Surgery can be performed for both chronic and acute liver disease.
The most common chronic disease is cirrhosis of the liver, which leads to progressive liver dysfunction. Cirrhosis can develop as a result of infection with the hepatitis B virus, the hepatitis C virus, prolonged abuse of alcoholic beverages or a metabolic syndrome.
The degree of liver damage in cirrhosis is measured using the MELD model or, more recently, the MELD 3.0 model.
Certain liver tumors may be another indication for transplantation. Hepatocellular carcinoma is the main tumor to be operated on if it meets certain clinical criteria. Recently , highly selected patients with cholangiocarcinoma and liver metastases from colorectal cancer who cannot be removed by conventional liver resection have been proposed for surgery.
The main acute liver disease that can lead to surgical intervention is fulminant hepatitis, which can be caused by intoxication (such as the consumption of certain types of poisonous mushrooms) or by infection with particular viruses.
Another indication is liver failure following conventional surgery (liver resection after removal of an excessive amount of tissue) or transplantation, in which the transplanted organ fails to regain its function.
Up to what age can a transplant be performed?
In the days of transplants, the upper age limit for surgery was 65.
Today, this limit has been exceeded and is no longer applied in a “bureaucratic” manner.
The patient is assessed for surgery on a case-by-case basis, and the doctors responsible for patient selection judge according to
- general conditions ;
- the presence of concomitant diseases (cardiac, pulmonary, systemic, …) ;
- the stage of the disease for which the patient is to undergo surgery;
even if the patient is over 65.
Where can a transplant be performed?
Transplant centers in Turkey vary. Almost every region has at least one. Find the best clinics and hospitals for your liver transplant in Turkey with competitive prices.
Turkey’s transplant centers are committed to providing comprehensive care, from initial consultation to post-operative recovery. Patients can expect a seamless experience, with dedicated staff assisting with logistics, accommodation, and translation services. Additionally, many clinics offer comfortable accommodations and opportunities for sightseeing and relaxation during recovery.
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Types of liver transplantation
There are three main types of liver transplantation:
- Living donor liver transplant: part of the liver, usually the left lobe, is removed from the living donor and transplanted into the patient. Both parts of the liver (the one remaining with the donor and the one received by the patient) are capable of regenerating until adequate liver function is achieved.
- Liver transplantation from a deceased donor: in cases where the donor, during his or her lifetime, has expressed to family members, in writing or verbally, his or her wish to donate his or her organs at the time of death, or has not expressed this wish, but family members do not object, the liver can be removed and transplanted into a patient on the waiting list.
- Split-liver transplantation: if the donor has expressed a wish to donate during his or her lifetime, the liver can be surgically divided into two parts, a right hemi-liver and a left hemi-liver (split): current protocols call for the left hemi-liver to be transplanted in a pediatric patient (aged 17 years and 365 days at the time of registration on the waiting list) and the right hemi-liver in an adult, but it is also possible for transplants to be performed in two adult patients.
Most liver transplants are carried out using organs from donors who are no longer alive, and almost all are performed in an “ orthotopic ” fashion, i.e. by transplanting the new liver into the same anatomical position as the removed organ.
The operation is divided into three phases: hepatectomy (removal of the patient’s liver), the anhepatic (liver-free) phase and transplantation.