What is Liver Transplant?

The vast majority of patients who require liver transplantation are patients with liver cirrhosis. Today, it is accepted that all patients with end-stage liver cirrhosis with a life expectancy of less than one year are candidates for liver transplantation and transplantation is recommended (or should be recommended) for these patients. Because half of the patients with this condition die within a year due to this disease or its complications.

Timely liver transplants have a success rate of over 80%. Organ transplantation is the only treatment for patients who have chronic organ failure. When organs are not found, death is inevitable for these patients.

In an early transplantation the patient’s  life span becomes longer, and in late transplantation, the cost increases. Therefore, appropriate timing and appropriate patient selection are very important.

Liver transplantation is performed between donors and recipients of the same blood groups. Although liver transplantation can be performed even among people whose blood types do not match in order to save lives in very urgent conditions, in practice it can only be considered as a last resort due to the size of the surgery.

Liver transplantation can be performed with a piece of liver taken from a relative and large enough for the recipient to live, but not endanger the life of the donor.

Unlike kidney transplantation, in the surgery, the diseased liver is completely removed and replaced with a healthy liver. Liver transplantation is the largest and bloodiest operation in general surgery. Its duration is around 8-18 hours. It is performed by a very crowded and well-trained team.

If the liver to be transplanted is to be taken from a living donor, the recipients and donors are taken to separate operating rooms at the same time. While a piece of healthy liver is taken from the healthy liver in one room, the diseased liver is removed in the other room, and then the liver piece from the donor is transferred into the recipient patient.

After the operation, the patients are taken to the intensive care unit. The donor recovers well to be discharged after a few days of treatment. The transplanted patient, on the other hand, is taken to the ward after he regains his vital functions in the intensive care unit, where his treatment continues.

In addition to general drug treatments, immunosuppressive drugs are given to all post-operative transplant patients. After adjusting the doses of these drugs and ensuring the adaptation of the patient to the new lifestyle, the patient is discharged.

Like all organ transplant patients, liver transplant patients also use drugs that suppress the immune system for life. Preventing the organ from being expelled by the body's defense mechanism and maintaining its function and vitality depends entirely on this drug treatment. If the drug is not used or used irregularly, the immune system immediately starts a war against this foreign liver and this results in the loss of the organ and perhaps life.

The main purpose of liver transplantation is to return the person to a normal, active and productive life, beyond rehabilitating them. People can return to their families, jobs, schools, travel safely, and take a vacation. After liver transplantation, sexual functions return, women begin to menstruate again, pregnancy and childbirth are possible.

When is the Liver Transplantation required?

Some hereditary anomalies, excessive alcohol and drug use, viruses that cause cancer or hepatitis can initiate irreversible damage to the liver. In this case, the liver hardens and shrinks, large and small swellings occur on it and cirrhosis develops. Cirrhosis of the liver; It is a condition that can lead to fatal results such as bleeding, jaundice, accumulation of fluid in the abdomen (ascites), infection and accumulation of toxic wastes in the body and coma. Ultimately, the only option is a liver transplant.

What kind of harmony is needed between the reciever and the donor?

Blood group compatibility is required. 0 Rh (-) universal donor, AB Rh(+) universal receiver. For example, A Rh (+) for an A Rh (+) recipient, 0 Rh (+), 0 Rh (-) blood groups for an A Rh (-) recipient can be a donor.

What is the risk of surgery for the donor?

The accepted risk in the world is around 1%.

When can donors return to their normal lives?

At cases without a problem Donors are discharged around 10 days and return to their active lives in 1 month. They cannot do sports for 3 months.

What kind of health problems may the donors encounter in the long term?

They do not experience any health problems, and very rarely, permanent sequelae may occur as a result of complications such as jaundice and vascular occlusions that feed the liver due to complications during the surgery. However, this probability is less than 1%.

How much of the liver is taken to transplant to the recipient?

For adult recipients, the right lobe is taken. This part of the liver is about 60%. In some adults, the left lobe can be removed (40%). For Child Recipients, a piece called the left lateral segment is taken (20%).

Will the liver remaining in the donor regenerate itself?

Yes, it reaches its full size in 6 weeks in unproblematic cases.

Does the transplanted liver regenerate itself?

The transplanted liver reaches the required size in 6-8 weeks, as in the donor. In normal humans, the liver is about 2% of body weight. For example, A person who weighs 75 kg has 1500 gram liver.

How long is the medication used after Liver Transplantation?

According to current information, it is necessary to use drugs for 10 years.

How often is follow-up done after the Liver Transplantation?

Control and blood tests should be done twice in the first two weeks, once a week for 3 months, once every two weeks until the end of the first year, and then once a month.