A transplant surgery gone wrong

While the doctors engage in their usual blame-game routine, no one can ease the pain of the family of the deceased.

Sehrish Wasif May 23, 2012
The liver transplant centre of Pakistan Institute of Medical Sciences (PIMS) witnessed its first liver transplant surgery on May 2. The establishment of this transplant centre was directed by Prime Minister Yousaf Raza Gilani and the utilisation of huge amounts of fund required for its construction still remains controversial.

The sad reality is that no one can hold the minister and his team accountable for this sum of money.

The surgery — which took place on May 2 — was historic because it was the first of its kind in the country. Indeed, this is true, for it met a fateful end. One wonders what hopes and dreams 36-year-old Attaullah Baloch of Khuzdar came with to receive his transplant — where his wife donated a piece of her liver to ensure the sustenance of her husband’s life.

Though the hospital’s administration made efforts to keep the surgery confidential from media and even from the majority of the centre staff, unfortunately they failed. Perhaps it was because they were already aware of the incompetence of its surgical team.

The surgery was carried out by a team of British and Pakistani surgeons and though one cannot comment on the skill of the former, it is apparent that the latter were not up for the task set for them.

Baloch was operated upon again — after the failure of his initial transplant surgery — during which his hepatic artery was ruptured, resulting in renal failure. Lack of preparation post-surgery, such as to procure blood for the patient to match his blood type, also suggests one reason which led to the tragic outcome.

Even though Attaullah Baloch died after the second surgery, he was kept on the ventilator for two days and later pronounced dead. There seems to be no fathomable reason for this other than to delay the negative publicity that would have followed.

And while the doctors are engaging in their usual blame-game routine, no one can ease the pain of the family of the deceased.

The prime minister himself ordered the establishment of the centre, but will he take notice of the death at the centre now, or does his job only entail giving directives and not following up on them whether they are implemented or not?
Sehrish Wasif
The views expressed by the writer and the reader comments do not necassarily reflect the views and policies of the Express Tribune.


Omer | 12 years ago | Reply This post is speculative and talks in generalizations. Unless the medical, board if there is one, conducts a review we cant know what the exact cause of death was, whether incompetence or actual risks of surgery. And the Board has to come out with a formal statement. Jumping to conclusions would be wrong and a disservice to the patients who might genuinely benefit from this medical capability.
Dr. Jahanzeb Effendi | 12 years ago | Reply Dear Sehrish, Before you write such criticism about at liver transplant, please do keep in mind that Mr. Baloch was already suffering from liver failure. Unlike renal failure, where dialysis can keep the function of the kidneys for a number of years, the mechanical replacement of the liver is extremely difficult and incredibly costly. Hence, liver failure is fatal unless transplant is arranged. The earlier in the course of failure, the better. I do not know about your medical back ground, but I do assume that you understand the risks of a living donor liver transplant. It is one of the most delicate procedures and even the donor is subjected to risk as they cut out one whole lobe of the liver. We recently lost a donor here in Chicago who was giving the liver to her husband. There was a hue and cry in the medical community as this mortality took place at one of tthe best liver transplant center here. You need to understand, complications can happen even in healthy. The human body is dynamic in its response to surgery. A patient who is in liver failure has multiple problems going on at the same time; the liver is responsible a cocktail of coagulation proteins, factors in the blood and detoxification on ammonia etc. The risk to surgery is manifold in such a patient who already has significant pathology of liver. So, death after transplant could be for a variety of reasons. Sometimes bleeding occurs due to uncontrolled platelet loss and the new graft could be responsible. There could be sepsis post op or the liver could just not function being foreign. Etc etc. That being said, it should have been the responsibility of the team to cross match blood and have an aggressive post op infection control. You see, liver transplant is just not the work of the surgeon. It has to be a multi-disciplinary approach to the patient. A transplant immunologist, hepathologist,cardiologis, gastroentrologist, infectious disease and other allied health sciences staff- social worker, transplant nurses, nutirtionist, psychologist, physical therapist- this is the team we have for patients here in the U.s. And all combine their expertise to treat each transplant patient. Now if the Prime Minister instead of spending billions on the building works on getting a proper team to care for the patient, we Will have better morbidity and mortality rates.
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