Lack of organ donors, not surgeons, is main hurdle to heart transplants in Pakistan, says Dr Asif Hasan
Karachi: Pakistan has the medical expertise and trained surgeons needed to perform heart transplants, but a shortage of organ donors, limited public awareness and the absence of an organised donor coordination system remain major obstacles to establishing a transplant programme, renowned British-Pakistani cardiac surgeon Dr Asif Hasan has said.
In an exclusive interview with Vitals News Editor Hamid ur Rehman during his visit to Pakistan on Wednesday, Dr Hasan said countries including Iran, India and Saudi Arabia had developed organ transplantation services, and Pakistan could make similar progress.
“The problem is not the availability of skilled surgeons. The real challenge is finding organ donors and developing a system that can identify potential donors and approach their families appropriately,” he said.
Pakistan needs a structured organ donation programme, supported by trained coordinators in hospitals, to help families understand the importance of donating organs after the death of a loved one, he said.
Citing Spain as an example, Dr Asif Hasan said the country had developed one of the world’s most successful organ donation systems by placing trained coordinators in hospitals. People from different educational and professional backgrounds could take on the role, he said, but they needed specialised training to communicate with grieving families.
Coordinators can help identify potential donors, explain the donation process to relatives and support families in making informed decisions, he said. Pakistan should introduce a similar system, with trained staff facilitating donation in line with the law and established medical procedures.
Public awareness is also essential, Dr Asif Hasan said, as many families remain reluctant to donate a deceased relative’s organs, even when transplantation could save lives.
Pakistan already has legislation governing organ transplantation, but effective implementation requires better hospital systems, public education and coordination among medical institutions, he said.
Referring to the experience of transplant surgeon Prof Dr Adib Rizvi, Dr Asif Hasan said that securing only around 15 deceased donors over approximately two decades illustrated the difficulty of obtaining family consent for organ donation in Pakistan.
Iran has established an effective kidney transplantation programme, while India and Saudi Arabia also perform organ transplants, he said. Pakistan already carries out kidney transplants and should now work to build the infrastructure and systems required for heart transplantation.
Discussing paediatric cardiac surgery in Pakistan, Dr Asif Hasan said local surgeons had considerable professional skills, and many could work to the standards expected in British hospitals. Pakistani doctors had demonstrated their competence while working in the United Kingdom and other countries with advanced healthcare systems, he said.
However, complex cardiac procedures depend on more than a surgeon’s technical ability.
“Cardiac surgery is a team effort. A surgeon cannot achieve good results without properly trained nurses, reliable blood transfusion services, infection control, anaesthesia and other essential support systems,” he said.
Hospitals need to strengthen nursing education, infection prevention, blood banking and other support services to improve outcomes, Dr Hasan said. He stressed that nurses must be recognised as essential members of the healthcare team and treated with professional respect.
Every member of a surgical team has a specific responsibility, he said, and weaknesses in any supporting service can affect patient safety and the quality of care.
Dr Asif Hasan recalled that a Pakistani doctor, Dr Munir, had worked with him on three paediatric heart transplant procedures, demonstrating that Pakistani medical professionals could participate in highly specialised transplant surgery.
Establishing a heart transplant programme would require trained anaesthetists, intensive care specialists, nurses, laboratory personnel and other professionals working within a coordinated system, he said. Pakistan should build on its experience in kidney transplantation and gradually develop the facilities and expertise needed for heart transplants.
Dr Hasan did not predict when regular heart transplants might begin in Pakistan, but said improvements in organ donation, hospital infrastructure and multidisciplinary training could make them possible.
Speaking about his personal journey, he said his parents had migrated to Lahore and made considerable sacrifices to provide their children with a good education. They wanted their children to become doctors and pursue careers that would allow them to serve society, he said.
Dr Asif Hasan has performed more than 4,000 open-heart operations during his career at Freeman Hospital in Newcastle. He has also contributed to paediatric cardiac surgery, heart transplantation and the training of cardiac surgeons.
He received the Pride of Britain Lifetime Achievement Award in recognition of more than three decades of service in the United Kingdom.
During his visit to Karachi, the Sindh Institute of Urology and Transplantation (SIUT) held a ceremony in his honour. Prof Dr Adib Rizvi and other members of the medical community attended.
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