prof Dr Amir Latif against the need of four while a surgeon, Dr Umer, has left the unit
as his degree from China was not recognised by the Pakistan Medical and Dental Council (PMDC), the sources added.
On an experimental basis, four successful liver transplantations were conducted till February 25, in the unit by sharing the operation theatre of cardiac surgery. The patients who had liver transplantation included Amir Raza (40), Khanullah (40), Ms Abida (50) and Muhammad Anwar (42).
The surgeons who are working in the unit at just Rs 52,000 package are still committed but reluctant to serve under pathetic and uncomfortable conditions.
At the inauguration of the unit in February, the chief minister announced the provision of equipment to the unit and directed Parliamentary Secretary for Health in Punjab Assembly Dr Saeed Elahi to resolve the matter within 15 days but nothing had been done practically despite holding three meetings with staff of the unit. When contacted, Punjab Heath Secretary Arif Nadeem said all facilities would be provided to the unit soon.
Report of 96 industrial Units presented to DCO: Various town survey teams on Sunday submitted a report of 96 industrial units located in the city to District Coordination Officer Noorul Ameen Mengal. According to a handout issued here, survey teams of Ravi, Gulberg, Allama Iqbal, Shalimar, Samanabad and Nishter towns presented their report to the DCO regarding 96 operative industrial units in thick populated areas.
Total 4 liver transplants performed despite full facilities provided by the hospital and full support of the Federal and later the Punjab Government.
First 2 transplants performed entirely by Indian surgeons.
Last 2 transplants performed by local shaikh zayed surgeons died immediately post-operatively because of serious surgical complications.
Results of local surgeons dismal as they have no experience in living donor transplants. These were the first Live Donor operations they had ever performed.
The condition of one of the donors, a young girl, is also reported to be critical as she suffered serious injury to her liver caused by these inexperienced surgeons.
All this information kept a secret from the media and the public. These surgeons first need to practice in the animal lab before experimenting on the pakistani public.
Media and Press needs to investigate and bring the truth to light. Please, no more experimentation on the Pakistani public!
Ref Mr. Abid Hassan's comment.
I am a regular visitor at the Shaikh Zayed Hospital, Lahore as I am a Hep C patient who requires a Liver Transplant. I have been informed by junior doctors that Dr. Amir and Dr. Tariq, the two doctors employed by Shaikh Zayed Hospital to do liver transplants, are not properly trained in liver transplantation. They were employed due to their good political connections. This is the main reason for the death of these patients. I have also come to know that they also took out the liver of a boy Arsalan, who was underage. Maybe this was illegal as somebody has gone to court against this inhuman act. Anyway, no liver transplants going on shaikh zayed hospital on regular basis as I am waiting for transplant for one year and with no hope. Maybe it is good as both liver transplants done in shaikh zayed have led to the death of the two patients. Press should investigate and tell us the real state of affairs.
If transplants done by Indian surgeons survived in the same hospital, what was the problem with our doctors that patients operated by our surgeons did not survive more than few days? I think, rather than hiding the facts from the public, the shaikh zayed hospital administration should come out with the true facts so that the public is reassured and we can regain faith in our own surgeons who are the best in the world.
I have heard that successful liver transplants are being carried out on a regular basis in Shifa International Hospital, Islamabad. Other good place for pakistanis for liver transplant is Apollo Hospitals, India, where it is safer and cheaper than pakistan. If one wants to take the risk for such a big and expensive operation, one should go to a place where the doctors are properly trained and not learning to do liver transplants. No one wants to pay 50 lakh rupees just to get killed by an operation.
Organ transplant case: Sheikh Zayed Hospital, Hota issued notices
http://dawn.com/2011/11/19/organ-transplant-case-…
ISLAMABAD, Nov 18: Islamabad High Court (IHC) on Friday issued notices to the administration of Sheikh Zayed Hospital (SZH) Lahore and Human Organ Transplant Authority (Hota) on a petition against the violation of Hota Act.
The petitioner referred a recent case of liver transplantation that was done at SZH. The petitioner, however, did not name the recipient of the liver as respondent in the petition. IHC Justice Riaz Ahmed Khan took up the matter and sought reply from both the respondents besides the cabinet division within a fortnight.
According to Advocate Syed Liaquat Binori, the petition was a `public interest litigation` in which his petitioner had challenged transplantation of liver to an influential person; the liver was taken from the body of a 15-year-old boy who expired in a traffic accident.
The transplantation at SZH, according to the petitioner, was done in violation of Hota Act 2010. He said under the act a hospital can transplant a human organ after getting clearance from an `evaluation committee` but in this case the clearance was not sought from the said committee.
The petitioner also contended that no human organ could be used for transplantation in case the donor was less than 18 years of age. The petitioner told the court that in September this year an injured child Arsalan was brought to the SZH. The child had sustained severe injuries in a traffic accident. Unfortunately the child could not survive and died. The hospital administration after seeking consent of his parents took out his liver and transplanted it to Amir Raza, a 42-year old person.
The petitioner said as per Hota Act, a donor of human organ must be more than 18 years of age. For organ transplant there is another condition that the donor must have had consented a will in his life where he/she may have expressed his willingness to donate the organs.
The will should also be registered with the Hota, the petitioner said. In this particular case the donor was less than 18 years and he did not qualify to consent the will. The petitioner has expressed his apprehension that the way this transplantation was done, poor people could be easily exploited against the money. He requested the court to order an inquiry into this matter.
DEATHS OF PATIENTS AFTER LIVER TRANSPLANT SURGERY AT SHAIKH ZAYED HOSPITAL, LAHORE CONCEALED FROM THE PUBLIC AND THE PRESS. INCOMPETENCE OR CRIMINAL NEGLIGENCE?
In spite of the government having spent millions of rupees in terms of expensive machinery, infrastructure and hiring two highly paid foreign “trained” Liver Transplant Surgeons to provide this essential service to the people of Pakistan, Liver Transplantation in Shaikh Zayed Hospital still seems to be a far fetched dream for most of us waiting desperately for this life saving operation.
As I am a regular visitor to the Liver Transplant OPD of this hospital, I have been able to gather some alarming facts regarding the safety of Liver Transplantation at this hospital from junior doctors and paramedical staff. The following needs your urgent attention and investigation.
To-date only 4 Living Donor Liver Transplant Surgeries have been performed at Shaikh Zayed Hospital, Lahore.
The first two Living Donor Liver Transplants were entirely performed and managed by Dr. Subhash Gupta and his team of surgeons, anesthetists and nurses who were specially brought in for this purpose from India.
It was a matter of great concern and a shock to me when I learned that the third patient (50 year old Mr. Muhammad Anwar of Sialkot ) who was unfortunate enough to be operated independently by the two local surgeons (operation carried out on 24th February 2012 and trumpeted in the press on 25th February 2012) soon after the Indian team had left , died of surgical complications only a few days after his Liver Transplant operation while he was still in the hospital. The hospital administration “ensured” a media black-out so that the news of the death of this unfortunate patient would not reach the media and the press. Junior doctors and paramedics were threatened of dire consequences for fear of this news leaking out.
I was told by a junior doctor that before the Indian surgeons left, they had clearly informed the administration of the hospital that as per their assessment the two local surgeons were not capable enough to do Living Donor Liver Transplantation and should not perform any such surgeries on their own.
I have come to know from reliable sources in the hospital that the two local liver transplant surgeons are not trained to do Living Donor Liver Transplantation. In fact, the operation they performed on this unfortunate patient was the first Living Donor Liver Transplant operation that either of the two had ever performed!
Living Donor Liver Transplants are much bigger, complex and technically demanding operations as compared to Cadaveric Liver Transplantation which is done in Ireland and England where these two surgeons claim to have received their training. Had Mr. Anwar been operated by surgeons with experience in Living Donor Liver Transplantation, he would still be alive and the approximately 5 million rupees spent on this single operation would have been worth it. The whereabouts and present state of health of liver donor, Kamrin, the 19 year old neice of Mr. Muhammad Anwar who underwent a major operation at the risk of her own life to donate half her liver for her uncle, are also unknown.
Despite this, the same team of surgeons carried out another Living Donor Liver Transplant operation on Mr.Abdul Rasheed of Samanabad, Lahore on June 20, 2012 (again trumpeted in the press as a successful transplant). What was not reported in the press was that this operation also failed badly. Mr. Abdul Rasheed had to be re-operated the very next day, kept alive in a critical condition on a ventilator in the ICU and died of serious surgical complications only a few days later. Mr. Rasheed’s young niece, who had donated half her liver in this case suffered serious injury to her liver during this operation; her whereabouts to this day are unknown. In this second case also, a complete media blackout was carried out by the hospital administration and this successive mortality was never reported in the press. Approximate cost of this failed operation was again assessed to be close to 5 million.
The patients who died and their relatives would never have given consent for this operation had they been made aware of the above facts before the operation. If these facts were now made available to the relatives of the deceased patients it would be a matter for severe civil liabilities and recommendation of criminal negligence by the Pakistan Medical and Dental Council and the Punjab Health Commission.
My request is that the credentials of these surgeons be examined, certificates of training from their trainers in the UK or elsewhere be obtained which should state categorically that these two surgeons are competent and have been trained to perform Living Donor Liver Transplantation independently before they are allowed to operate any further. If they are allowed to carry out any more “experimental” operations on the Pakistani public now, further deaths will be the responsibility of the hospital administration, the Punjab Government and also the press. Any further deaths at the hands of these two surgeons will leave the hospital administration open to prosecution and civil liabilities.
Repeated mortalities after liver transplant attempts at shaikh zayed hospital, lahore should be investigated by the hospital authorities and the government to prevent future deaths.
"1.2 million patients in the country need liver transplantation while 150 patients are on the waiting list of the liver transplant unit but the unavailability of required facilities including an operation theatre, CT scan, high dependency units and at least six medical officers for back-up treatment in the ward after transplantation have made it useless.andling this long list with one one facility is a pretty tall order.
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