About the Department
Organs that can be transplanted in today’s medicine are: heart, lungs, heart and lungs together, liver, kidneys, pancreas and intestines. Liver, heart and kidney transplants are successfully performed in Turkey; and lately pancreas transplants are also being performed.
In addition to patient-physician-hospital components, organ donor is an inevitable component in organ transplantation. Due to a continuous shortage of donor livers and the high incidence of liver disease, the waiting time is increasing every year. Hundreds of people die each year while waiting for a liver to be offered.
Memorial Hospital Organ Transplantation Unit is the first private healthcare institution approved and licensed by the Health Department for organ (liver and kidney) transplantation and related laboratory services.
Liver and kidney transplantations are being successfully performed at Memorial Hospital Organ Transplantation Unit.
The most common reason for liver transplant in adults is, cirrhosis. Cirrhosis is a disease which healthy liver cells are damaged (mostly caused by hepatitis B). Other conditions that cause cirrhosis are: some congenital diseases, and some metabolic diseases.
If, because of a liver failure, someone can not keep on his/her daily life and activities; then it is time for a liver transplant.
There are different sources of donor livers. Usually the liver is obtained from a cadaveric donor (a person diagnosed as "brain dead" but whose other organs and systems are functioning properly). Due to a continuous shortage of donor livers and the high incidence of liver disease, the waiting time is increasing every year. Hundreds of people die each year while waiting for a cadaveric liver to be offered. Donor livers also can be obtained from a family member or a friend who donates a portion of his/her liver to the patient.
Both blood type and liver size compatibility are essential in liver transplant. If there is a family member or a friend willing to donate a part of his/her liver it is possible to save the patient’s life by removing a piece of liver a living donor and transplanting it into a recipient.
A living donor doesn't have to be a blood relative of the liver recipient, but the blood type must be compatible. The donor must be in good health and be motivated to donate for altruistic reasons. If living donor is a feasible option for a patient, a donor evaluation will be performed after the recipient's testing is completed. After testing the donor, the transplant team decides whether the donation can be performed or not. Living donors are usually the only chance for children. Ideally, liver transplant should be between people whose blood types are matching. However, in emergency cases it could also be performed between non matching blood types, to save the patient’s life. But liver size matching is a must.
Frequently Asked Questions
What is liver transplant?
It is a surgery to remove a diseased liver and replace it with a healthy one.
When is a liver transplant indicated?
Liver transplant is indicated for many types of liver diseases like cirrhosis, some congenital diseases and liver tumors.
Where the livers for transplants come from?
Whole livers come from people who have just died (a person diagnosed as "brain dead" but whose other organs and systems are functioning properly). This type of donor is called a cadaveric donor. In order to take the liver from the dead body; this person should have donated his/her organs or his/her relatives should agree on donating the organ after the person dies. Organs can not be sold, it is illegal.
Is it possible to perform a liver transplant from a living donor?
Yes it is. If there is a family member or a friend willing to donate a part of his/her liver it is possible to save the patient’s life by removing a piece of liver a living donor and transplanting it into a recipient. A living donor doesn't have to be a blood relative of the liver recipient, but the blood type must be compatible. The donor must be in good health and be motivated to donate for altruistic reasons. If live donation is a feasible option for a patient, a donor evaluation will be performed after the recipient's testing is completed. After testing the donor, the transplant team decides whether the donation can be performed or not. Living donors are usually the only chance for children. Ideally, liver transplant should be between people whose blood types are matching. However, in emergency cases it could also be performed between non matching blood types, to save the patient’s life. But liver size matching is a must.
Can any liver be donated to anyone?
No it can not. There are certain qualifications in order to safely perform a liver transplant. The donor must be:
- Approximately the same weight and body size as the recipient
- Free from disease, infection, or injury that affects the liver
- Usually of the same or a compatible blood type
In very urgent cases, liver transplant could be performed between non compatible blood types to save the patient’s life.
Is liver transplant risky?
Yes. A liver transplant is like the any other operation, has its own risks that common to all forms of major surgery. Situations like; bleeding, poor function of grafted liver and infections are major risks when occurs just after the surgery. Sometimes the new liver does not function as it should, and when that happens, infections could be a major problem in those patients.
What is rejection?
Transplant rejection occurs when a transplant recipient's immune system attacks a transplanted organ or tissue. Human body's immune system protects itself from potentially harmful substances, such as microorganisms, toxins, and cancer cells. These harmful substances have proteins called antigens on their surfaces. If the immune system identifies antigens that are foreign, it will attack them.
In the same way, foreign blood or tissue can trigger a blood transfusion reaction or transplant rejection. To help prevent this, tissue is "typed" before the transplant procedure to identify the antigens it contains.
Though tissue typing ensures that the organ or tissue is as similar as possible to the tissues of the recipient, the match is usually not perfect. No two people (except identical twins) have identical tissue antigens.
Immunosuppressive drugs are needed to prevent organ rejection otherwise, organ and tissue transplantation would cause an immune response and result in destruction of the foreign tissue.
The goal of treatment is to make sure the transplanted organ or tissue functions properly, while at the same time suppressing the recipient's immune response. Suppressing the immune response can treat and prevent transplant rejection.
Is medication a lifelong affair after liver transplant?
Yes, the patient will have to take anti rejection medication for the life. Taking medication regularly is essential for a transplant to be successful. If the medicines are not taken, the patient’s immune system will immediately recognize this foreign organ and will fight against it. This may cause organ failure or death.
What is the success rate of liver transplant?
The average success rate of a liver transplant is 93.8 % in Memorial
Can the patient goes back to his/her normal life after liver transplant?
Yes. After a successful liver transplant, most people can go back to their normal daily activities. It is in fact the purpose of the procedure. Pregnancy and child birth are also possible after liver transplant. Most people can engage in physical activity and exercise in a year.
Kidney transplant is the best treatment for patients suffering of chronic kidney failure at the terminal stage.
Patients who lost at least 80% of their kidney functions need hemodialysis or periton dialysis to survive. Dialysis provides life support for many patients however it might cause many other problems. The damage it causes on the circulation system might have a negative effect on the patient’s social life. Therefore kidney transplant is the best solution. Kidney transplant improves the quality of life of the patient by ensuring the kidney is going to function properly, however kidney transplant could not be performed on every patient with kidney failure. Several examinations and tests are performed to decide whether the patient is a candidate for kidney transplant or not.
There are two types of donors:
- Living donor ( from a family member)
- Cadaveric donor (a person diagnosed as brain dead but whose other organs and systems are functioning properly.
It is best to divide donor and recipient matching into 3 distinct areas: blood type matching, tissue type matching, and cross-matching. Each of these is a distinct and important aspect of donor and recipient matching.
Blood Type Matching
The necessities of the basic kidney transplantations are very similar to those used for blood transfusions.
There are four major blood types in humans. These types are simply noted as blood type A, B, AB and O. Another factor, the Rh factor, adds a plus or a minus following the above blood type letter, so that all of us have a blood type such as A+ or B- and so on. This plus or minus factor, however, relates only to a particular cell type in the blood and this factor is not part of the kidney. Thus, the positive or negative feature in blood typing has nothing to do with the matching of a kidney between a donor and a recipient.
A recipient with blood type O can receive a kidney only from a donor with blood type O. A recipient with blood type A may receive a kidney from a recipient with blood type O or A and a recipient with blood type B can receive a kidney from a donor with blood type O or B. Obviously, a recipient with blood type AB can receive a kidney from a person of any blood type.
It is obvious that the closer the degree of tissue matching between the donor and the recipient, the longer the transplanted kidney lives. A 0 missmatch kidney has 40% more chance to live (for a 5 year period) than a 4-6 missmatch. Tissue matching is very important in cadeveric donors or if donor is a patient’s relative. However, in cases called alternative transplantation (Spouses or unrelated donors), tissue matching might not be indispensable since the patient has no other choice.
Panel Reactive Antibodies (PRA)
PRA is a way of measuring immune system activity within the body. PRA is higher when more antibodies are being made. PRA might grow out of pregnancy or previous transplants. These HLA antibodies should definitely be determined before the transplant. Failing to determine this antibody might cause rejection. It is possible to decrease these antibodies with a medical treatment.
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