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  • Writer's pictureProf. Dr. Deniz Balcı

Liver Transplantation

The liver is an organ located in the upper right side of the body, with numerous functions including metabolism, synthesis, breakdown, storage, and blood purification. Liver diseases are common in society, and liver transplantation for end-stage liver failure is the second most common type of transplant after kidney transplantation.

In 2013, approximately 1250 liver transplants were performed in our country. About 1000 of these were from living donors, and about 250 were from deceased donors.

As of last year, our country has become one of the countries with the highest number of liver transplants from living donors.

Liver transplantation is the permanent and most important treatment for complaints and symptoms resulting from irreversible structural damage to the liver, known as cirrhosis.

In adults in our country, the most common causes are hepatitis B and C virus infections, liver cancer, alcoholic liver cirrhosis, and liver cirrhosis developing on a fatty liver background, while congenital metabolic and structural diseases are rarer. In pediatric patients, the most common cause is inadequate development of the bile ducts and a disorder characterized by jaundice called biliary atresia.

Liver transplantation is not performed on individuals with widespread and uncontrolled infections, widespread extrahepatic cancer disease, severe heart and lung failure, active HIV infection, and those who still actively use alcohol.

In this surgery, while the patient's liver is removed from the body, a healthy new liver is transplanted in its place. Liver transplantation can be performed from two sources: deceased donors and living donors.

Deceased donor liver transplantation is the removal of the liver from a deceased donor whose brain has died, and the transplantation of the liver to the patient's liver.

All patients requiring liver transplantation are registered on waiting lists at authorized centers in our country, and these lists are kept in a database at the Ministry of Health.

When brain death is determined anywhere in the country and the organs are donated, this is reported to the national coordination team affiliated with the Ministry of Health, and the organs are distributed sequentially among the centers, primarily in the region where they are located.

In our country, the rate of deceased donor liver transplantation is about 5 per million population. This rate is around 20 in Europe and 25 in the USA. Due to insufficient organ donation in our country, hundreds of liver patients lose their lives every year while waiting for organs.

Living donor liver transplantation refers to the transplantation of a part of the liver taken from a healthy individual to replace the patient's liver.

The main issue here is to minimize the risk associated with the donor and to transplant an adequate amount of liver for the recipient, as the donor is a completely healthy individual and a voluntary donor.

To be a liver donor, one must be between the ages of 18-60, have mental and physical health, and not have a chronic illness that would be a hindrance to transplantation. In addition, for non-relatives, approval is possible through an ethics committee, consisting of doctors, lawyers, and coordinators established within the Ministry of Health.

Liver transplantation is a long, difficult, and risky surgery. It is a complex procedure that requires the teamwork of many experts from different disciplines for the preparation of patients before surgery, the performance of surgery, and the follow-up of patients after surgery. Experience is vital in this process.

Liver transplantation from both deceased and living donors is successfully performed for both adult and pediatric patients at Ankara University Organ Transplantation Unit.


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