The commercial trade in human organs is prohibited by law in Turkey.
In a liver transplant, the surgeon removes your failing liver and replaces it with a healthy one.
Liver transplantation for foreign patients in Turkey is performed only with living donors. In this transplant method, a living donor donates part of his liver. Also, the living donor may be a family member or a friend.
Our liver is the largest internal organ in the body and has essential functions:
- Processing nutrients, drugs, and hormones
- Producing bile that helps to absorb fats and cholesterol
- Producing proteins that help in blood clotting
- Clearing toxins and bacteria from the blood
- Prevent infection and regulate the immune system
Surgeons usually perform liver transplantation for end-stage chronic liver patients. However, it can also be effective in rare cases of sudden liver failure.
The liver is an organ that heals immediately after surgery and reaches its normal size quickly. The liver is the only organ to regenerate lost or injured tissue.
Why Is It Done?
The purpose of liver transplantation is to treat liver failure patients. It also effectively treats certain liver cancer types when the disease does not respond to other treatment options.
Liver failure is a disease that may occur both quickly and over time. Acute liver failure may occur within weeks. It is a rare disease that usually occurs due to complications from certain medications.
Liver transplantation may treat acute liver failure. However, treatment is most helpful for patients with end-stage liver failure. The formation of chronic liver failure takes months or even years.
Chronic liver failure may occur from a variety of health problems. However, the most common cause is an injury to the liver, namely cirrhosis. This scar tissue replaces normal liver tissue and prevents the liver from functioning properly.
Diseases that cause cirrhosis:
- Hepatitis B and C
- Alcoholic liver disease, liver damage from excessive alcohol use
- Non-alcoholic fatty liver disease, where fat builds up in the liver, causing inflammation or liver cell damage
- Genetic diseases affect the liver. Such as Wilson’s disease causes excessive copper buildup in the liver
- Diseases affecting the ducts that remove bile from the liver. For example, biliary atresia, which causes liver transplants in children
Also, a liver transplant may treat certain types of cancer that arise from the liver.
How Do You Prepare?
Choosing a transplant center
There are some criteria that you should consider when choosing the hospital or transplant to get a liver transplant:
- Types and number of transplants performed
- Survival rates
- Additional services such as support groups, travel arrangements, helping with your recovery
- Latest technology and techniques
The evaluation aims to determine if you are eligible for a liver transplant.
To have a liver transplant, you should:
- Be healthy enough to have surgery and tolerate lifelong medication use
- Not have a disease that will prevent the success of the transplant
- Be able to use your medications according to your doctor’s directions
- Be able to follow the advice of your transplant team
During the evaluation process, the tests your transplant team will perform:
- Lab tests: Blood and urine tests measure the health of your internal organs
- Imaging tests: Such as an ultrasound of your liver
- Heart tests: Evaluate the health of your cardiovascular system
- General health examination: This includes measuring your public health and checking for other diseases that may affect the success of the transplant.
Additionally, your evaluation may also include the following:
- Nutritional consultation with dietitians before and after the procedure
- Psychological evaluation for mental problems such as depression or anxiety
- Addiction consultation for alcohol, drug, or tobacco addiction
After the transplant team has finished testing and evaluation, the ethics committee will discuss your situation and decide on your eligibility for transplant. If you are eligible for a transplant, you and your living donor can start preparing for the surgery.
Before the Procedure
Living Liver Donors
Doctors previously used living-donor liver transplants only for children. Today, adults with end-stage liver disease can also benefit from this procedure.
With a living-donor liver transplant, you can avoid the complications that can arise while waiting for the donation list. Firstly, your donor should be healthy enough to undergo a surgical procedure. The donor’s age, blood type, and liver size are critical factors in determining your match.
In most cases, the living donor comes from family members or friends. The success rate of living donor liver transplantation is relatively high. On the other hand, living liver donors undergo a comprehensive evaluation. Your doctor and transplant team must ensure your donor is compatible with you.
With your transplant team, you can discuss the risks and benefits with your potential donor.
Domino Liver Transplant
This type of liver transplant is possible with donors with a rare disease called familial amyloidosis. This disease causes damage to internal organs due to protein accumulation in the long term.
Your living donor with this disease receives a liver transplant for treatment. Then, you will get their liver that is still working properly. Doctors call this process a domino liver transplant. Although the liver you received is not entirely healthy, it usually takes 10 years for any symptoms to appear. Therefore, patients 55 or older are eligible for domino liver transplantation because these recipients are unlikely to experience symptoms during their normal life span.
After the transplant, your doctor and transplant team will closely monitor you for symptoms.
It would be best if you worked to be healthy before and after a liver transplant.
Being fit and active is essential for the success of the transplant and the speed of your recovery.
- Take your medications as prescribed
- Follow diet and exercise guidelines
- Do not miss your appointments with your transplant team
- Keep your morale high with healthy activities
During the recovery period, you should often communicate with your transplant team and share any changes in your health.
Liver Transplant Procedure
Living Donor Liver Transplant
Since your donor is alive, your doctor and transplant schedule your surgery date. Your surgeon performs the liver transplant surgery under general anesthesia, and you will not feel anything during the procedure.
Firstly, the surgeon operates on your donor and takes a portion of the healthy liver. Next, the transplant surgeon makes an incision across your abdomen to reach your liver. The location and size of the incision vary from patient to patient.
Then, your surgeon removes the failed liver and replaces it with a healthy piece of liver. Then, they connect your blood vessels and bile ducts to the new liver. Lastly, your surgeon will close the incision with stitches and staples. After the procedure, your recovery process begins in the intensive care unit.
The surgery can take up to 12 hours, depending on your situation.
The healthy liver regenerates rapidly and reaches standard sizes within a few weeks.
After the Procedure
After a liver transplant, you may spend the first few days in intensive care. During this process, doctors and nurses monitor you closely for signs of complications. They also check your liver frequently to make sure it’s working. You will spend 5-10 days in the hospital after your condition stabilizes in the intensive care unit.
Also, it would be best for you to have frequent check-ups while you recover at home. For this purpose, your transplant team will be able to create a suitable check-up schedule for your needs. Initially, you will have blood tests several times a week, but this decreases over time
After a liver transplant, you must take medicine for the rest of your life. These drugs are to prevent your immune system from attacking the new liver. Moreover, you will need medication for other complications after transplantation.
You may take 6 months or more to recover from liver transplant surgery fully. However, you can resume your normal activities and work for a few months after the surgery. The recovery time may depend on your disease's advancement before the transplant.
Our doctors and transplant teams perform liver transplantation with a 1-year survival rate of 90% and a 5-year survival rate of 75%. In addition, the short-term survival rates of living-donor liver transplantation are higher than those of deceased-donor liver transplantation.