ISLAMABAD: While there has been a demand to begin lung transplants for many years, a process has finally been started for the transplants for the first time in Pakistan, as logistical preparations are under way at Shifa International Hospital, leveraging its existing liver transplant approval.

Dr Mohammad Asghar Nawaz, Pakistan’s sole lung transplant surgeon, is optimistic about gaining the approval soon.

Shifa International Hospital organised a seminar in this regard, wherein he discussed the procedure’s feasibility, while other speakers explored transplant immunology, highlighted pulmonologists’ role and added global perspective to it.

“Transplant, slightly more intricate than liver transplant, necessitates at least one lobe from the donor,” Dr Mohammad Asghar Nawaz, Pakistan’s sole lung transplant surgeon, cites UK studies indicating a 90 per cent one-year success rate and Japanese data reporting a commendable 62pc success rate over 10 years, globally recognised.

“In the UK, whole lungs from deceased individuals were transplanted, but live donors can provide lobes. Donors are discharged within 24 hours, while recipients stay for two weeks. Lobe retrieval takes an hour, and transplantation adds three hours, doubling for two lobes,” he explained.

“The lung transplant facility will be available at Shifa International Hospital, Islamabad. Contacts with the Human Organ and Tissues Transplantation Authority (HOTA) are underway to establish rules and registration procedures, similar to existing registrations for liver, heart, kidney, and bone marrow transplants,” he added.

“In several cases heart is also transplanted along with the lungs. The donor will be the blood relative of patient and their tissues will be matched before going for the transplant. In Pakistan mostly transplants are held from live donors,” he said.

Asked about success rates, Dr Nawaz cited a 90pc one-year success rate and 80pc for five years in the UK.

Replying to another question, he said that in the case of liver transplant, lobe of liver repaired whole of the liver but it was not the same case in lung transplant. “The lung, expanding like a balloon, provides ample oxygen for the patient. Recommending physical activity and discouraging smoking prevents breathlessness. Matching sizes, adult donors cater to adults, and children receive organs from children,” he said.

He said that in UK lung transplants were being done only in public sector hospitals and not in private set-ups. “In Japan, the 10-year success rate is 62pc. Lung transplants avoid cancer but address Asthma, fibrosis, including pulmonary fibrosis, and Covid-19,” he added.

Replying to a question about cost of the surgery, he said that “cost comparable to or slightly more than a liver transplant”. Dr Jim Egan from Dublin, Ireland; Dr Masaaki Sato from the University of Tokyo, and Dr Vipin Mehta from Wythenshawe Hospital Manchester University added a global perspective to the seminar.

Published in Dawn, November 14th, 2023