Liver Transplantation in Turkey

Key Functions of the Liver

The liver performs crucial functions in the body, including:

1. Secretion of bile, which is partially responsible for the digestion and absorption of food, especially proteins and fats.

2. Facilitation of the absorption of vitamin K, a vital element for maintaining blood clotting mechanisms and preventing potentially fatal blood hemorrhages.

3. Production of "albumin," a fundamental protein naturally present in the blood.

4. Acting as a natural and efficient storage facility for various essential nutrients, such as iron, copper, as well as fat-soluble vitamins A, D, K, and E.

5. Breakdown of toxins and harmful substances in the body, expelling them as components of feces.

6. Secondary role in enhancing the functional efficiency of the immune system.

Despite the immense importance of the liver, it can be severely damaged due to specific health issues, including viral hepatitis, liver fibrosis, cirrhosis, portal hypertension, etc., leading to a decline in liver function and posing a threat to the patient's life. Liver transplantation emerges as the sole therapeutic means to save the patient's life in such critical conditions

What is Liver Transplantation in Turkey

Liver transplantation is a surgical procedure performed on individuals suffering from an advanced and critical condition of functional liver failure. In this procedure, the damaged liver is replaced with a healthy liver lobe obtained from a donor. After the transplantation of the healthy liver lobe, it gradually grows to its natural size within a period not exceeding 2-3 months. At this stage, the liver functions return to acceptable, normal levels.

Indications for Liver Transplantation in Turkey

Liver transplantation is sought as the ultimate and sole treatment for individuals experiencing an advanced stage of functional liver failure. In cases of such advanced liver failure, liver transplantation is considered a life-saving procedure.

Moreover, in a related context, the treating physician may recommend liver transplantation in cases of acute liver failure or in the early stages of liver cancer. The removal of the cancer-afflicted liver and its replacement with a healthy one is an effective option to limit the spread of the cancerous tumor. However, before proceeding, diagnostic tests and tumor markers must be conducted to ensure that the tumor's spread is confined solely to the liver tissues.

Critical Requirements for the Donor:

First and foremost, blood type must be compatible, along with tissue compatibility between the patient and the donor. The higher the compatibility ratio, the greater the chances of success in the liver transplantation process.

The donor's age should range between 18-60 years. The donor must be a mentally competent individual with full awareness and understanding, qualifying them to sign an informed consent document. This document includes the donor's voluntary agreement, with full freedom, to undergo the removal of a liver lobe for donation to the patient. Additionally, the document should feature a clear confirmation from the donor, indicating their understanding of all surgical steps and details related to the recovery phase post-surgery.

The donor's weight should be within the normal range, as obesity is a hindrance to liver donation. Obesity may lead to fatty liver disease or liver cirrhosis, increasing the likelihood of liver fibrosis later on.

The donor should be in good overall health and free from chronic conditions such as hypertension, kidney failure, or diabetes. Additionally, it should be ensured that the donor is not infected with viral hepatitis (B).

As much as possible, it is advisable for the donor not to be a smoker, ensuring the availability of a liver with excellent functional capacity.

Preparation for Liver Transplantation in Turkey

To enhance the chances of success in liver transplantation in Turkey, it is essential to follow the following advice and instructions:

1. One of the most important preparations necessary for liver transplantation in Turkey is to undergo laboratory tests and clinical examinations. These tests are primarily aimed at accurately assessing the patient's overall condition and include a complete blood count, blood glucose level examination, kidney and liver function tests, coagulation and clotting tests, electrocardiogram, abdominal and pelvic ultrasound, and computed tomography imaging. Regular blood pressure measurements are also essential.

2. If the patient is taking blood thinners (such as aspirin or heparin), it is necessary to completely stop such medications for 2-3 weeks before undergoing liver transplantation to avoid the risk of excessive bleeding.

3. To enhance the success of liver transplantation in Turkey, it is crucial to abstain from both passive and active smoking for a full month before the surgical procedure.

Liver Transplantation Procedure in Turkey

Liver transplantation in Turkey follows the steps outlined below:

1. The patient is initially placed under general anesthesia.

2. The anatomical position of the liver (upper right portion of the abdomen) is identified, followed by a surgical incision through the abdominal layers in this location to access the damaged liver.

3. At this stage, the blood vessels connected to the liver and the bile ducts associated with the liver are suspended and tied off.

4. The damaged liver is excised, and the healthy lobe obtained from the donor is positioned in place.

5. The blood vessels and bile ducts are connected to the healthy liver lobe. Subsequently, the ties are gradually removed, ensuring there is no bleeding.

6. After confirming the stability of the healthy lobe in its natural anatomical position and ensuring the absence of any bleeding or other medical complications, the abdominal layers are closed using sterilized surgical threads.

7. Once the final closure of the outer skin layer is completed, a sterile surgical dressing is applied to the incision site.

8. The patient is then transferred to the intensive care unit for several days, with careful monitoring of their condition and vital signs (blood pressure, heart rate, temperature, respiratory rate, urine output).

Recovery Stage

During this recovery stage, it is crucial to adhere to the doctor's instructions and the prescribed medication, especially immunosuppressive drugs, which will need to be continued permanently to prevent the immune system from rejecting the newly transplanted liver.

To minimize the risk of liver transplant failure, it is essential to adopt a healthy lifestyle. This includes paying attention to proper nutrition, ensuring an adequate amount of nightly sleep, avoiding smoking, and steering clear of fatty foods.

What are the risks of liver transplantation in Turkey

Risks of Liver Transplantation in Turkey 

One of the most crucial and dangerous complications in this regard is the body's immune system rejecting the newly transplanted liver. The immune system becomes activated, leading to an immune response against the liver as a foreign entity that should be expelled from the body. To prevent this, it is essential to adhere to the treating physician's instructions and ensure lifelong intake of immunosuppressive drugs.

Additionally, liver transplantation may involve complications commonly seen in any surgical procedure, including:

1. Anesthesia-related issues, such as anesthesia allergies, acute respiratory failure, etc.
2. Blood clotting and the formation of blood clots.
3. Localized infection at the surgical site.
4. Hemorrhage.

These complications can be overcome by following the physician's instructions and selecting a medical facility that provides outstanding medical and nursing care.

On the other hand, some long-term side effects may arise from the use of immunosuppressive drugs and corticosteroids. The most significant of these side effects include:

1. Increased susceptibility to infections due to weakened immunity caused by immunosuppressive drugs.
2. Localized obesity, hirsutism, along with an increased risk of diabetes and osteoporosis due to long-term corticosteroid use.

In this regard, it is advisable to have regular and continuous follow-ups with the treating physician and promptly seek specialized medical advice if any unusual symptoms of illness appear.

Cost of Liver Transplantation in Turkey 

Turkey stands out as a distinguished destination for surgical procedures in general, particularly for liver transplantation. Despite this, the cost of liver transplantation in Turkey is significantly lower compared to European Union countries and the United States, without compromising the quality of medical services provided.

In general, the process of liver transplantation in Turkey varies slightly from one location to another, depending on a range of factors and variables. These include the size of the medical facility and its equipment, as well as the experience of the medical team responsible for these procedures.

Advantages of Liver Transplantation in Turkey 

Turkey is the preferred destination for foreign patients seeking liver transplantation, owing to the following reasons:

1. Top-tier Doctors and Surgeons: Turkey boasts the best liver transplant specialists and surgeons who possess the highest level of skill and expertise. Through years of extensive education and long hours of work, they have successfully conducted numerous liver transplant surgeries, showcasing unparalleled proficiency.

2. State-of-the-Art Hospitals: Turkey is home to several hospitals equipped with the latest technologies in devices and medical facilities specifically designed for liver transplantation procedures.

3. World-Class Medical Care: The best possible medical care is offered in Turkey at highly reasonable prices, which are significantly lower compared to other countries. This ensures access to excellent healthcare services with affordability.

4. Advanced Diagnostic and Treatment Methods: Diagnostic and treatment methods in Turkey are at the forefront of medical advancements, reflecting the latest achievements in medical science.

5. No Waiting Lists and Simplified Procedures: There are no waiting lists, and the procedures necessary for liver transplantation are streamlined, eliminating unnecessary complications.

6. Highest Success Rates: The success rates of liver transplantation in Turkey are the highest compared to any other country, making it a standout choice for those seeking this medical procedure.