Liver Transplant

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What is a liver transplant?

Liver transplant is the only treatment for chronic liver failure. It means replacing the sick liver with a healthy liver. Cirrhosis constitutes the most common liver transplant disease group in the world. This is followed by some congenital diseases and some liver tumors.

Liver transplant should be done in a fully equipped hospital by a team of experienced specialists. Liver transplant is not just a surgical procedure. For the preparation and post-transplant follow-up process; From the operating room to the laboratory, from imaging units to intensive care unit, from inpatient floors to other branches, it is very important that the department is of high quality and it collaborates.

In which diseases does it applied?

The condition of liver failure, where liver transplantation is applied, occurs in two ways, both acute and chronic.

Acute liver failure can develop within days and weeks. The most common cause is mushroom poisoning and the use of certain medications. Chronic liver failure develops often due to cirrhosis, hepatitis B and C, biliary tract diseases, some nutritional disorders, some genetic diseases, excessive alcohol use, a hereditary disorder that causes the body to absorb and store too much iron called hemochromatosis or metabolic diseases. In this case, the liver transplant can bring the person back to a healthy life.

How is it applied?

Organ transplant requires organs and the source of the organs is people. The organ suitable for transplantation can be obtained from people who have lost their lives or from relatives of the patient, or from living donors. When the relatives of people who have died (cerebral death) in intensive care conditions make an organ donation decision, the lives of many patients are saved with those organs. Liver transplantation with organs donated in this way is called "cadaveric liver transplant". Since the number of organ donations is not enough, most of the patients die while waiting for a new liver. As a solution to this, it is possible to save the life of the patient by taking a part of the liver from another person (may be a relative of the patient). This is called a living donor liver transplant. For this purpose, a relative of the patient's own blood group volunteers for such an operation. The person who is a candidate donor is subjected to intense examinations and evaluations. If there is no obstacle for being a liver donor; The liver part (right or left) suitable for the patient's weight is removed from the donor and replaced with the patient's liver.

The purpose of liver transplant is to bring the person back to normal, active, productive life. Both patients and donors are expected to return to their preoperative performances. Liver transplants in our center have reached the numbers above the accepted success rates in the world.

FREQUENTLY ASKED QUESTIONS ABOUT LIVER TRANSPLANT

Can any liver be transplanted to any person?

For liver transplant, the blood groups of the patient and donor must be suitable. Then, the candidate donor's examinations are started. This process consists of social, psychological and medical evaluations. Medical evaluation can be grouped as; blood and urine tests, investigation of infectious diseases, radiological examinations and taking opinions of other medical units (cardiology, thoracic diseases, etc.). Many factors such as the amount of liver needed by the patient, the general health of the donor candidate, whether the liver can be divided properly and the structure of the biliary tract play a role in the operation between the patient and the donor candidate.

Is liver transplant risky?

This risk varies with the severity of the disease that requires liver transplantation. These patients are usually in very severe condition with all kinds of reserves depleted. On the other hand, liver transplant is one of the largest known surgeries. "Severe patient + major surgery" is the most important factor that increases the risks. Also, while the liver is changing, the largest vessels of the body are cut and sutured, and serious undesired bleeding may occur. Sometimes the newly transplanted liver may not work well in the body where it is attached. In these immune-suppressed patients, infections can cause serious problems.

What does tissue rejection mean?

Our body's immune system recognizes its own cells and does not react to them. However, when someone else's cells (Blood, organ ...) enter the body, they immediately realize that these cells are foreign and armed against them and look for ways to remove this foreign substance from the body. The microbes that enter the body are treated similarly. This reaction of the body that damages the transplanted organ is called tissue rejection. Tissue rejection is a reaction that can be seen at any time in organ and tissue transplants and causes the transplanted tissue or organ to become useless (death) if it is not detected early and measures are not taken. In order to prevent tissue rejection, organ transplant patients use medicines to minimize this effect of the immune system for life. This is called immunosuppression (suppression of immunity). Despite these medicines, tissue rejection sometimes develops. It is possible to recognize this by impaired functions of the newly transplanted liver and determining the signs of tissue rejection in the liver biopsy. This type of exacerbation is usually treated without any problems and everything returns to normal.

Should liver transplant patients use medicine for life?

As with kidney transplant and all organ transplant patients, liver transplant patients use medicine to suppress the immune system for life. This is the main condition for the success of treatment. If medication is not used or irregularly used, the immune system immediately starts a war against this foreign body, and this situation may end with the loss of the organ or the loss of the patient's life.

Prepared by Memorial Medical Editorial Board.