A large majority of the patients, who require a liver transplantation, are patients with liver cirrhosis.
Presently, it is accepted that all patients with a liver cirrhosis in the last stage and with a life expectation of less than 1 year are candidates for a liver transplantation and these patients are recommended (or should be recommended) to undergo a liver transplantation. That’s because half of the patients in this situation loose their lives due to this disease or its complications.
The success rate of liver transplantations is above 80%, if performed timely.
Organ transplantation is the only treatment method for patients with a chronic organ insufficiency. Death is inevitable for these patients when no organ can be found.
The risk of the surgery will decrease and the life expectation will increase if the transplantation is performed before the general condition worsens, meaning before their general condition deteriorates and the costs will be higher for late transplantations. Therefore, appropriate timing and patient selection are very important.
This is a risky surgery due to the bad general condition of the patients and the complicated nature of the surgery. And this risk may further increase due to the severity of the disease that requires transplantation surgery. The patients are generally exhausted in all aspects and many are in very bad condition. Moreover, death is inevitable, if surgery is not performed. Thus, liver transplantation means a ray of hope for these patients.
Liver transplantation is performed between recipients and donors with the same blood type. Whilst liver transplantations even between persons without matching blood types can be performed in very severe cases in order to rescue the life, this can practically be taken into consideration due to the severity of the surgery.
The size of donor liver should not endanger life of the recipient and the donor, while liver can be obtained from the cadaver donor with declared death of brain.
On the contrary to the kidney transplant, the diseased liver is completely removed and replaced with a healthy liver. Liver transplantation is the largest-scale and bloodiest surgery in the field of general surgery. It lasts around 8-18 hours. It is performed by a quietly crowded team with members who are well educated and trained in this field.
When the donor liver is to be obtained from a living donor, the recipient and the donor are transferred to the operating rooms at the same time and while a piece of liver is obtained from the donor in one room, the diseased liver is removed in the other room. Next, donor liver is transplanted to the recipient.
The patients are postoperatively transferred to the intensive care unit. The donor is usually healthy enough to be discharged after the donor is maintained on treatment for a couple of days. And the recipient is transferred to the inpatient clinic, after vital signs are restored to physiological ranges at the intensive care unit.
All transplant patients are postoperatively prescribed immunosuppressive medications along with other medications. Patient is discharged to home after doses of those drugs are adjusted and patient is adapted to the new lifestyle.
As it is the case for all organ transplant patients, liver transplant patients also have to use immunosuppressive medications. This medication treatment ensures prevention of organ rejection and maintenance of functions and viability. The immune system will immediately initiate a fight against this foreign liver and this will result in the loss of the organ and probably the life when the medication is not used or used irregularly.
Liver transplant primarily intends making the patient gain normal, active and productive life beyond restoring the health status. Patients can safely get back to their families, work and school and travel and make holidays.
Reproductive, fertility and sexual problems are commonly faced by patients with terminal stage liver disease along with general health impairments. Following liver transplant surgery, sexual functions are restored, women start menstruating and conception is achieved.
Organ transplantations performed in our country meet international standards. The success rate of transplantation of important organs, such as liver and kidney, is above 80-90%.
However, a donor is definitely needed for all organ transplantations. Relatives of all patients in our country, where the family bounds are very strong, volunteer to donate organs. Unfortunately, not every donor’s organ can be transplanted to every recipient, and serious health problems are identified in donors, resulting in inability of donating organ, and organ donation fails in most cases.
Moreover, many organs, such as heart, lung and pancreas, cannot be obtained from living donors. The primary requisite of organ donation is that donation does not cost the health and life of the donor.
As the case all around the world, main source of organ supply should be cadavers with declared death of brain rather than voluntary donors. Organ donation figures are far below expectations in our country. While increased prevalence of chronic diseases boosts the need to organ transplantation, increase in number of cadaver donor is far from meeting this need.
In general terms, there is no age limitation for being a donor. The principle is based on health status of the donor and the organ and maintenance of a healthy life after organ donation.
While organs can be donated from living donors, families can also donate organs of family members after death of brain is declared.
Organ donations are accepted at all hospitals, where organ transplant surgeries are performed, and relevant institutions of the Ministry of Health.