LIVER TRANSPLANTATION

A liver transplant is a surgical procedure that removes a liver that no longer functions properly (liver failure) and replaces it with a healthy liver from a living or deceased donor.

A liver transplant is a surgical procedure that removes a liver that no longer functions properly (liver failure) and replaces it with a healthy liver from a living or deceased donor. In Turkey, only transplantations from a living donor are performed on foreign patients.

Your liver is your largest internal organ and performs several critical functions, including:

Removing bacteria and toxins from the blood
Preventing infection and regulating immune responses
Processing nutrients, medications and hormones
Producing bile, which helps the body absorb fats, cholesterol and fat-soluble vitamins
Making proteins that help the blood clot

Liver transplant is usually reserved as a treatment option for people who have significant complications due to end-stage chronic liver disease. In rare cases, sudden failure of a previously normal liver may occur.

The human liver regenerates and returns to its normal size shortly after surgical removal of part of the organ.

In 2019, about 847 liver transplants were performed in Turkey among both adults and children. Of those, about 651 involved livers from living donors.

At hospitals, a team of surgeons, doctors, transplant nurses and other health professionals take care of you before, during and after transplant. They provide quality care focused on the needs of you and your family.

Having all of this subspecialized expertise in a single place, focused on you, means that you're not just getting one opinion — your care is discussed among the team, your test results are available quickly, appointments are scheduled in coordination, and your transplant care team works together to determine what's best for you.

Our partners has one of the largest liver transplant programs inTurkey. Its liver transplant team is recognized nationally and internationally for its expertise in comprehensive specialty treatment for people with serious liver conditions.

Why it's done

Normal liver vs. liver cirrhosis

Liver transplant is a treatment option for people with liver failure whose condition can't be controlled other with treatments and for some people with liver cancer.

Liver failure may happen quickly or over a longer period of time. Liver failure that occurs quickly, in a matter of weeks, is called acute liver failure (fulminant hepatic failure) and is usually the result of medication-induced liver injury.

Although a liver transplant may treat acute liver failure, it is more often used to treat chronic liver failure. Chronic liver failure occurs slowly over months and years.

Chronic liver failure may be caused by a variety of conditions. The most common cause of chronic liver failure is scarring of the liver (cirrhosis), a process in which scar tissue replaces normal liver tissue and impairs liver function. Cirrhosis is the most frequently cited reason for a liver transplant.

Major causes of cirrhosis leading to liver failure and liver transplant include:

Hepatitis B and C.
Alcoholic liver disease.
Nonalcoholic fatty liver disease.
Genetic diseases affecting the liver (including hemochromatosis and Wilson's disease).
Diseases that affect the bile ducts (the tubes that carry bile away from the liver), such as primary biliary cirrhosis, primary sclerosing cholangitis and biliary atresia. Biliary atresia is the most common reason for liver transplant among children.

Liver transplant may also treat certain cancers that originate in the liver (primary liver cancers).

Its liver transplant team is recognized nationally and internationally for its expertise in comprehensive specialty treatment for people with serious liver conditions.

Our doctors and surgeons offer specialized procedures available at only a small number of institutions. These services include heart-liver transplants, treatment for bile duct cancer, and treatment for obese patients who need liver transplant with weight-loss surgery (sleeve gastrectomy).

Risks

Complications of the procedure

Liver transplant surgery carries a risk of significant complications. There are risks associated with the procedure itself as well as with the drugs necessary to prevent rejection of the donor liver after the transplant.

Risks associated with the procedure include:

Bile duct complications, including bile duct leaks or shrinking of the bile ducts
Bleeding
Blood clots
Failure of donated liver
Infection
Rejection of donated liver
Mental confusion or seizures

Long-term complications may also include recurrence of liver disease in the transplanted liver.

Anti-rejection medication side effects

After a liver transplant, you'll take medications for the rest of your life to help prevent your body from rejecting the donated liver. These anti-rejection medications can cause a variety of side effects, including:

Bone thinning
Diabetes
Diarrhea
Headaches
High blood pressure
High cholesterol

Because anti-rejection drugs work by suppressing the immune system, they also increase your risk of infection. Your doctor may give you medications to help you fight infections.

How you prepare

Choosing a transplant center

If your doctor recommends a liver transplant, you may be referred to a transplant center. You're also free to select a transplant center on your own or choose a center from your insurance company's list of preferred providers.

When you're considering transplant centers, you may want to:

Learn about the number and type of transplants the center performs each year
Ask about the transplant center's liver transplant survival rates
Understand the costs that will be incurred before, during and after your transplant.
Consider additional services provided by the transplant center, such as coordinating support groups, assisting with travel arrangements, helping with local housing for your recovery period and offering referrals to other resources
Assess the center's commitment to keeping up with the latest transplant technology and techniques, which indicates that the program is growing

Evaluation

After you've selected a transplant center, you'll be evaluated to determine whether you meet the center's eligibility requirements for a liver transplant.

The goals of the evaluation process are to determine whether you:

Are healthy enough to have surgery and tolerate lifelong post-transplant medications
Have any medical conditions that would interfere with transplant success
Are willing and able to take medications as directed and follow the suggestions of the transplant team

Once you undergo specific tests and consultations, the transplant center's selection committee meets to discuss your situation. It determines whether a liver transplant is the best treatment for you and whether you're healthy enough to undergo a transplant.

What you can expect

Before the procedure

Living liver donors

Access to living-donor liver transplant is determined primarily by identification of a living donor who is healthy and able to safely undergo a major surgical procedure and is also the right size and blood type.

living liver donors should be family members (to the 4th degree) or friends of the liver transplant candidate (will need to go through the ethical committee). If you have a family member or friend who is willing to donate part of his or her liver to you, talk to your transplant team about this option.

Living-donor transplants have good results, just as transplants using livers from deceased donors. But finding a good living liver donor match is difficult due to restrictions on the donor's age, blood type, size and health. The surgery also carries significant risks for the donor.

Your transplant team can discuss the benefits and risks with you and the potential donor.

Staying healthy

Whether you're waiting for a donated liver or your transplant surgery is already scheduled, work to stay healthy. Being healthy and as active as you're able can make it more likely you'll be ready for the transplant surgery when the time comes. It may also help speed your recovery from surgery. Work to:

Take your medications as prescribed
Follow your diet and exercise guidelines
Keep all appointments with your health care team
Stay involved in healthy activities, including relaxing and spending time with family and friends

Stay in touch with your transplant team, and let them know of any significant changes in your health. If you're waiting for a donated liver, make sure the transplant team knows how to reach you at all times. Keep your packed hospital bag handy, and make arrangements for transportation to the transplant center in advance.

During the procedure

Living-donor liver transplant

If you're receiving a liver transplant from a living donor, surgeons will transplant a portion of the donor's liver in your body.

Surgeons first operate on the donor, removing the portion of the liver for transplant. Then surgeons remove your diseased liver and place the donated liver portion in your body. They then connect your blood vessels and bile ducts to the new liver.

The transplanted liver portion in your body and the portion left behind in the donor's body regenerate rapidly, reaching normal volume within a couple months.

After the procedure

After a liver transplant

After your liver transplant, you can expect to:

Possibly stay in the intensive care unit for a few days. Doctors and nurses will monitor your condition to watch for signs of complications. They'll also test your liver function frequently for signs that your new liver is working.
Spend 5 to 10 days in the hospital. Once you're stable, you're taken to a transplant recovery area to continue recuperating.
Have frequent checkups as you continue recovering at home. Your transplant team designs a checkup schedule for you. You may undergo blood tests a few times each week at first and then less often over time.

Expect six months or more recovery time before you'll feel fully healed after your liver transplant surgery. You may be able to resume normal activities or go back to work a few months after surgery. How long it takes you to recover may depend on how ill you were before your liver transplant.