The Telegraph
Wednesday , January 8 , 2014
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Pak liver transplant tie-up hits wall

Islamabad, Jan. 7: A four-month-long effort by Indian surgeons to share their expertise in liver transplantation procedures with doctors in Pakistan has stalled amid concerns about post-surgical care standards in a Lahore hospital.

Surgeons from the Apollo Hospital in Delhi had helped their counterparts in Lahore with 22 liver transplantation surgeries between July and November last year, kindling hopes among patients with end-stage liver disease in Pakistan, doctors in Lahore and Delhi said.

But the Indian surgeons decided to pull out after a liver transplant recipient developed an infection and died in November, a senior doctor at the Shaikh Zayed Postgraduate Medical Institute, Lahore, said.

The Indian surgeons identified what the doctor said were “serious deficiencies” at the Lahore hospital and have asked the institution to make improvements to minimise the risk of post-surgical infections.

Sources in Lahore said the Indian doctors were paid $30,000 (Rs 18.6 lakh) for their help during the 22 successful transplants, but a source in the Apollo Hospital has said its doctors had lent their expertise without any payment.

“There was no payment involved, some of our doctors went to share their expertise with doctors there with whom they have personal friendships,” the Apollo source said. “Our surgeons are not licensed to operate there.”

But sources in the government-owned Lahore hospital said the two institutions had drawn up an agreement for the training of doctors, nurses, and technicians for the liver transplantation procedures which many surgeons believe are among the most challenging of operations. Under the agreement, the “receiving party” would pay for the international air travel, inland travel expenses and professional charges.

Gastrointestinal surgeons in several hospitals across India are trained for liver transplantation procedures. Doctors estimate that about 1,000 patients receive new livers in India each year, but Pakistan lacks facilities and appropriate expertise for this surgery.

A doctor at the Shaikh Zayed Hospital said about 10,000 patients in Pakistan are at present candidates for liver transplantation. While patients have the option to travel abroad for the procedures, doctors estimate less than 5 per cent of patients are able to avail of this option.