All You Need to Know: A Guide to liver transplant in Turkey

All You Need to Know: A Guide to liver transplant in Turkey

  • February 1, 2020

The fruits of Turkey’s persistent dedication and consistent development in the medical field have ripened, and they taste so sweet. With geographical territories extending to Europe and Asia, Turkey has become a prominent destination for medical tourism. Gaining recognition as the go-to location for several medical procedures and claiming the highest ranks as a health tourist attraction; liver transplant in Turkey has become the new wave hitting the shores of Turkey’s health care system. Liver transplants are surgical procedures that remove the damaged liver from patients and replace it either with a full liver obtained from a deceased person or with a part of a liver from a living donor.

Functions of the liver

  • Livers are responsible for breaking down and processing medication, hormones, and nutrients.
  • Production of bile, a material crucial for breaking down fats and fat-soluble minerals and vitamins, as well as excreting specific waste products.
  • The liver is responsible for manufacturing proteins required for blood clotting in the case of an injury.
  • Detoxing the body through eliminating and excreting harmful bacterial bodies and toxins.
  • Monitoring the components of the innate immune system and regulating the activity of the immune system to prevent infections. [1]

The stages of liver disease

There is a standard series of order for the progression of liver disease, that goes as follows:

Stage 1: Healthy liver

  • A healthy liver is a liver with an unaffected ability to regenerate and regrow when exposed to damage.
  • A malady that strikes the liver and strips it off the capacity to self regenerate, puts the individual’s life at risk.

Stage 2: Inflammation

  • Inflammation generally occurs as an attraction tool to alert immune cells of the presence of foreign objects.
  • The physiological changes that occur in the liver under inflammation include hyper swelling and enlargement of the organ.
  • Because the liver is an internal organ, the signs, and symptoms of inflammation are hard to detect leading to the progression of the condition.
  • If left untreated, the persistent attacks on the liver for prolonged periods without intervention will wear the organ down and initiate permanent and irreversible damage.
  • However, the treatment plan for liver inflammation is typically successful and simple and does not require surgical intervention. [2]

Stage 3: Fibrosis

  • Fibrosis is a stage marred by the first appearance of scar tissue (fibrous tissue) on the liver.
  • Gradually, the scar tissue begins to spread and replace healthy tissue.
  • With time, as the healthy tissue to scar tissue ration grows smaller, the unaffected tissue has to operate at a faster pace and take on the load to compensate for the lost labor.
  • Scar tissue prevents blood from following to and from the liver wearing down the remaining viable tissue. [2]

Stage 4: Cirrhosis

  • cirrhosis is an advanced stage of fibrosis.
  • The danger of a liver shutdown or failure becomes more imminent as more healthy tissue gives away.
  • If professional treatment was not sought, the liver could enter a cancerous stage or completely shut down.
  • During cirrhosis physical, symptoms begin to appear. [2]

Physical symptoms of cirrhosis:

  • You may experience easily induces bleeding or bruising.
  • Water build-up in the legs or abdomen. 
  • An apparent tawny shade on the eyes and skin known as jaundice.
  • A frequent sensation of itchiness. 
  • Increased risk of blood vessels bursting as blood builds up in the vessels leading to the liver due to scar tissue blocking the stream. 
  • Hypersensitivity to medications and their proposed side-effects. 
  • Possibility of acquiring insulin resistance or type-2 diabetes. 
  • Toxin accumulation in the brain leading to a default in neurological processes that executes itself as issues with memory, concentration, sleep functions and many more in a condition known medically as encephalopathy. [2]

stage 4: End-stage liver disease (ESLD)

  • ESLD presents itself as decompensation or functional deterioration.
  • ELSD is immune to medical therapy and necessitates a transplant to reverse the damage. [2]

When are liver transplants necessary

Throughout the vicissitudes of the liver disease progress, treatment can be obtained without surgery in every phase preceding ELSD. Once functional deterioration ensues, the liver organ has to be replaced to prevent further complications or death as the liver permanently loses the capacity to self regenerate.

Liver transplants

Certain conditions that lead to adverse health complications and liver failure necessitate the surgical procedure of liver transplants. Typically the reasons that fuel the deterioration of the liver and the surgical intervention vary between children and adults.

Conditions that lead to the need for liver transplants in children

Biliary atresia

  • Biliary atresia is a condition characterized by an underdeveloped bile duct.
  • The bile duct is responsible for transporting bile to the bladder.
  • Bile is a material with essential physiological significance that includes the digestion of fats and fat-soluble vitamins
  • In addition to contributing to the excretion of certain wastes. [3]

Conditions that lead to the need for liver transplants in Adults

The causes that drive the progression of liver damage to end-stage liver disease

  • Chronic hepatitis B
  • Chronic hepatitis C
  • Chronic hepatitis D
  • Biliary Cirrhosis
  • Autoimmune hepatitis
  • Drugs and toxins
  • Alcohol consumption
  • Non-alcoholic fatty liver disease [4]

Types of liver transplants

  1. Deceased-donor liver transplant: Deceased-donor liver transplants rely on liver donations from deceased individuals. The disadvantages of a cadaveric donation are the increasing needs for donations to the low number of deceased donors, which creates a shortage of donations. [5]
  2. Living-donor liver transplants: Because the liver is the only organ that can repair its damages and resume regrowth, healthy adults can donate a restricted part of their livers to the recipient. The donor will not be afflicted by any adverse complications. Within three weeks the liver would have replaced between 80-90% of the donated portion. Similarly, for the recipient patient, the liver will return to its natural mass as well over time. [6]

Complications of liver transplants

Similar to procedures of paralleling magnitude, liver transplants carry a risk of 10% for complications and less than 1% for fatality risk.

Complications associated with liver transplants include:

  • Bile duct complications. Bile duct could possibly leak or shrink.
  • Bleeding
  • Blood clots
  • Failure of the donated liver
  • Infection
  • Rejection of donated liver
  • Mental confusion or seizures [7]

Complications associated with medications include:

Patients are expected to resume their medication course for the rest of their lives to assist the body in accepting the donated liver and avoid a rejection attack. The anti-rejection medications can initiate a number of side effects that include:

  • Bone thinning
  • Diabetes
  • Diarrhea
  • Headaches
  • High blood pressure
  • High cholesterol

Aside from the symptoms stated above, anti-rejection medications increase the risks of infection through their suppressant impact on the immune system. Your doctor will prescribe medications to support the immune system.

Requirements for a liver transplant

In order to be a suitable candidate for a liver transplant, there are certain conditions you have to meet and lifestyle changes to make.

Health conditions: Patients considering liver transplants should be free of the following health conditions.

  • Cancer in any location aside from the liver
  • Active infections
  • Incapacitating psychiatric disorders
  • History of medical non-compliance [8]

Lifestyle: Certain lifestyle practices have to be aborted in order to be considered an ideal candidate for liver transplant surgery.

  • Avoid alcohol consumption for 6 months preceding treatment or evaluation.
  • Complete avoidance of substance abuse.
  • Presence of adequate social support. [8]

What is the MELD score in liver transplant surgery?

  • MELD is an abbreviation for the Model of End-stage Liver Disease and is a metric system of scores oscillating between 6 and 40.
  • The MELD score is a means of evaluating the progression of liver failure and likewise eligibility for deceased-donor liver transplant in individuals over the age of 12.
  • In order to be considered eligible for a deceased-donor liver transplant surgery, you have to have a MELD score greater than 25.
  • In other words, the MELD score prioritizes the cases of liver failure, the higher the score, the greater the mortality risk, and hence the more urgent a case is considered for a liver transplant. [9]

How a MELD score is calculated: A MELD score is a number obtained from several lab tests that include:

  • Creatinine levels in the blood to evaluate the function of the kidneys
  • Bilirubin levels to determine how well the liver is producing bile.
  • The international normalized ratio which is a test that mirrors how well the liver is manufacture blood clot-related factors
  • Serum sodium levels that indicate the concentration of sodium in the body. [9]

How often is the MELD score recalculated:

  • If it was established that you suffer from a certain degree of liver disease, you will have to receive the MELD test repeatedly.
  • How often you receive the MELD test relies on your score.
  • A MELD score of less than 10 necessitates one repetition annually.
  • A MELD score of 11-18 necessitates periodic repetition every 3 months.
  • A MELD score between 19-24 requires recalculation every month.
  • A MELD score of 25 and above requires recalculation every week. [9]

Is the urgency for a deceased-donor liver transplant exclusively dependent on the MELD score?

Factors that affect your rank on the liver donation waiting list are not limited to the MELD score alone. Other conditions include:

  • Donor shortage deceased-donor livers
  • The market of supply and demand
  • Your geographical location and vicinity from the donated liver
  • Blood type compatibility and availability of a donor match
  • Body size
  • Age

In cases where an individual is expected to have a few hours or days live, they will be granted a priority status known as 1A. In extreme cases as such, even blood compatibility can be disregarded.

What is the PELD score in liver transplant surgery?

The PLED score stands for a pediatric model of end-stage liver disease which bases a criterion of urgency and necessity for children under the age of 12 to opt for deceased-donor liver transplant surgery. The PELD score helps prioritize cases on a gradation criticality. The higher the score, the more urgent a case is. [10]

Who is a candidate for living-donor liver transplants?

Living-donor liver transplant surgery criteria suggest that minimal liver failure can be reversed before the damage spreads to be considered critical and in need of a complete liver transplant. Usually, patients with a MELD score of less than 20, are more suited for a living-donor transplant.

Who is a candidate for deceased-donor liver transplants?

Deceases donor liver transplant criteria suggest that advanced levels of liver failure necessitate a complete liver transplant. Because the number of complete liver donations is meager, it is exclusively reserved for critical liver failure that is beyond repair via a living-donor transplant. Typically cases of MELD score greater than 25, are considered eligible for deceased-donor liver transplants.

How does a liver transplant work?

  • The liver is attached in place via connections with blood supply and the bio-duct.
  • In order to remove it, the connections have to be removed.
  • The inferior vena cava, portal vein, hepatic artery, and the bile duct are detached from the liver.
  • The damaged native liver is then removed from the body.
  • Depending on the type of surgery the new organ is attached in place.

During the deceased-donor liver transplant:

  • During a deceased-donor liver transplant, a complete liver is donated.
  • The procedure is necessary for advanced and critical stages of liver failure.
  • The liver is secured in place by connecting the liver to the right arteries, veins, and ducts.

During a living-donor liver transplant:

  • During a living-donor liver transplant donor transplant a section of the liver.
  • Typically, the sections are split into three: the left lateral segment, the left lobe, and the right lobe.
  • The left lateral segment makes up 15-20% of the liver mass and is considered for donation when an adult is donating to a child recipient.
  • The left lobe makes around 30-40% of the liver mass and is utilized in adult-adult liver donations.
  • The right lobe constitutes 60-70% of the liver structure and is utilized in adult-adult donations.

Who can be a liver donor?

  • Someone with no underlying selfish incentives, you should not expect any gains from the donation
  • Certainly, someone who understands that gaining any financial from organ donation is illegal
  • Someone between the ages of 18-55 for adult-adult donations
  • Someone between the ages of 18-60 for child-adult donations
  • An individual with a good state of physical health
  • An individual with a good state of mental health
  • The donor should not be suffering from any liver diseases
  • Bodyweight of the donor should be near normal
  • A family member, friend, or stranger can all be your liver donors if the blood type is compatible with yours.

Recovery for a liver donor

Doctortrsuted will ensure that your liver transplant in Turkey goes according to plan with the health of both the donor and the recipient closely monitored. Therefore, exclusively operates with hospitals that run comprehensive donor evaluation. Donor evaluation is necessary to eliminate any long term or short term complications in the future.

  1. Donors will stay in a surgical ICU overnight.
  2. In addition to spending 4-6 days at the hospital.
  3. Daily activity can be resumed in four weeks.
  4. As for strenuous activity, you can engage in it in 2-3 months.

Tests for liver donors?

If you happen to be fortunate enough to have a family member or a dear friend willing to donate a part of their liver for you, or if you are merely interested in donating a part of your liver to an anonymous recipient here are the tests you should perform to be accepted as a donor:

  • Blood type testing
  • General blood work
  • Imaging of the chest (x-ray, CT scan, or MRI)
  • Liver biopsy and further testing when necessary.
  • A medical and social history questionairre.

Liver transplant in Turkey

Liver transplant in Turkey: process

At our aim is to find the best medical facilities and assistance in the shortest time period to meet your financial plan while ensuring that you receive the highest quality of medical care.

  • Step 1: The first step in beginning your liver transplant in Turkey process is to contact for us to reach out to you and assign a pretransplant nurse who will carefully evaluate your case and construct the most ideal treatment plan for you.
  • Step2: Your designated nurse coordinator will request information from you regarding your medical history, demographics, social and financial status.
  • Step 3: According to the information you provide, a suitable hospital match will be assigned to you
  • Step 4: Doctortrusted will establish a convenient means of communication between you and your surgeon to set up an online consultation, completely free of charge, where your surgeon will address your concerns and evaluate your case with the provided information.
  • Step 5: Once you feel comfortable with your surgeon, Doctortrusted will coordinate all your travel arrangements to facilitate your arrival to Turkey. Accommodation, translation, and transportation services are all included to have you completely focused on your liver transplant surgery.
  • Step 6: Your surgeon will request several tests during in-person consultation to confirm you meet the criterion of eligibility for a liver transplant in Turkey.

Benefits of liver transplant in Turkey

Affordable prices

  • A liver transplant is quite an expensive procedure that is rarely covered by insurance.
  • For instance, the average procedure of liver transplant in the US would cost anywhere around $600,000 give or take, and the mean annual salary is around $31,100
  • The average salary to the average cost of liver transplant in the US would be 0.05
  • The average liver transplant in Turkey would be around $75,000 with the average annual income being around $5,100
  • The ration average income to the average cost of liver transplant in Turkey would be around 0.06 which is a value close to the ration in the USA.
  • Therefore, it can be concluded that the affordable prices of a liver transplant in Turkey are a matter of perspective.

Top-quality medical care

  • Medical care in Turkey is rapidly advancing with the surge in medical tourism.
  • The Turkish government and the ministry of health in Turkey monitor medical establishments frequently to ensure all medical operations are above board
  • Surgical procedures are performed in accordance with international standards
  • Turkish hospitals host highly experienced internationally certified doctors and surgeons

Liver transplant FAQ

Why should I consider living donor liver transplant?

Donated livers from deceased donors are generally inferior in number to the waiting list. Priority is given to critical cases which often leads patients to deteriorate further in terms of health. Many patients suffer a higher risk of death on the waiting list. If you are eligible for a living donor transplant, it is advisable that you seek assistance from family or friends. Survival rates are higher with living-donor transplants. Remember the longer you wait, the more you suffer.

What should I quit before my liver transplant surgery?

In order to be a perfect candidate for liver transplant evaluation, you will have to eschew from the consumption and abuse of the following items:

  • Alcohol
  • Nicotine
  • Marijuana
  • Cocaine/heroin
  • Other illicit substances

How long will my liver transplant last?

If patients lead a healthy lifestyle and abide by liver transplant aftercare instructions provided by their surgeon, the procedure can have monumental success in terms of results. Recipients of a liver transplant are predicted to lead a perfectly normal life for 3 decades after surgery.

For reference, the most recent data computation by UNOS/OPTN (2004) national average rate of survival after one year of a liver transplant is estimated at 83%, and 87% survival rates for patients receiving a deceased donor liver and 92% for those transplanted with an organ from a living donor. After five years from a liver transplant, the survival rate for patients is estimated are 76% (deceased/2000) 81% (living/2000), respectively.

Although the statistics give vague assumptions, it is important to consider the versatility of the sampled demographic as well as the complicated factors interlinked with every respective individual. Patients both the old and the young of ages exceeding 80 and preceding one year are included in the data which impact the results. Some patients suffer illnesses that create complications, others do not abide by aftercare instructions which then skews the data.

It is very well within your hands to preserve the transplanted liver and maintain your health. Complying with medications provided such as immunosuppressants will trigger the immune system to initiate attacks on what it will perceive as a foreign body. Such negligence can adversely and drastically interfere with your recovery and the success of the surgery.

Consistent follow-up regarding your health is essential in maintaining the success of the surgery. Monitor your drug and medication schedule and pick-up a routine to help your body operate well and respond effectively to treatment. Implement infection-avoidance techniques and avoidance of toxicants can increase the rates of survival and success.

What will my quality of life be like after a liver transplant?

Typically, the first three months post-surgery entail the most complicated aspects of recovery. During the period of the first 3 months, the body begins to adjust around and accept the new liver and the new and lifelong treatment plan of medications. The discharge period varies from one person to another depending on how their body responds to the transplant as well as their innate state of health in terms of diseases and complications. Generally, the discharge period can be anywhere between a week to 3 weeks. The transplant team discharges patients once it is apparent they can tend for their basic needs and care after themselves.  A fully normal lifestyle with no restrictions becomes possible after 3-6 months. That includes strenuous activity, traveling, leading a social life. People who receive a liver transplant are perfectly capable of experiencing a typical life.

Will my liver disease come back after a transplant?

There are certain conditions expected to recur after treatment such as Hepatitis C. Particularly if the patient was still infected during treatment, chances of re-infection are very likely. Virus levels significantly drop after surgery for 23 hours, during this time your transplant team will consider all possible treatment options to eliminate the progression of the disease into cirrhosis.

How much pain is typical after the surgery?

In comparison to surgeries of equivalent magnitude, the pain experienced after a liver transplant is monumentally more bearable than other surgeries. Pain will be significantly diminished after surgery as the nerves in the area will be severed in response to the incision created and its depth. The nerve damage is not permanent, however, and nerves will regenerate typically over a time period of six months, but until then the area will be mostly numb.

In any case, the transplant team will prescribe pain medication for you in accordance with your general condition to ensure you have a pain-free recovery.

How large is the incision scar of a liver transplant surgery?

A Chevron incision technique is most popularly utilized for liver transplant surgery. It typically starts on the midsection of the abdomen near the end of the rib ends on the right side. The incision then extends in curvature to the left side of the abdomen. Another incision is created in a vertical line under the breast bone made to connect with the Chevron incision.

How long is the period of recuperation with a liver transplant?

Hospitalization is commonly between 7 to 10 days, however, according to the health condition of the patient, their response to the surgery, and recovery it can extend to around three weeks.

Will I need to take medications after my liver transplant?

What most liver transplant patients will mostly receive is a long term medication known as immunosuppressants. Immunosuppressants are crucial in maintaining the well being of the liver. Otherwise, the immune system can reject the grafts, consider a foreign body, and attack the liver causing permanent damage.

Because immunosuppressants diminish the performance of the immune system, you will most likely be given medications to fight infections during recovery. Patients will be leaving with around 6 different types of medications some are for short-term use some are for long-term. Your surgeon will provide you with all the information you need and instruct you on how to use the medications. essentially, with recovery, you will most likely eliminate many of the medications to dwarf down the collection to two treatments after six months.

What are some common side effects of liver transplant medications?

Because the medications prescribed vary so do the side effects. A vast array of side effect symptoms can arise during recovery that includes:

Mood changes
Hair growth
Hair loss
Increased blood pressure levels
Bone weakness
Muscles weakness
Increased blood sugar levels
kidney dysfunction

You will only have to use two medications for the rest of your life, the remaining medications will be gradually decreased until you completely stop them. So although there might be some degree of inconvenience and discomfort, the period won’t last long.
However, if the side effects are unbearable your transplant team can replace your treatment plan to find a more suitable alternative for you.

Can I return to work after my transplant?

You can resume your daily activities typically after 4 weeks, however, a 3 month period of rest before returning to work. You can coordinate with your work to take on tasks of trivial duty that do not require much physical activity. However, the period of disability even in extreme cases doesn’t surpass 6 months. You will be able to resume all activities in three months.

Can I drink alcoholic beverages after my transplant?

Alcohol and other toxic sting substances are prohibited through your recovery and for the rest of your life. For one alcohol consumption harms the liver and excess consumption of it possess a risk of cirrhosis and liver failure on the liver.
In addition, liver transplant medications do not interact well with alcohol as the substance impairs the metabolic Processing of medication.

Will I be able to have children after my transplant?

Patients of liver transplant are perfectly capable of leading a healthy normal life and that includes pregnancy and motherhood. It is advisable to postpone conception until a year after the transplant surgery to ensure no complications or harm can arise to both the baby and yourself.
It is always safest to discuss your motherhood and pregnancy plans with your surgeon to evaluate and assess your health accordingly and decide whether your body can handle pregnancy at the time you are interested.
Many couples are able to have children after liver transplantation with minimal risk to the mother and baby. Medications could be altered, immunosuppressants affect the child development and babies born to transplant mothers are often underweight but aside from this difference, no health implications are induced by the condition of the mother.

Conduct frequent tests, consistent follow-up with your obstetrician, and frequents visits to your surgeon to monitor the progress of the pregnancy.

Liver transplant in Turkey FAQ

Who do I contact and where do I go to start my liver transplant in Turkey?

DoctorTrusted is an organization that operates to match health tourists with hospitals and surgeons in accordance with the patient’s financial plan and health conditions. If you are interested in liver transplant in Turkey, or any organ transplant for the matter, contact DoctorTrusted and the team of pre-transplant nurses and medical specialists will link you with a compatible medical facility.

Will the language barrier be an obstacle during my liver transplant in Turkey treatment

The language barrier will never have to be an issue for patients that seek treatment in Turkey through our services. DoctorTrusted is not merely a team that will provide you with assistance until your arrival. On the contrary, throughout your stay and recovery, our team will be by your side coordinating your accommodation, transportation and translation services. All communication with your doctors and surgeons will be with the assistance of a representative from our organization to break language barriers. Your liver transplant in Turkey will be an experience exclusively focused on your treatment. All the details of your stay will be handled by DoctorTrusted.

The success rate of liver transplant in Turkey

Liver transplant, in general, is a low-risk procedure, and therefore the same statistics apply to the procedure of liver transplant in Turkey. Only qualified hospitals are given the license to perform organ transplants in Turkey. At DoctorTrusted, we only cooperate with hospitals of extremely high caliber to ensure a safe recovery for you.

Contact DoctorTrusted

Contact DoctorTrusted to test the waters with medical tourism in Turkey and have the minutiae of your treatment entirely coordinated.

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