ISLAMABAD: In early 2014, Faisal Abdullah Malik’s life took an unexpected and terrifying turn. From February to December, he battled dilated cardiomyopathy, a severe heart failure where his heart’s efficiency plummeted to just 7%. That year was defined by fragility, pain, and a relentless struggle for survival.
In January 2015, he received a second chance through a heart transplant in Chennai, India — a life-saving opportunity that remains unavailable in Pakistan. This experience raises a critical question: Why are heart and lung transplants still impossible here? Is it due to legal barriers, a lack of skilled surgeons, or the absence of organ donors?
In 2009, a local newspaper reported a Federal Shariat Court ruling affirming that organ transplants are permissible in Islam, following a 2007 presidential ordinance. This led to the creation of the Human Organ Transplant Authority (HOTA) in Sindh, aimed at establishing a cadaver organ donation registry. By 2019, hospitals were instructed to report brain-dead patients to HOTA, but despite this progress, societal and cultural resistance to organ donation remains high.
As American surgeon Atul Gawande once said, “The difference between what we do and what we are capable of doing would suffice to solve most of the world’s problems.” Pakistan has the legal framework but lacks the cultural shift and action needed to implement it.
In an interview with The News, Faisal Abdullah Malik, Pakistan’s first heart transplant recipient in India, said that in 2018 he learned that Mansoor Ahmed Khan, Pakistan’s World Cup-winning hockey goalkeeper, was also suffering from dilated cardiomyopathy. Unfortunately, his fate was sealed by the limitations of our healthcare system, and he passed away later that year. During this time, Malik said, he met Dr. Pervaiz Chaudhry, head of cardiac surgery at the National Institute of Cardiovascular Diseases (NICVD), who had handled Mansoor’s case. Dr. Chaudhry had the skills to implant a Left Ventricular Assist Device (LVAD), a temporary solution in the absence of organ transplants, yet the lack of organ donors made this the only option.
We have skilled doctors in Pakistan who are capable of performing heart and lung transplants, but without a culture of organ donation, their hands are tied.
Pakistan already has a framework through HOTA and leading institutions like the NICVD, the Punjab Institute of Cardiology, and the Armed Forces Institute of Cardiology (AFIC). Yet the missing piece is awareness.
In contrast, Tamil Nadu, India, has become a global leader in organ donation and transplants. Malik said his surgeon, Dr. KR Balakrishnan, and his team have performed over 600 heart and lung transplants. Tamil Nadu’s success is driven by the establishment of the Transplant Authority of Tamil Nadu (TRANSTAN) and its extensive awareness campaigns, which even set a Guinness World Record for the largest organ donation talk.
Malik wondered why Pakistan can’t follow a similar model. Our provinces, under the leadership of HOTA, should create a supportive environment for transplants by maintaining donor registries and encouraging public pledges for organ donation.
He once asked Dr. Balakrishnan if he would come to Pakistan to perform a heart or lung transplant with local doctors. His response was enthusiastic: “Yes, of course! I would love to see Pakistan.” Despite the political tensions, cross-border collaboration could save countless lives in Pakistan.
A united effort, driven by compassion and the goal of saving lives, could revolutionize healthcare in Pakistan. We have the laws, the doctors, and the institutions—but what we lack is the awareness to build a sustainable organ donation system.
The dream of a heart and lung transplant programme in Pakistan is not out of reach. It’s waiting for the right spark to set it into motion. Let that spark be us.