Liver Transplantation in Turkey Procedures, Surgery, and Recovery
What is liver transplantation?
Liver transplantation is a surgical procedure to replace a failing liver with a healthy one from another person.
You can receive a whole liver from a recently deceased donor or a part of a liver from a living donor. A divided liver can grow back to its full size in both your body and the living donor’s body.
Why do some people need liver transplantation?
You cannot live without a functioning liver. If your liver is failing, or if you have primary liver cancer, a liver transplant can save your life. Many conditions can cause your liver to fail, including acute causes such as toxic poisoning or chronic liver diseases.
There are more people in need of liver transplants than there are available donor livers.
What conditions can be treated with liver transplantation?
- Liver transplantation is usually reserved for:
- Liver failure (acute or chronic)
- Primary liver cancer (hepatocellular carcinoma)
- Acute liver failure
This occurs when a previously healthy liver sustains severe damage. If you suffer from acute liver failure, you will experience symptoms of liver failure, which indicate that your liver has stopped working.
This is an emergency. Some livers recover from acute liver failure, but others do not.
Chronic liver failure
Chronic liver failure is the final stage of progressive chronic liver disease.
It usually means that much of your liver tissue has been replaced by scar tissue, which does not allow blood flow. This is also called cirrhosis. As liver function deteriorates, signs of liver failure begin to appear.
Primary liver cancer
The type of cancer that starts in the liver is called primary liver cancer or hepatocellular carcinoma.
If the cancer has not spread outside the liver, removing the liver can eliminate the cancer and cure it. Sometimes, a partial liver resection (removal) may be performed. However, if your liver is in poor condition, a transplant may be necessary.
How long can you live without a liver transplant?
If you suffer from acute liver failure, you might recover, though this is not guaranteed. Those who do not recover may die within days. Chronic liver failure is a more gradual process.
You can live with cirrhosis for months or years while awaiting a liver transplant, although the need becomes more urgent as complications, such as portal hypertension, develop.
If you are awaiting a liver transplant for primary liver cancer, the cancer may still be in its early stages. Liver transplantation is only a treatment for liver cancer if the cancer has not yet spread outside the liver.
However, most people with primary liver cancer also suffer from chronic liver disease, so your outlook depends on several individual factors.
How common are liver transplants?
Approximately 8,500 people receive liver transplants annually. About 12,500 people are added to the donor waiting list each year. Nearly all liver transplants (95%) come from deceased donors. However, the number of transplants from living donors is increasing, with a 30% rise in live donor liver transplants in 2019 compared to 2018.
Operation Details
What are the criteria for qualifying for a liver transplant?
There is a high demand for liver transplants, and those who qualify will undergo intensive surgery and a long recovery. Healthcare providers want to ensure the success of the operations, so they require certain criteria to be met to qualify for a liver transplant.
The requirements to qualify for a liver transplant include:
- Clinical signs of liver failure or primary liver cancer.
- Being in good health to handle surgery and recovery well.
- No risk of future alcohol or drug abuse.
Healthcare providers will conduct a thorough evaluation of your physical health. If you have any conditions that could impede the transplant, you will need to treat them first.
Once you meet the necessary criteria, the liver transplant process will begin.
The liver disease scoring system used is called MELD (Model for End-Stage Liver Disease) or PELD (Pediatric End-Stage Liver Disease).
It is calculated based on blood test results, which measure:
- Bilirubin: High levels indicate bile leakage into the bloodstream.
- Prothrombin time: The time it takes for a blood sample to clot.
- Creatinine: A measure of kidney function, used for adults.
- Albumin: A measure of kidney function used instead of creatinine for children.
Donor requirements for liver transplants
You can donate a portion of your liver for a transplant. After donation, your liver cells will regenerate, and the organ will grow back to nearly its original size for both you and the recipient. To be an eligible donor, you must meet the following criteria:
- Good physical and mental health
- Aged between 18 and 60 years
- Body mass index (BMI) under 35
- Blood type compatibility with the patient
- No heart or kidney diseases
- No malignant tumors
- Not infected with HIV/AIDS
- No hepatitis
- No active or chronic infections
- No substance abuse
Organ donation laws in Turkey One of the primary requirements for organ donation in Turkey (liver or kidney) is that the patient and donor must be from the same family, with the degrees of kinship as follows:
- First degree (father, mother, children)
- Second degree (siblings, grandparents, grandchildren)
- Third degree (aunts, uncles, cousins)
How much of the liver is donated for a transplant?
The amount of liver needed for transplantation depends on the case. Most adults require one lobe of the donor’s liver. If the donated lobe is healthy, it will regenerate to its previous size.
Surgeons often choose the right lobe because it is slightly larger, but the left lobe can also suffice. Most children only need about 20% of an adult liver, equivalent to one of the left lateral lobes.
What happens during the liver transplant operation?
A liver transplant is a major surgery that takes six to twelve hours. You will be under general anesthesia during the procedure.
Surgeons will place various tubes in your body to perform specific functions while you are unconscious. These tubes will remain in place for several days post-surgery. You will have:
- An intravenous line (IV) in a vein in your arm or hand to deliver fluids and medications.
- Another IV in a vein in your neck or groin to monitor blood pressure and take blood samples.
- A tube through your mouth to your airway connected to a ventilator to mechanically expand your lungs during the surgery.
- Tubes in your abdomen to drain blood and fluids surrounding the liver.
- A nasogastric tube inserted through your nose into your stomach to drain secretions until bowel function returns to normal.
- A urinary catheter to drain urine.
To begin the surgery, the surgeon will make a long incision across your abdomen to access the liver. The surgeon will carefully detach the liver and connect the blood vessels and bile ducts to the new liver. After closing the incision, you will be transferred to the intensive care unit.
What happens after the liver transplant operation?
You may remain in the intensive care unit for several days after surgery. The healthcare team will monitor your condition for signs of complications. Blood samples will be taken to check how well the new liver is functioning. Fluid/electrolyte balance, blood sugar levels, and blood volume may need to be managed through the IV lines.
Once your condition stabilizes, the tubes will be removed, and you will be moved to the recovery unit for a stay of one to three weeks. It may take a few days for your bowels to start functioning again. You will gradually start drinking fluids and slowly reintroducing solid foods. You will gradually reduce IV painkillers before going home.
What kind of post-operative care will you receive during recovery?
As you continue to recover at home, you will have regular follow-up appointments with your healthcare team. They will continue to conduct regular blood tests to check the condition of your new liver. The stitches from your incision may be removed after a few weeks. You will be prescribed several medications right after surgery, and some will need to be taken for the rest of your life.
Turkey Healthcare Group stands out with a team of distinguished medical experts in Turkey, who always strive to provide the best healthcare services to patients.
If you are looking for exceptional healthcare or need medical consultation from top doctors, feel free to contact us.
We also invite you to view our leading medical staff and get to know their qualifications and experiences up close.
We are here to ensure you receive the best possible healthcare.
