Govt plans to reinforce liver transplant capabilities in the country

Infograph: TBS

The government is planning to strengthen institutions to perform liver transplants in Bangladesh. Preparations are underway to initiate the procedure at two institutions– Birdem General Hospital and the National Gastroliver Institute and Hospital.

Experts from India, Pakistan, and Turkey will assist in launching the initiative. The government is set to sign Memorandums of Understanding (MoUs) with specialised hospitals in these countries.

Professor Dr Sayedur Rahman, special assistant to the chief adviser for the health ministry, told The Business Standard, "We intend to start liver transplants at two centres. Birdem already has the facilities (the Hepato-Biliary-Pancreatic Surgery and Liver Transplant Unit), and the government will provide necessary support there. The Gastroliver Hospital will take four to five months to be fully ready."

"The first transplant at Birdem could take place within the next three months. At the outset, experienced surgeons from India, Pakistan, Turkey, and other countries will join operations in Dhaka and train our doctors. A few cases will be performed under their supervision. The technology will be transferred, after which local surgeons will take over the programme," he added.

He further said, "Unless screening and case selection are done well, transplant outcomes are poor. Infections must be kept at zero through every stage– from the operating theatre to post-operative care."

Professor Mohammad Ali, who led the country's first liver transplant team and currently heads the Department of Hepato-Biliary-Pancreatic Surgery and Liver Transplant at Birdem, is once again spearheading efforts to relaunch liver transplants in Bangladesh.

Speaking to The Business Standard, he said, "Due to a shortage of skilled personnel and various other challenges, liver transplants have not been performed in Bangladesh since 2020. The government has now taken the initiative to restart the programme. This will allow patients to get treated within the country, reducing both cost and suffering. We're preparing our team to begin transplants as soon as possible."

According to the health ministry, liver transplants in Bangladesh could cost around Tk30 lakh, compared to Tk70 lakh to Tk1 crore abroad. While not everyone may access the procedure initially, patients who currently travel abroad will be able to seek treatment at home.

Who needs liver transplants?

Prof Mohammad Ali explained that liver transplants are needed for patients with liver cirrhosis, liver failure, and in some cases, liver cancer. About one crore people in Bangladesh suffer from liver diseases, and 15–20% of them may develop cirrhosis.

A healthy person aged 18 to 65 whose blood group matches the recipient's can donate a portion of their liver. Both donor and recipient must pass a rigorous screening process. The donor's remaining liver typically regenerates within 6 to 12 weeks.

Under Bangladesh's organ transplant law, only close relatives with matching blood groups can donate. After a successful transplant, recipients can lead a normal life for many years.

Three liver transplants have taken place

Birdem Hospital started the country's first Hepato-Biliary-Pancreatic Surgery unit in 1999. The first successful liver transplant was performed there in June 2010, followed by a second in August 2011. The most recent transplant took place in February 2020, all led by Dr Mohammad Ali.

MoUs with multiple countries for liver transplant collaboration

On 3 June, a meeting was held in the health ministry's conference room to discuss the liver transplant programme. It was decided that the National Gastroliver Institute and Hospital will sign MoUs with reputable specialised hospitals in India, Pakistan, Turkey, or any other interested country. The government will also provide financial support to build capacity at Ibrahim Cardiac Hospital and Research Institute.

The meeting was chaired by Noorjahan Begum, adviser to the health and family welfare ministry. She said that in order to make liver transplants viable at the National Gastroliver Institute and Hospital, the government will ensure the presence of expert doctors, necessary equipment, training, skill development, and infrastructure. Reducing reliance on foreign treatment and building domestic medical capacity are key government goals.

Professor Dr A K Azad Khan, President of the Bangladesh Diabetic Association, said in the meeting that MoUs with interested countries like India, Pakistan, and Turkey will facilitate liver transplants in three phases– training, monitoring, and independent operation. He stressed that members of the specialised medical team must remain dedicated throughout the process.