It has been more than a hundred years since the first experiments in organ transplantation. In early studies, transplantation experiments were performed only on animals. The first organ transplantation procedure on humans was performed approximately fifty years ago. Thanks to the great achievements in medicine and healthcare, organ transplantation has finally reached a level that saves human life. As a reference center for many complex treatments, ACIBADEM Healthcare Group has achieved many firsts in Turkey, which include firsts in organ and tissue transplantation as well. Among the firsts of ACIBADEM there are; the first kidney transplantation performed on the baby with the lowest weight, the first donor nephrectomy of an 84-year-old donor, the first single-port donor nephrectomy, the first donor nephrectomy through the vagina with the NOTES method, the first kidney transplant from an 85-year-old donor with brain death and the first transplant of a liver piece from the mother donor to her 8-year-old child are a few examples of such achievements. Promising advances take place in organ transplantation every single day. Recipients and donors, as well as scientists and physicians keep striving for healthier and longer lives. The dysfunctionality of an organ/tissue may lead a slow or sometimes a fast deterioration of the entire body. Although, there are many treatment options for patients with organ failure, transplantation is accepted as the best alternative in terms of the therapeutic benefits, quality of life and cost effectiveness. Organ/tissue transplantation is the transfer of an organ/tissue from one body or from a donor site to the patient’s own body. The reason of organ/tissue transplant is to replace a damaged or absent organ/tissue. Kidney failure, liver failure, lung or heart diseases, Type I diabetes and some cancer types such as leukemia are conditions that might be treated with organ/tissue transplantation. Organ/tissue transplantation may be either within the same person’s body, which is called an autograft, or from another body, which is called allograft. There are two types of organ/tissue transplantation regarding donor types: from living donors and from deceased donors (patients in intensive care units with brain death). Since people are born with two kidneys, and one kidney is sufficient to continue our lives and the liver is a regenerative organ, kidneys and liver may be transplanted from a living donor.
ACIBADEM Organ Transplant Centers are the focus of attention with its team of experienced specialists, state-of-the-art technology and the successful liver transplants.
The liver is regarded as the most complicated and metabolically active organ in our body. However, the liver can also continue functioning even when 70% of its tissue has to be removed. When a liver donor donates more than half of his/her liver for transplantation, the remaining part can resume its function without any loss or serious complication. We owe this ability to the liver’s capacity for regeneration, because the liver is the only organ that can regenerate itself after the removal of more than half of its tissue.
Even when inflammations related to alcohol consumption or fatty liver disease, hepatitis infections, long-term congestions or stones of the bile ducts, certain metabolic diseases, tumors, or congenital enzyme deficiencies are present, patients can continue a normal life for a long time as long as the progress of the disease is slow. But once the liver insufficiency becomes manifest, it may lead to itching, edema in the lungs and ascites in the abdomen, severe hepatitis, bleeding and anemia. In advanced liver disease, changes in personality and behavior may be observed. Weight loss, reduced amount of urine, and fatigue may progress to a coma. These symptoms point out that the patient’s liver cannot fulfill the body’s needs. This condition, called “liver failure”, leaves a liver transplant as the only option for the patient.
In ACIBADEM Organ Transplant Centres, liver transplantation is performed both from live donors and cadavers. The method applied during these operations is orthotopic liver transplant, a method regarded as the “gold standard” around the world. Through this modern technique, the large vein located behind the liver is preserved using surgical clips before the transplant is performed. For the success of this operation, a surgical team and equipment with a high technical capacity are required. Like every transplant, liver transplants should also be carried out in hospitals and operating rooms equipped with the highest technology. When the transplant is made from a live donor, half of the liver is transplanted to the organ receiver. Thus, the surgical process is technically very demanding. Following the transplant, while live donors can be discharged within 6-7 days, organ receivers have to stay at the hospital for 15-20 days. The transplanted liver then regenerates itself and grows rapidly to a size large enough to meet the needs of the receiver.
The ACIBADEM Organ Transplant Centers give service with their technical infrastructure matching international standards. Organ receivers and donors are treated in operating rooms and intensive care units under completely sterile conditions with laminar flow and state-of-the-art technological equipment. The laboratory procedures are carried out at ACIBADEM Labmed, a laboratory of international standards which is also a member of the ACIBADEM Healthcare group.
The Organ Transplant Centers possess all the necessary technology for liver transplantation. Director of this liver transplant center is Prof. Dr. Remzi Emiroğlu, who has broken new ground in kidney and liver transplants in Turkey. Since 1998, Prof. Emiroğlu has performed approximately 700 liver and kidney transplants. Prof. Emiroğlu and his team are experienced both in auxillary (i.e. without removing the whole liver), and in standard orthotopic liver transplants. The team also has experience in every kind of shunt surgery and Sugiura procedures in patients with bleeding due to liver cirrhosis. Prof. Emiroğlu, who has performed the first transplants to adult and paediatric patients from live donors and cadavers has approximately 100 scientific articles on organ transplantation, 85 of which have been published abroad.
The ACIBADEM Healthcare Group opened its first Organ Transplant Center in October of 2010. Today, it serves with 3 centers located at the International Hospital in Istanbul, then ACIBADEM Bursa Hospital and ACIBADEM University Hospital. The Organ Transplant Centers host teams trained at world-renown institutions with experience of over 2000 kidney, 250 liver and 60 pancreas transplants over the course of their careers. The centers are supported by the best clinical laboratory and intensive care unit of the country and performs kidney and liver transplantation.
The operating rooms and the intensive care units of the Organ Transplant Centers are equipped with the latest technology infrastructure. The full laparoscopic technique diminishes the need for intensive care for the donor. However, for liver and some kidney recipients full-fledged intensive care units are of critical importance. The donor protection program (follow-up and care of the donor after the transplantation) is one of the unique services offered by the International Hospital Transplant Center. The Organ Transplant Centers are fully dedicated to highest of moral and ethical standards in organ donation and transplantation. It adheres to the principles of The Declaration of Istanbul on Organ Trafficking and Transplantation Tourism by the Transplantation Society and the International Society of Nephrology, as well as the Consensus Statement of the Amsterdam Forum adopted by The Transplantation Society on the care of the living kidney donors. The Center also meets the standards of the Turkish Organ and Tissue Transplant Coordination System.
Operation theatres, laboratories and intensive care units are the most important of areas in organ transplantation. The advanced technology and internationally recognized high quality standards made available enable organ transplantation patients and donors to receive utmost medical services and care in the laboratories, intensive care units and operation theatres of ACIBADEM. Specialists with international experience perform operations using high-tech methods. Such an example is the removal of kidney with a mere 5-cm incision in the groin, performed entirely by laparoscopic surgery. The advanced medical methods practiced enable donors to be discharged within 24-hours after surgery and to be able to start work within a week’s time. Recipient can be discharged from the hospital within approximately one week. First in ACIBADEM : – The first single port (from navel) donor nephrectomy of Turkey in 2011. – The first donor nephrectomy with NOTES method (from vagina) of Turkey in 2011. – The first single port + NOTES donor nephrectomy (from vagina) of Turkey in 2013.
Full laparoscopic techniques used for surgery enable a minimum length of stay for donors. These techniques are used only at centers with highly experienced and expert staff and they offer many advantages over open surgeries: For example, while open surgeries involve 15-20 cm incisions, laparoscopy enables incisions only 5-cm in length. The operation is made possible by a camera inserted into the abdomen and enabling high visual control. A smaller operation area implies less post-operation pain and surgical wounds carrying less risk. The absence of large surgical scars diminishes cosmetic concerns and lowers risk of herniation, numbness, surgical site infections, and pulmonary embolisms. With the laparoscopic technique, donors are enabled to be mobilized and to start fluid intake the evening of the surgery, to start solid food intake and get discharged the following day, and to start work the next week. The recipient is discharged within approximately a week.