PESHAWAR: Transplantation at the Institute of Kidney Diseases here has been suspended for almost a year adversely affecting patient care and doctors’ training.

The health department had established the Medical Transplantation Regulatory Authority (MTRA) in February 2018 and the public sector IKD became the first institute in the province to begin transplanting kidneys to patients.

The initiative was also meant to control illegal renal transplants, register and equip hospitals for lawful transplants, and train doctors to begin procedures in regional hospitals of the province.

However, not a single renal transplant has been carried out at the IKD since the retirement of lead transplant surgeon Prof Asif Malik in September 2020.

After the retirement of Prof Asif, the authorities tasked Prof Nasir Orakzai, the then director of the IKD, with ensuring the resumption of transplants with the help of the existing dedicated team, to no avail.

The IKD located on the premises of the Hayatabad Medical Complex has a separate director. It is managed by the HMC board of governors (BoG).

Following Prof Orakzai’s retirement, Dr Sultan Zafar was directed to make TORs for the resumption of transplants. The IKD transplant team made a presentation to the subcommittee constituted by the BoG on Feb 20, 2021, and got approval for the recommencement of transplants. The team asked for the CT angiogram, tissue typing, and cross-match laboratory.

The subcommittee promised the provision of the sought-after facilities in two months and directed the IKD (urology and transplant) chairman to make TORs and hire a transplant surgeon if needed. However, no progress was made on it yet again.

HMC BoG chief says transplant surgeon to be hired soon

IKD director Dr Sultan Zafar stepped down two months ago, so the task was given to Prof Zahid Aman, dean of the Khyber Girls Medical College and the additional director of the IKD, but to no avail.

The sources claimed that 40 patients were ready to undergo transplantation, while around 80 were registered for the purpose when Prof Asif Malik left the institute.

They said Prof Asif had performed more than 300 renal transplants with limited resources available to him as there was no separate ward for the purpose and that he performed surgeries along with other urological surgeries in the IKD.

The sources said the government didn’t accept the repeated requests of doctors to retain the services of Prof Asif, so not only the patients suffered but the training of doctors and the government’s plan to expand renal transplant services to regional hospitals was also affected.

They said all patients were availing themselves of transplant facilities in a private hospital of Hayatabad area with the cost of each surgery i.e. Rs1.5 million being borne by the Sehat Sahulat Programme.

The hospital doctors say they require a senior transplant surgeon to lead them.

According to them, they’re trained by Prof Asif but can’t carry out surgery independently.

The experts told Dawn that the government should ensure the resumption of renal transplants in the IKD as it was the only public sector hospital in the province with the facilities required for the purpose.

They said the suspension of renal transplantation had badly affected patient care and the training of doctors, who wanting to become transplant surgeons.

Dr Zubair Zahir, chairman of the Provincial Doctors Association, told Dawn that the government should ensure the early resumption of transplants as the prevalence of kidney failures was very high in the province.

“We want to see the IKD become a centre of excellence,” he said.

Dr Zubair, who is also an urologist, said many wards had closed down in public sector hospitals due to the resignation or retirement of senior and experienced consultants.

He said suspension of renal transplants had dealt a big blow to the IKD, which was supposed to act as an umbrella for the development of renal transplants throughout the province.

When contacted, chairman of the HMC BoG Sahibzada Mohammad Saeed said the board would advertise TORs for the hiring of a transplant surgeon shortly to pave the way for the resumption of renal transplants in IKD.

“We will recruit a competent renal transplant surgeon in accordance with the TORs,” he said.

Published in Dawn, August 15th , 2021