Driven by social misconceptions leading, tha scarcity of organ donations is leading to as many as 10 to 15 fatalities each day in Pakistan — the number reaching up to 20 for the United States.
The concerning situation has led to experts calling for urgent reforms to promote both living and cadaver organ donations, while also exploring the revolutionary potential of xenotransplantation, or animal-to-human organ transfers.
In Pakistan, despite the growing number of patients suffering from organ failure, cultural misconceptions and religious hesitation continue to suppress organ donation, leaving thousands to die while waiting for a second chance at life.
Speaking at the First International Conference on Transplantation (FICT) hosted by the Dow University of Health Sciences (DUHS) in Karachi, Pakistani-American transplant pioneer Prof Dr Mohammad Mansoor Mohiuddin emphasised the gravity of the crisis.
"In the United States, one patient dies every 80 minutes due to the unavailability of organs," he said. Prof Mohiuddin, who successfully transplanted a genetically modified pig heart into a human in a groundbreaking US procedure, added: "Xenotransplantation can potentially extend human life by up to 20 years and holds immense promise for countries like Pakistan, where the organ donation rate is critically low."
The expert explained that the early trials in xenotransplantation began with pig-to-monkey transplants and initially failed, but advancements in genetic modification have since made the procedures viable. Still, he acknowledged that both ethical and religious concerns remained global barriers to the adoption of animal-to-human organ transfers.
The conference, which DUHS Vice Chancellor Prof Saeed Quraishy described as a milestone in Pakistan's medical history, brought together over 22 international experts from the US, United Kingdom, Europe and the Middle East.
Notable participants included Prof John Fung, Prof John LaMattina of the University of Chicago, Prof Paulo Grossi from Italy, Prof Faiz Kurt Bred Dickman from Barcelona, Spain, Prof Aamir Ehsan from Texas, US, and Prof Adnan Sharif from the UK.
Prof Fung highlighted that post-transplant infections remained a leading cause of death, which was why infectious disease specialists had also been invited to the conference. He stressed the importance of medication to manage such infections and noted that with the right post-operative care, transplant survival rates could be drastically improved.
"One donor can save up to seven lives," he said, adding that Islamic countries like Iran and Saudi Arabia already permit organ donations from brain-dead patients, a practice now endorsed by leading scholars in Pakistan as well.
Prof LaMattina praised the surgical expertise of the DUHS's transplant team and welcomed the growing collaboration between the DUHS and the University of Chicago under the umbrella of the International Liver Transplant Society (ILTS) and The Transplantation Society (TTS). He announced that the next global transplant conference would be held in Chicago.
DUHS Conference Chair Prof Dr Sohail Rao told the media that the two-day event featured 44 international-level presentations, with live-streamed liver and kidney transplants conducted for the first time in Pakistan. "For aspiring surgeons and physicians, this was a historic opportunity for real-time learning," he said.
Pro-Vice Chancellor Prof Jehan Ara Hasan remarked that these live surgeries offered new levels of confidence and exposure to trainees, made possible via high-tech broadcast from operating theatres to the seminar hall and social media.
Experts such as Dr Asim Ahmed and Dr Tasadduq Khan underscored the importance of strengthening legal frameworks, ethical standards and public trust to build a fair and transparent organ donation system. "Organ trading exploits the poor. What we need is equity, not desperation," said Dr Ahmed.
On the technical side, Dr Ayaz Khan described advanced techniques such as Hand-Assisted Laparoscopic Donor Nephrectomy (HALDN) as safer, faster and especially effective for donors with complex vascular anatomy, including children.
In the closing remarks, Dr Rao emphasised that the unified religious stance now allowed for broader acceptance of brain-dead donor transplants in Pakistan. "With clear religious guidance and advancing medical expertise, the conditions are right for a transformation in Pakistan’s transplant ecosystem," he maintained.