Liver Transplant Center in Turkey

The Liver Transplant Center in Turkey provides services following international standards, with world-renowned academic staff, specialized doctors, and healthcare professionals dedicated to post-transplant care. Liver transplants for both children and adults are successfully performed, achieving some of the best results globally in both cadaveric and living donor liver transplants.

The center offers comprehensive organ transplant services, including the latest laboratory techniques, advanced imaging units, state-of-the-art operating rooms, intensive care units, and inpatient services. With limited access to adequate organ donations in Turkey, around 80% of transplants rely on living donors. This approach has made Turkey a global leader in living donor transplantation. The center also serves as an international training hub, where leading hospitals and surgeons from around the world, including the U.S., collaborate with Turkish universities to learn organ transplantation techniques.

Liver Transplant Overview

Liver transplantation is the only treatment for chronic liver failure. It involves replacing a diseased liver with a healthy one. The most common reason for liver transplants worldwide is cirrhosis, followed by congenital conditions and certain liver tumors.

Finding a Healthy Liver for Transplantation

Organ transplantation requires a donor. The liver can come from either:

1. Living donors (often family members or immunologically compatible individuals).
2. Cadaveric donors (individuals declared brain-dead with family consent for organ donation).

When there are not enough organ donations, many patients die waiting for a liver. As an alternative, part of a living donor’s liver (right or left lobe) can be transplanted to the patient, with the donor undergoing extensive evaluation to ensure compatibility.

Key Criteria for Liver Transplantation

Successful liver transplantation requires matching the donor and recipient’s blood types. After matching, the donor undergoes a series of social, psychological, and medical assessments, including blood tests, infectious disease screening, radiological imaging, and input from other medical specialists. Factors such as the required liver size, bile duct structure, and the overall health of both donor and recipient play critical roles in the transplant process.

Lifelong Medication after Transplantation

As with all organ transplants, liver transplant recipients must take immunosuppressive medications for life to prevent the immune system from rejecting the new organ. Non-compliance with these medications could result in the immune system attacking the liver, potentially leading to graft failure and life-threatening complications.

Life after Liver Transplantation

The goal of liver transplantation is to restore the patient to a healthy, active, and productive life. Both donors and recipients are expected to return to their pre-surgery performance levels. The success rates at Turkey’s liver transplant centers exceed internationally accepted benchmarks, offering new hope to patients suffering from severe liver conditions.

Indications for Liver Transplantation

Liver transplantation is recommended for the following conditions:

• Chronic liver diseases: Cirrhosis caused by alcohol, viral infections, autoimmune diseases, primary biliary cirrhosis, and primary sclerosing cholangitis.
• Acute liver diseases: Acute liver failure and severe hepatitis.
• Liver tumors: Hepatocellular carcinoma (HCC) and, in some cases, metastatic liver cancer.
• Genetic liver disorders: Wilson’s disease, alpha-1 antitrypsin deficiency, and hemochromatosis.

Contraindications for Liver Transplantation

Certain conditions may disqualify a patient from liver transplantation:

• Active infections: Uncontrolled infections pose significant risks.
• Malignancies outside the liver: Metastatic cancer limits the effectiveness of a liver transplant.
• Multiple organ failure: Simultaneous failure of other vital organs (e.g., heart or kidneys) complicates transplantation.
• Alcohol or drug addiction: Transplants may be denied unless the patient demonstrates long-term recovery.
• Severe heart or lung conditions: Chronic diseases may affect surgery outcomes.
• Non-compliance with post-transplant care: Patients unable to follow treatment protocols may not be eligible.
• Advanced age: Older patients may face higher surgical risks.
• Severe obesity: Excessive weight increases surgical risks and hinders recovery.

Types of Liver Transplant Procedures

1. Deceased Donor Transplant:
   The entire liver from a deceased donor is transplanted into the recipient.
2. Living Donor Transplant:
   A portion of a living donor’s liver, usually a family member’s, is transplanted. Both the donor’s and recipient’s livers regenerate over time.
3. Split Liver Transplant:
   The liver from a deceased donor is divided between two recipients, providing a solution for multiple patients.
4. Auxiliary Liver Transplant:
   Part of a healthy donor liver is transplanted alongside the patient’s own liver, which may recover over time.
5. Domino Liver Transplant:
   A functioning liver from a patient with a metabolic disorder is transplanted into another patient, as in cases of amyloidosis.

Pre-Transplant Preparation in Turkey

Before surgery, both donor and recipient undergo detailed evaluations. Recipients undergo:

• Comprehensive blood tests to determine liver function and compatibility.
• CT or MRI scans to assess tumors or other conditions.
• Psychological and social assessments to ensure they are prepared for surgery and post-operative care.

Donors also undergo extensive medical assessments, including:

• Blood tests to confirm blood type and tissue compatibility.
• Liver imaging to verify health and suitability for donation.

Once compatibility is confirmed, surgery is scheduled, following strict protocols for patient safety and quality.

Liver Transplant Procedure

Liver transplantation is a complex surgery conducted under general anesthesia in two phases:

1. Removal of the Diseased Liver:
   The surgeon makes a large incision to access and carefully remove the damaged liver, minimizing bleeding and preserving surrounding structures.
2. Transplantation of the New Liver:
   The donor liver is connected to the recipient’s blood vessels and bile ducts to restore normal function. Once the liver is confirmed to be functioning, small drainage tubes are placed, and the incision is closed with precision sutures.

Potential Complications

While liver transplantation offers a new lease on life, complications can occur:

• Graft rejection: The immune system may attack the new liver.
• Graft failure: The new liver may not function correctly.
• Vascular complications: Blood clots may form.
• Bile complications: Issues such as bile leakage or duct narrowing.
• Infections: Due to weakened immunity post-surgery.
• Side effects from immunosuppressants: Such as diabetes, hypertension, or kidney problems.
• Complications from anesthesia.

Post-Transplant Recovery and Care

After surgery, patients begin a gradual recovery process:

• Hospitalization and Monitoring: Close observation ensures pain control and early detection of complications.
• Gradual Return to Daily Life: Patients slowly resume activities, supported by regular medical check-ups and imaging tests.
• Collaboration with Specialists: Liver specialists monitor recovery, manage medication side effects, and guide healthy lifestyle choices.
• Individualized Care Plans: Each patient receives personalized care for optimal recovery and long-term health.
• Liver Regeneration: The liver’s ability to regenerate plays a vital role in transplant success, benefiting both donor and recipient.

Advancements in Liver Transplantation in Turkey

Turkey has made significant progress in liver transplantation, achieving higher success rates through advanced technology and expertise. With proper post-operative care and patient commitment, liver transplant recipients can enjoy a new and improved quality of life.