Liver Transplantation: Procedure, Conditions, and Outcomes
What is Liver Transplantation? It is a surgical procedure that involves obtaining a portion of the liver from a healthy person (the donor) and transplanting it into a patient suffering from severe liver failure. Notably, the donor's remaining liver gradually regrows to its original size within about two months. Similarly, the transplanted segment in the recipient grows progressively, allowing the patient to regain functional efficiency over several months.
Indications for Liver Transplantation: In Turkey, liver transplantation is considered the only treatment option for severe liver damage and is a life-saving procedure. Generally, it is recommended in the following cases:
Liver failure to a degree that impacts the patient’s life.
Acute liver failure.
Liver tumors.
Liver inflammation (Hepatitis).
Viral infections.
Donor Requirements:
Mental Competence: The donor must be of sound mind to understand the surgery and post-operative details.
Age: Must be between 18 and 55 years old.
Kinship: A biological relationship is required (exclusively from the patient's family).
Compatibility: Tissue matching is essential; kinship enhances the chances of compatibility.
Health Status: Must be free of chronic diseases (heart disease, diabetes, kidney failure).
Hepatitis B: The donor must not be infected with Hepatitis B.
Weight: Must be within healthy BMI ranges.
Smoking: Preferably a non-smoker to ensure optimal liver function.
Degree of Kinship: The donor must be at least a fourth-degree relative for procedures in Turkey.
Surgical Steps and Procedures:
Preparation: Comprehensive tests including CBC, liver/kidney functions, blood sugar, coagulation tests, ECG, CT scans, and ultrasounds. Evaluations by cardiology, pulmonary, neurology, and anesthesia specialists are mandatory.
Anesthesia: The patient is placed under general anesthesia.
The Surgery: Lasts 5–7 hours. A surgical incision is made, the damaged liver is removed, and the donor segment is implanted.
Connection: Hepatic vessels, arteries, and bile ducts are connected to the new liver.
Recovery: The patient is moved to the ICU. Long-term commitment to immunosuppressant medications is vital to prevent organ rejection.
Potential Complications:
General: Bleeding, blood clots, narrowing of arteries or bile ducts, and wound infections.
Rejection: The immune system may attack the new liver. This is managed by lifelong adherence to immunosuppressants.
Side Effects of Medication: Increased infection risk, osteoporosis, diabetes, weight gain, hypertension, and hair loss or hirsutism.
Survival and Life Expectancy:
1-Year Survival: 85–95%.
5-Year Survival: 75–85%.
10-Year Survival: 50–75%.