Lahore: Two Pakistanis, including a man and a teenage girl, are alive today with donor hearts transplanted in India by their citizens and beating inside their chests because no deceased donor heart was available in Pakistan, a stark reminder of the country’s near absence of cadaveric organ donation and the lack of a domestic heart and lung transplantation programme despite thousands of patients dying annually from end-stage organ failure.
The issue came under discussion at a scientific seminar on deceased organ donation hosted by the Pakistan Kidney and Liver Institute and Research Centre (PKLI) in Lahore, where transplant experts, regulators, religious scholars and international specialists warned that Pakistan’s reliance on living donors has reached its limits and that a functioning deceased donor system is the only way to save patients needing heart, lung, pancreas and emergency liver transplants.
According to data presented at the seminar by Prof Saeed Akhtar, Chairman Board of Governors PKLI and one of Pakistan’s pioneering transplant surgeons, more than 50,000 Pakistanis are estimated to die every year from end-stage organ failure without receiving a transplant. Of these, around 15,000 to 18,000 die from kidney failure while another 10,000 die from liver failure, with thousands more requiring heart, lung and pancreas transplants that are either unavailable or extremely limited in Pakistan.
He said Pakistan’s burden of organ failure is increasing rapidly because of soaring rates of diabetes, hypertension, hepatitis C and chronic kidney disease. Data presented at the seminar estimated Pakistan’s annual requirement at around 25,000 kidney transplants, 100,000 liver transplants, 7,000 heart transplants, and 2,000 each for lung and pancreas transplants.
Yet despite these enormous needs, Pakistan has performed only 21 deceased donor transplants since the establishment of the Human Organ Transplant Authority system, according to data presented by the Punjab Human Organ Transplant Authority (PHOTA).
The figures showed that only six deceased donors have been identified so far, leading to retrieval of 15 solid organs and four tissues. Of the transplanted organs, nine were kidneys, six were livers, two were pancreases and four were corneal tissues. The data further showed that two organs had to be obtained from the United Arab Emirates to save Pakistani patients.
The PHOTA presentation also revealed that only 486 people across Punjab had formally registered as organ donors after death by May 2026, a remarkably low number in a country of more than 240 million people. Photos of the provincial donor registry presented at the seminar showed how limited public participation remains despite years of advocacy efforts.
Officials said the absence of deceased organ donation has prevented Pakistan from establishing sustainable heart and lung transplantation programmes because such procedures are almost entirely dependent on organs recovered from brain-dead donors.
Prof Saeed Akhtar told participants that heart, lung and pancreas transplantation are not realistically possible without deceased donation. He noted that a single deceased donor can save up to eight lives by donating the heart, lungs, liver, pancreas, kidneys and other organs, while tissue donation can improve the lives of dozens more people.
The seminar was told that Pakistan’s transplantation system remains overwhelmingly dependent on living donors. Official data presented by PHOTA showed that by May 2026 Pakistan had recorded 15,110 living donor transplants and tissue procedures, including 5,956 kidney transplants, 1,873 liver transplants, 6,561 corneal transplants, 699 bone marrow transplants and 21 bone transplants. In contrast, deceased donor procedures accounted for only 21 transplants nationwide.
Prof Amir Zaman Khan, Director General PHOTA, presented details of Pakistan’s legal framework governing organ transplantation and said the country already possesses laws allowing donation after death but lacks the public awareness, institutional infrastructure and hospital-based donor identification systems needed to make deceased donation routine.
He said Punjab currently has 69 recognised medical institutions authorised for transplantation activities, including 34 kidney transplant centres, five liver transplant centres and one pancreas transplant facility.
His presentation traced the legislative journey from the 2007 ordinance against organ trade to the enactment of the Transplantation of Human Organs and Tissues Act in 2010, legislation that helped curb commercial organ trafficking and transplant tourism that once gave Pakistan an international reputation as a destination for organ trade.
Experts noted that before the 2010 law, organ transplantation had been performed in Pakistan for decades without a dedicated legal framework. The first successful kidney transplant was performed in 1979, nearly three decades before the country’s first transplantation ordinance, creating what PHOTA described as a regulatory vacuum that allowed unethical practices to flourish.
Prof Faisal Saud Dar, Dean PKLI and one of the country’s leading liver transplant surgeons, stressed that deceased donation represents the future of transplantation in Pakistan. He argued that while living donor liver transplantation has saved thousands of lives, certain patients, particularly those needing urgent retransplantation or those lacking suitable family donors, can only be saved through a deceased donor programme.
He maintained that a mature deceased donation system would not only increase organ availability but would also reduce pressure on healthy family members who currently undergo major surgery to donate organs to relatives.
International experts attending the seminar highlighted how countries such as Spain, the United Kingdom and the United States transformed transplantation outcomes through systematic identification of brain-dead donors, dedicated organ procurement organisations and public awareness campaigns.
One presentation noted that more than 170 million people are registered organ, eye and tissue donors in the United States, where deceased donation accounts for over 80 percent of organ transplants. In 2025 alone, nearly 49,000 transplants were performed from 23,788 donors in the US.
Religious concerns, often cited as a barrier to donation after death, were also addressed during the seminar. Experts and Islamic scholars maintained that organ transplantation is permissible in Islam as a treatment for life-threatening illness, while the sale and purchase of human organs remains strictly forbidden. Presenters cited endorsements from major Islamic scholars and institutions in Pakistan and abroad supporting ethical deceased organ donation.
Prof Saeed Akhtar argued that Islam is not the obstacle; misunderstanding of Islamic teachings is. He said religious scholars from multiple schools of thought had previously unanimously endorsed deceased organ donation and that similar programmes operate successfully across many Muslim countries.
Ends