Some 10 years after the first successful liver transplant in the country, physicians at a cardiac hospital on Wednesday said they are going to do it regularly with the availability of well equipped transplant operation theatres at their hospital.
Professor Dr Mohammad Ali, the pioneer of hepato biliary pancreatic surgery in the country made the firm ambition as they, a team of 30 physicians, conducted a successful liver transplant using their own support equipment and manpower on February 13 this year.
The first liver transplant was done in the operation theatre of Ibrahim Cardiac Hospital and Research Institute where Comilla resident Jahanara Khatun was the recipient and her son Shariful Islam was the donor.
Approached, the professor said: "This is my struggle of 20 years that is going to pay off for the betterment of the country's people."
Professor Mohammad Ali joined Ibrahim Cardiac Hospital in 1999 after completing his higher studies in Hepato-Biliary-Pancreatic Surgery. He is a pioneer of such surgery in the country, having established the department at BIRDEM hospital.
It took more than ten years to build his team to perform the first successful liver transplant performed on June 3, 2010, and the second successful transplant on August 6, 2011.
After the successful second liver transplant, he was thanked by the parliament in 2011. Following a request from the physician, the government agreed to support him financially, resulting in the establishment of the full fledged unit in 2020 that allowed him to pursue the latest operation.
“No one came forward to finance the unit as the equipment is very expensive. Without government help the dream of having a full fledged equipped unit would never be possible,” he recalled.
He said the operation is a lengthy procedure which can take some 17 to 18 hours as well. As such, "we need to ensure three operation theatres at the unit," he said.
Two teams work simultaneously
According to the professor, two specialized teams of liver transplant surgeons work simultaneously in two equipped operation theatres. In the case of a living donor transplant, a team deals with the donor operation while another team works for the removal of the damaged (cirrhotic/cancer) liver and finally implants the recipient with the donated liver (allograft).
In a deceased donor liver transplant the retrieval of the liver may be done in other centres and the liver is transported as quickly as possible to the recipient surgery theatre, he added.
It would also require two different sets of support staff and nurses as well.
Equipment was a major part and took a long time to install at the unit. But training efficient manpower was another challenge. And now, in 2020 they have a set of efficient manpower that can lead the treatment process.
What does the operation mean for the country?
The physician said it would bring several dimensional impacts to the country's health sector, especially in the case of organ transplants.
First, with this most recent operation, the country now has a full set of facilities in a unit for liver transplant operations. The previous two in country operations were done with borrowed equipment from four different hospitals in the city.
Second, it ensures a team of physicians and support staff who are efficient and could perform more transplant operations in the country.
Third, some ten young professionals of the specialized sector from outside of Ibrahim Cardiac Hospital attended the operation and learned about the operational procedure directly.
Some ten physicians from Dhaka Medical College Hospital and a private hospital attended the operation who later expressed their willingness to attend more such operations and envision starting such units in their respective hospitals.
If it could be done at a tertiary level government hospital, the cost would undoubtedly go down, he said.
Mentioning lack of physicians with knowledge about liver transplants in the country as the barrier to liver transplantation in the country, he said this successful operation would create awareness among the people.
A large number of people went abroad for such treatment and they had to spend a lot as it is an expensive operation taking some six months to even a year of recovery, after a successful liver transplant. However, normal activities may be resumed a few months after the transplant, he added.
Mentioning that the current organ transplant law is very rigid, he said many patients could not go for the transplant despite having a donor available, but one who is not a blood relation.
The professor, however, thanked the High Court for its verdict regarding kidney transplants in December last year, saying that voluntary donors, even those who do not have direct blood relations with patients, can now donate kidneys for transplants.
This should be applicable for all organs, as lives do matter, he said.
