Overview

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 very important 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 in a very short time. The liver is the only organ in our body that can regenerate lost or injured tissue.

♦ The commercial trade in human organs is prohibited by law in Turkey

Why is it done?

The purpose of liver transplantation is to treat liver failure patients. It is also effective in treating certain liver cancer types when the disease did 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 and is 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 that 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

Evaluation

The purpose of the evaluation is 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 ultrasound of your liver

Heart tests: Evaluate the health of your cardiovascular system

General health examination: It includes measuring your general health and checking for other diseases that may affect the success of the transplant.

Additionally, your evaluation may also include:

• 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 quite high. On the other hand, living liver donors undergo a comprehensive evaluation. Your doctor and transplant team must make sure that 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 who have 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 his/her liver that still working properly. Doctors call this process a domino liver transplant. Although the liver you received is not completely 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.

Staying healthy

You should work to be in your best health before and after a liver transplant. Being healthy and active is important 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 communicate often with your transplant team and share any changes in your health.

During the Procedure

Living donor liver transplant

Since your donor is alive, your doctor and transplant schedule the date of your surgery. 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, he/she connects 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 normal 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.

Additionally, you will need to undergo frequent check-ups as you continue your recovery at home. For this purpose, your transplant team creates 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 have to 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 that may occur after transplantation.

It may take 6 months or more for you to fully recover from liver transplant surgery. However, you can resume your normal activities and work for a few months after the surgery. The length of recovery time may depend on how advanced your disease was before the transplant.

Results

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 the deceased-donor liver transplantation.

For More Information

In Istanbul Medical Assistance your comfort during or after all kinds of procedures is our priority. Whether you are looking for more information, an initial evaluation, or a second opinion, do not hesitate to contact us via Whatsapp on +90 530 884 47 22 and we will get back to you as quickly as we can.