RAWALPINDI, Dec 6: Pakistan should establish at least five liver transplant centres rather than feeling content with the initiation of liver transplantation at Sindh Institute of Urology and Transplant, said Prof (Dr) Yaman Tokat, a liver transplant specialist from Turkey, here on Saturday.

In his lecture on liver transplant at the 2nd surgical conference, he said the detractors of the new technique spoke about the high economical costs involved in the process. However, they forget that huge amounts are spent on keeping the clinically dead artificially alive, which was criticized by none.

Dr Tokat said liver transplant centres should carry out at least 25 transplants every year, otherwise the activity would be remain a hobby with surgeons associated with it.

He said the use of live organ transplants was as good as a cadaveric transplant and, in almost all cases, either one lobe or complete liver could be used.

Initially, the live transplant was regarded a necessary evil to overcome cadaveric organ shortage, but now it is a very promising method for countries having difficulty in finding cadaveric organs.

Prof Tokat said cadaveric donations were very few, but the situation could be improved if the doctors were committed to the issue and approached the heirs of the clinically dead patients, properly motivating them for organs donation.

Surgeons should be very careful in liver transplants, particularly in cases where live organs are being used. Liver transplant surgery can have the highest death rate in the world, which is 200 per cent, losing both donor and the recipient.

Speaking about the post-operative complications, Dr Tokat mentioned biliary problems among both donors and recipients, while hypertension and diabetes was the usual outcome in the recipients.

Refinements in the surgical techniques, judicious patient selection, careful pre-operative evaluation, excellent anaesthetic management, good nursing care, early detection and treatment of complications increase success rate and rapid growth of the liver transplant technique, the guest surgeon from Turkey said.