The development of PKLI grew from an effort to establish a specialized institution in Pakistan capable of providing advanced kidney and liver care, transplantation, research and treatment access within an autonomous institutional model. Punjab government records from 2015 identify Prof. Dr. Saeed Akhter as Chairman of the PKLI Trust and document the government’s allocation of land and funding for the project. The institute’s foundation stone was laid in August 2015.

The model sought to combine public funding with professional autonomy, market-based recruitment and a mission of providing subsidized or free treatment to patients unable to afford specialized care. Government reporting later described the project as having begun after discussions between then-Punjab Chief Minister Shehbaz Sharif and Dr. Akhter regarding the creation of a specialized kidney and liver institution.

His career later became increasingly focused on healthcare institution building. At the Pakistan Kidney and Liver Institute & Research Center, he served in senior roles including Chief Executive Officer, Director of Transplant Surgery and Chairman of Urology. His work has subsequently continued through leadership associated with Pakistan Kidney and Liver Institute & Research Center, and Pakistan Kidney Institute, reflecting a broader commitment to developing sustainable institutions for specialized care, medical education, research and patient access. - (APP)

Service, Recruitment and Compensation Model

From its development stage, PKLI sought to recruit highly trained Pakistani physicians from established careers abroad while prohibiting private practice and requiring full-time commitment to the institution. Contemporary reporting described a market-based compensation structure intended to make that recruitment possible. The News International

Reporting in May 2018 stated that Prof. Dr. Saeed Akhter had not drawn a salary in his role as PKLI’s CEO during the preceding three years while the institute was being developed. The same report stated that he began receiving Rs1.2 million per month as a practicing urologist from December 2017, after the hospital became operational. PKLI officials also said that he personally financed professional travel undertaken to recruit physicians from abroad. The News International

How the Proceedings Began

A March 2019 account by lawyer Babar Sattar in The News traces the beginning of the PKLI dispute to a private meeting at the residence of then-Chief Justice Mian Saqib Nisar on March 11, 2018. Prof. Dr. Saeed Akhter and his wife, Dr. Masooma Saeed, had been invited to the Chief Justice’s home along with PKLI board member Sheikh Amin and his wife. The meeting reportedly began cordially. The News International

The tone changed after Dr. Sajid Nisar, the Chief Justice’s younger brother and a professor at Services Hospital Lahore, joined the gathering. Babar Sattar’s account records that Dr. Sajid strongly objected to the comparatively higher salaries being paid to foreign-trained physicians recruited for PKLI. Dr. Akhter defended the institute’s compensation model, explaining that PKLI was attempting to attract highly trained specialists from established careers abroad while requiring full-time institutional commitment and restricting private practice. The News International

The discussion then became confrontational. Sattar records that Chief Justice Nisar became visibly agitated during the exchange and, while Dr. Akhter and Dr. Masooma were still guests in his home, announced that he would take suo motu notice of the issue his brother had raised. Dr. Akhter and his wife understood that as their cue to leave. Within weeks, PKLI’s salary structure and institutional affairs had become the subject of Supreme Court proceedings. The News International

There is also independent reporting from January 2019 in The News in which legal experts specifically discussed what the paper described as the former chief justice’s “humiliating behavior” toward Dr. Saeed in the PKLI matter. The News International

The manner in which Dr. Akhter was subsequently treated during the PKLI proceedings also drew criticism from members of Pakistan’s legal community. In a January 2019 review of Chief Justice Nisar’s tenure, The News reported senior lawyers’ criticism of his treatment of Dr. Akhter and identified the PKLI proceedings among the controversial episodes of his judicial tenure.

Institutional Consequences

The consequences extended beyond Dr. Akhter personally. PKLI had recruited physicians and surgeons from the United States, United Kingdom, Europe and the Middle East, many of whom had left established careers abroad to participate in the development of the institute. The News International

In March 2019, the Association of Physicians of Pakistani Descent of North America (APPNA) appealed to the federal government to protect PKLI and warned that uncertainty surrounding the institution was affecting its ability to retain internationally trained physicians. APPNA reported that five U.S.-trained physicians had already resigned and were returning to the United States. The News International

An earlier 2018 APPNA statement had expressed concern that the public treatment of Dr. Akhter could discourage overseas Pakistani physicians from contributing their expertise to Pakistan, urging that professionals returning to serve the country be protected from political pressures and reputational harm. APPNA

By April 2019, The News reported the departure of several foreign-trained specialists, including physicians in urology, critical care, pathology, nephrology and pediatric medicine. The report described their departures as part of a broader loss of confidence in PKLI’s institutional direction. The News International

Later reporting in September 2019 stated that roughly half of a group of 25 highly skilled physicians and surgeons recruited from abroad had left PKLI. The same report said liver transplantation had ceased after March 2019 and that kidney-transplant activity was substantially below the institution’s earlier target. The News International

Lost Time and Program Disruption

In March 2019, Dr. Akhter told Dawn that the prolonged investigations and administrative uncertainty had stalled financial and operational activity, delayed equipment procurement and affected transplantation and hepatitis programs. He estimated the institutional loss during the approximately eleven-month period at about Rs6 billion. The figure was his assessment rather than a judicial finding, but the disruption of programs and management during this period is documented across contemporary reporting. Dawn

Return to the United States

Following the court proceedings and subsequent changes in PKLI’s governance, Dr. Akhter returned to the United States. The Prime Minister’s Office later stated that he had gone back to the United States after the court proceedings and related issues and that Prime Minister Shehbaz Sharif personally played a role in bringing him back to Pakistan in 2022. He was subsequently reappointed Chairman of PKLI’s Board of Governors. Associated Press of Pakistan

When Dr. Akhter returned to PKLI, the Prime Minister’s Office directed that departments be revived in phases and that projects delayed during the previous three years be completed on an emergency basis. Associated Press of Pakistan

Institutional Renewal and Achievements Since Dr. Akhter’s Return

Following his return to Pakistan and reappointment as Chairman of the Board of Governors in 2022, Prof. Dr. Saeed Akhter resumed a leadership role at PKLI during a period of renewed institutional expansion. The achievements that followed were the work of PKLI’s multidisciplinary clinical, academic and administrative teams under its governing structure, rather than the work of any one individual.

In the years that followed, PKLI substantially expanded its transplantation and advanced surgical programs. By September 2026, reporting on PKLI’s transplant activity cited approximately 1,350 liver transplants, 1,250 kidney transplants and 22 bone-marrow transplants at the Lahore institution. PKLI also expanded its transplant footprint to Rawalpindi, where the institute performed its first liver transplants in August 2026 and its first kidney transplant in September 2026. Daily Times

The institute also developed advanced surgical capabilities beyond transplantation. PKLI’s official institutional history identifies robotic surgery, pediatric transplantation, advanced imaging, modular operating theatres and the largest dialysis unit in Punjab among its major capabilities. It also records Pakistan’s first pancreatic transplant as one of the institution’s milestones. PKLI

By March 2026, Radio Pakistan reported that PKLI had performed more than 500 robotic surgeries and approximately 14,500 surgical procedures in addition to its transplant activity. The same report stated that a large proportion of deserving kidney and liver patients were receiving free treatment. Radio Pakistan

PKLI also expanded its public-health role through a network of 18 Hepatitis Filter Clinics across Punjab. These clinics provide screening, referral and follow-up for Hepatitis B and C patients and are connected to PKLI specialists through telehealth services. PKLI&RC

The institution’s clinical development was accompanied by external recognition. At the Healthcare Asia Awards 2025, PKLI&RC received both “Tertiary Hospital of the Year – Pakistan” and “Specialty Hospital of the Year – Pakistan.” Healthcare Asia’s published winners list confirms both awards. Healthcare Asia Magazine

PKLI also reports achieving Joint Commission International accreditation, describing itself as the only public-sector hospital in South Asia to have attained that accreditation. Its expanding academic program has included specialist training, scientific symposia and research in transplantation, robotic surgery, hepatology and other advanced specialties.

The period from 2018 onward therefore became more than a dispute over an individual or an institution. It became a test of whether an ambitious public-sector healthcare model could survive institutional disruption, retain specialist expertise and ultimately continue to grow. PKLI’s subsequent expansion in transplantation, robotic surgery, public health, training and regional access forms an important part of that longer institutional history.