Liver transplant in Turkey
Liver transplant in Turkey
Liver transplant in Turkey:
Liver transplantation in Turkey Liver transplantation (liver transplantation) is the only and last treatment option in cases of acute liver failure and end-stage liver failure (cirrhosis) with irreversible liver damage and some liver cancers. Liver transplantation is the most popular treatment for patients with liver failure in the world. Every day, many people around the world get a chance to live with a liver transplant (liver transplant in Turkey) and return to their healthy active life.
What is the function of the liver?
The liver is the largest organ in the body, weighing 1.4-1.7 kg, soft, pinkish brown, triangular.
The basic functions of the liver are listed as follows.
+ It turns what you eat into nutrients your body can use. (For example, starch is converted into sugar, and bile is produced for the digestion of fats.)
It produces blood clotting factors, enzymes, and other proteins.
+ It stores energy sources like iron, vitamins, fats and sugars.
+ Removes toxic substances such as drugs and alcohol that may be harmful to your body.
Self-renewal of the liver
More than half of the liver can be taken from a donor for an organ transplant without impairing liver function or other serious damage. The liver is the only organ in the body that can regenerate after removing most of it. The liver, part of which is removed, reaches its normal size between 7 days and 3 months. Most of the regenerations occur within the first week. Thanks to this feature, half of the liver taken from the donor can be successfully transplanted to patients with liver failure.
Liver diseases that require a liver transplant:
Liver damage can be caused by various diseases. The destruction of the normal structure of the liver due to this damage over time and its replacement by nodules and fibrous structures is defined as cirrhosis. The only treatment for this irreparable damage to the liver is a liver transplant. Currently, cirrhosis is one of the diseases that undergo liver transplantation in Turkey, in both the world and in our country. However, liver transplantation is also used for some congenital diseases and some liver tumors. Cirrhosis is one of the most important causes of loss of life in many regions of the world and in our countries.
While alcohol consumption in Western Europe and North America is the main factor in the disease, viral hepatitis, an important public health problem in many other parts of the world, ranks first in the causes of cirrhosis. The main cause of cirrhosis in our country is known as viral hepatitis. Liver transplant in Turkey
In end-stage liver failure, all or some of the following symptoms may be seen.
Mild fever
Vomiting and nausea
Edema
Spontaneous bleeding from the nose or gums
Redness and bruising on the body
Anorexia
Muscle cramps
Weakness, fatigue, weakness
Itchy
Breast enlargement (gynecomastia)
Decrease in capillaries and disturbance in their distribution
Changes in sexual behavior and reluctance
Weight loss or gain
Low blood pressure
Slow motion and speech
Liver transplant in Turkey:
Liver transplantation is the only and final treatment option in cases of acute liver failure, liver failure in the final stage with permanent liver damage and some types of liver cancer.
Liver transplantation from a cadaver:
It is a type of transplant that can be performed after the families of people with brain death donate their organs. In order to have a transplant from a cadaver, it is necessary to show with some tests that the person whose organ was removed does not have any infectious disease, cancer or liver disease.
The liver, which has been removed under appropriate conditions and preserved in special protective fluids, must be transferred to the patient within 24 hours at the latest.
2- Liver transplantation with a nearby living donor:
It is a form of living donor transplantation to remove a portion of the liver from a living donor. In order to perform this operation, there must be a fourth degree blood link between the recipient and the donor. In cases where there is no kinship but there is a question about a voluntary basis, the approval of the ethics committees established in the health directorates is required.
With all of the examinations performed on the volunteer, it must be established that it is okay for the person to give a piece of his liver.
In examinations conducted; This should be clarified by looking at the donor’s blood ratings that no additional disease is required for organ donation. In the second stage, it is examined whether the liver has a suitable anatomy of the blood vessels and bile ducts,
And whether there is enough liver for the recipient and the donor, and whether the liver is fatty by imaging methods. It is usually necessary to take the left side of the donor’s liver for young children, and the right half of the donor’s liver for adult patients.
Who can donate a liver transplant in Turkey?
For a person who decides to become a liver donor, it is checked if there is a suitable donor after making detailed assessments in advance. Organ donation is not acceptable if any risk or suspicion is revealed regarding the recipient or the donor.
At this point, for a person to be a liver donor, they must have the following characteristics.
The donor must be over 18 years old.
Depending on the general health of the donor and recipient, the age of the donor must be under 60 years old.
The donor must donate on a voluntary basis.
There should be a blood link up to the fourth degree between the donor and recipient candidate. In our country, while blood ties up to the fourth degree do not require the approval of the Ethics Committee, it is necessary to obtain the approval of the Ethics Committee from the Regional Health Directorate for the degree of kinship after the fourth degree.
In the absence of blood ties, there should be no financial link and approval of the Ethics Committee must be obtained.
The donor and the recipient must match in the same blood type (same group or zero group).
The donor should not have a history of diseases
The most common questions about liver transplantation in Turkey
What are the causes of liver failure?
The liver has the ability to overcome the damage it has caused after many diseases by replenishing itself. However, in some cases, this capacity may not be sufficient and the liver may be irreversibly damaged. most of them are from; While it may be the result of genetic / family / hereditary abnormalities, especially in children, the causes are different in adults. The most common cause in infants and children is the absence of congenital bile ducts (biliary atresia), followed by other metabolic and hereditary diseases (PFIC: progressive familial cholestasis within the liver, Wilson’s disease, and hepatoblastoma: childhood liver cancer, deficiency of a genetic enzyme) .
The most common cause in adults is the hepatitis B virus (HBV). Hepatitis C virus (HCV) is more common in the Western world. Moreover, alcohol can be an autoimmune disease (autoimmune hepatitis, primary biliary cirrhosis, primary sclerosing cholangitis), Wilson’s disease, Chiari-Bodhi syndrome, and coding cirrhosis (an unknown cause). Liver cancer development based on any chronic liver disease is also an important reason for transplantation.
When should a liver transplant be done?
In cases of acute liver failure, the patient must be transplanted urgently.
In cases of chronic liver failure called long-term; Patients with end-stage hepatic insufficiency should be given the opportunity for transplantation under constant doctor’s follow-up, after completion of various imaging and biochemical examinations, according to internationally defined criteria. It should not be forgotten that one of the most important steps that increase the success rate of liver transplantation is “not to delay”.
What are the advantages of liver transplantation?
organ transplant; Today, it is accepted as a routine, valid and advanced treatment method applied in many chronic organ diseases. Since there is no dialysis-like support system in kidney failure that can perform liver function, patients with liver failure are truly life-threatening. A process that occurs with the transplantation of a vital organ such as the liver; It opens the door to a new “healthy” life for our patients. Patients with a survival rate of 10% or less without a liver transplant have a 90% chance of survival with a liver transplant.
Is tissue compatibility necessary for liver transplantation?
No. Blood type compatibility is sufficient.
What are the requirements for a live liver transplant?
The mother, father, brother, husband or other relatives and relatives must volunteer. ought to
All checks on this volunteer show that it is okay for a person to give a piece of his liver. These tests are two-way:
first one; Performing checks on all systems to prevent any harm to the organ donor. All organs such as the heart, lungs, digestive system and mental state.
Recent liver exams. In these examinations, all structural features of the liver, arteries, veins, and bile ducts are examined.
If all the checks are appropriate, it is decided that there is no harm in donating the volunteer’s organs. It is usually necessary to take the left side of the donor liver for young children, and the right half of the donor liver for adults or older patients.
The minimum age for liver donation is 18 and the maximum is 50 (60) years. Although there is no certainty about this issue, issues that arise at age 50 and over may prevent this process can be an upper limit of 50 or 60 depending on the status of the sender and the receiver.
How much liver is taken from a living donor?
For young children, it is usually necessary to take the small left side (25%) of the donor’s liver, and for adult patients, the right half (60%) or the left half (40%) of the donor’s liver often needs to be taken.
How long does live donor surgery take?
The liver transplant surgery in Turkey with a living donor takes between 8-18 hours. The duration of the donor surgery is 4-6 hours.
How is living donor surgery performed?
In this surgery, two teams that remove the liver and transplant the liver usually work together and at the same time. The portion of the liver taken from proximal is placed in place of the patient’s liver, which is removed by protecting the patient’s main abdominal vein (the vena cava). It is a more difficult technique than cadaveric surgery as a surgical method. It requires a bigger team. At least 4 surgeons, 6 nurses and an anesthesiologist work during the operation. In addition, the microsurgery and ultrasound examinations performed during surgery are also required to suture the very small artery.
How long will a living donor stay in intensive care after surgery?
Although it varies according to transplant centers, the average duration of intensive care is one day.
Will a living donor develop liver disease in the future?
There are no such risks for long-term donors. The liver is the only organ in the body that can regenerate itself (regenerate), and the organ regains its previous size within 3 months for people whose livers have been removed for any reason. There may be a loss of the donor due to problems related to the period of the operation, but for donors (donors) who are adequately examined before surgery in centers with experience, this risk is 0.5%. In the long term, problems with the donor are not expected. The remaining portion of the liver is sufficient for a healthy individual without endangering his life. The liver reaches its previous size in about 3 months, but the fastest growth occurs within the first 10 days after surgery.
Can a living donor return to work after surgery?
It is very normal to feel tired in the first three months after surgery due to increased energy and need while the liver reaches its previous size. For this reason, those who work in physical activity-based jobs, especially in hard work areas, can return to these jobs within 5-6 months at the earliest. Those with similar light duty and office jobs can return to these jobs within 3-4 months.
Is the remaining liver sufficient for a living donor to continue life?
As a result of the operations that are performed in the centers with experience, this risk is less than 1%.
What does my sex life look like after a liver transplant?
There is no change.
Can I have a baby after a liver transplant?
There is no change.
Yes. Although it does not pose any obstacle for male donors, it is recommended that female donors wait one year before becoming pregnant.
How long after liver transplant surgery will the recipient be discharged from the hospital?
After an average of 15-20 days, this period can take up to a month.
What can I eat and drink after a liver transplant?
After surgery, you may eat and drink as soon as your intestines start working. If your gas outlets are provided, it’s okay to drink water. If you do not experience nausea or vomiting while drinking the water, you can eat liquids and soft foods. You can start eating normal food within two days. Sometimes, donors may not return to their eating habits so quickly, and some donors may experience severe nausea that lasts 3 to 4 days between 3-7 days after surgery. The less painkillers are used, the faster the bowel will recover.
How often will I attend the examination after liver transplantation, liver transplantation in Turkey?
Patients who complete the first 3 months, weekly and 15 days outpatients without any problems after transplantation, are called for monthly controls after the sixth month, every two months, and cases that have completed one year are called for observation every 3 months.
What are the potential complications of donor liver transplant surgery?
The risk of losing life in donor surgery is 0.2 – 0.5 percent, which is very low. Complications such as excess fat in the liver, anatomical dissection, unexpected formation, disparity in the liver or visible lumps in the abdomen, etc., which may occur during donor surgery, may cause this surgery to end. Post-operative bleeding and bile leakage may occur. This condition rarely requires a blood transfusion and repeat surgery. Although the incidence of these complications is very low for Liver Transplant in Turkey, there is always a risk. These risks will be explained to you in detail during the assessments. Small bile leaks, minor wound infections, and some gastrointestinal disturbances (constipation, indigestion, and nausea) are among the most common complications.
Will I have severe pain after the surgery for a liver transplant?
After the operation, pain is controlled by taking intravenous medications for the first 3 days and then orally.
Will I live a normal life after liver transplant surgery in Turkey?
If there are no complications, we expect you to return to your old life in about 3 months. The risk of long-term complications is very low.
When can I travel after a liver transplant in Turkey?
Don’t make any plans to travel abroad for at least 4 weeks, or preferably 8 to 12 weeks. If you want to go home and there is a doctor in your city who can go to the controls and has knowledge of liver transplantation from a living donor, you can go home after 2 to 4 weeks If you feel comfortable we must remind you that you will be called back to our center for evaluation and treatment in case The slightest suspicion of complications. At the end of the twelfth week, you can travel wherever you want.