A liver transplant is a life-saving option for liver failure. Acibadem Liver Transplant Center is a reference center for complex cases in Turkiye and abroad.
Liver transplantation is the only permanent cure for patients with end-stage liver disease. A healthy liver is responsible for critical functions, including metabolism, detoxification, immune function, coagulation. A person cannot live without a liver, and its functions cannot be replaced by a machine. Therefore, patients with chronic liver failure and some acute liver diseases need transplantation of a healthy organ. During liver transplant surgery, the diseased liver is removed from the body and replaced with a healthy organ from a donor. The operation involves reconnection of blood vessels and bile duct to allow the new organ to work properly. The method used at Acibadem is Orthotopic Liver Transplant, regarded as the ‘gold standard’ worldwide.
Liver transplantation is one of the most complicated interventions in surgery. It requires high-end expertise throughout the process. Competent patient evaluation, surgery, intensive care, and follow-up after the operation are equally important for successful outcomes.
All over the world, the number of people awaiting a liver transplant exceeds the number of donated organs from deceased donors. Therefore, these patients are included in waiting lists on a national or regional level. Every state determines strict selection criteria for matching and allocation of the available organs. Most countries allow only their citizens to register on the waiting lists. The waiting time may vary between the countries. However, most patients wait for years, and some of them might never receive a liver from a deceased donor. In Turkiye, only Turkish citizens can be registered on the waiting lists. International patients can apply for living donor transplants if they have a donor willing to donate.
The liver is the only organ that can regenerate itself. It can continue functioning even if 70% of its tissue is removed. That makes the living-donor liver transplant possible. It can be an alternative to the long waiting lists for some patients. After the surgery, the two parts of the liver in the donor and the recipient will grow back and provide a normal liver function for both of them.
The main advantage of the living-donor liver transplant is the short waiting time. The recipients don’t need to wait for a suitable deceased donor while their health deteriorates even further. Besides, the donor can be examined in detail and prepared for the surgery. Living donation provides better outcomes since the donor and the time of surgery are carefully selected.
A living-donor liver transplant is a complex and technically demanding surgery, posing risks for the donor and the recipient. Thereby, extensive preoperative evaluation and the experience of the medical team are crucial for the outcomes.
Liver transplants in children are quite different than in adults. The difference comes, first, from the reasons why a transplant is required. In adults, liver failure is often caused by hepatitis, alcoholic steatohepatitis, or fatty liver disease. Children usually need a liver transplant due to congenital anomalies, and biliary atresia is the most common cause. Besides, narrow vessels, narrow bile ducts, and narrow space for the liver present an additional challenge for the surgeons.
At Acibadem, liver transplants for pediatric patients and infants are performed routinely, with excellent outcomes. Some of our patients are complex cases rejected as ‘not suitable for liver transplantation’ by other centers. Combined liver-kidney transplants are carried out successfully for children with metabolic diseases.
To be considered for a living donor transplant, both the donor and the recipient should meet certain criteria. At Acibadem Liver Transplant Center, the selection criteria for the donor include age 18-55, good overall health, normal liver function, and a matching blood type. The donor should be a close relative or approved by the Ethics Committee, who agrees to donate gratuitously. Possible recipients are patients with irreversible end-stage liver disease whose general health allows them to undergo the operation. Both donor and recipient will go through an extensive evaluation process. It might include various consultations and blood tests, radiologic imaging tests, liver biopsy, imaging tests for bile ducts, genetic tests, etc.
For international patients coming to Acibadem, the liver transplant process usually starts with detailed information about organ transplantation, the legal requirements in Turkiye, medical expectations for the procedure, its effects on quality of life, the post-transplant process, and possible complications. The patients are invited to provide their medical documents, surgical reports, and test results. The process continues with detailed examinations and tests for the donor and the recipient to assess their eligibility. If all medical and non-medical requirements are met, the surgery is scheduled within a short term.
It is performed simultaneously for the two patients, and a portion of the donor’s liver is transplanted into the recipient. After the operation, both patients have to stay at the Intensive Care Unit for one day. If everything runs smooth, the donors are usually discharged 4 or 5 days after the surgery. The standard hospitalization period for the recipients is 12 to 15 days, but it may vary according to their condition. Transplanted patients usually have to stay in Turkiye 2 to 4 weeks after discharge for control examinations.
Success rates of liver transplants are constantly improving. Developments in surgical techniques, organ preservation, and immunosuppression contribute to better outcomes. However, success rates depend strongly on the indication for liver transplantation and the experience of the medical teams. At Acibadem Liver Transplant Center, the 1-year survival rate is 92%, and the 5-year survival is 89%. These numbers include complex cases, pediatric liver transplants, and combined transplant surgeries, including in children below one year.
After a liver transplant, both the living donor and the recipient should follow some rules. They can resume their normal lives after a recovery period, according to their doctors’ advice. The living donor’s liver usually recovers in 3 months. The transplanted patients, on the other hand, must be monitored closely during the first year. They should follow strictly the prescribed regimen for taking their immunosuppressive medications to avoid rejection of the new liver. The recipients should also be careful about their diets and do exercises regularly.
At Acibadem Liver Transplant Center, we have some of the best transplant physicians in Turkiye and worldwide. Our patients can benefit from: