Liver Transplantation

What is Liver Transplantation?

Due to various diseases occurring in the body, conditions such as tissue and organ functions being disrupted to a certain extent or completely insufficient may develop. If the organs fail irreversibly, serious health problems may occur due to the inability to perform vital functions for the body. Replacing the insufficient organ with another healthy organ or transplanting a healthy organ to the body is one of the frequently used treatment methods today in order to sustain life. One of the organs that can be transplanted in this context is the liver.

The liver regulates and controls the biochemical substances and metabolism that provide life in the human body. It functions in the production of vital substances for the body and in the removal or neutralization of harmful substances for the body. Apart from these, it undertakes many other different tasks. In case of failure experienced in the liver, a new liver tissue must be transplanted to the body in order to perform all these important functions and to continue the patient’s life.

Liver transplantation is the process of transplanting liver tissue, which is determined to be compatible with the patient’s body tissues, from the donor body to the patient’s body. The patient’s blood circulation is connected to the bile ducts. Thus, the transplanted liver tissue grows in harmony with the new body in which it lives and functions as the body’s new liver organ.

On the other hand, since the newly transplanted liver tissue has the characteristics of another person, there is a risk that the patient’s body cells will perceive it as foreign tissue. In this case, the immune system may try to remove the liver tissue from the body. To prevent this, patients need to use immunosuppressive drugs after the transplant. If the drugs are insufficient, the transplanted tissue may die over time, and various health problems may develop due to the transplant process or the drugs. For this reason, the liver transplantation process should be managed carefully and in a controlled manner, and by expert and experienced health professionals.

Why is Liver Transplantation Performed?

The functions of the liver are of vital importance to the body. A disruption in these functions brings the existence of the problem of liver failure to the agenda. Insufficiency symptoms may develop in liver tissues affected by the following health problems.

Liver failure may develop as a result of cell death due to viral infections affecting the liver tissue. Hepatitis B and hepatitis C infections are the most common causes of liver failure today.
Liver cells of people who chronically use alcohol may be damaged over time. As a result, liver failure may occur with cirrhosis in the long term.
Liver tissue may not be able to perform its functions due to metastases to the liver from cancers of the liver’s own cells or from different tissues such as the stomach, lung, and colon. As a result, liver failure may occur.
With the increase in fatty tissue in the liver, the tissue structure may deteriorate and liver failure may occur.
One of the most important functions of the liver is the production of bile fluid. Bile secretion reaches the intestines via the bile ducts, and the disruption of the functions of this path for various reasons may cause the accumulation of bile secretion in the liver tissue, cell death, and liver failure.
Liver failure may occur as a result of the body’s own immune system cells perceiving liver cells as foreign and attacking them.

How is Liver Transplantation Performed?

The most important problem encountered in organ transplantation is the development of incompatibility between the transplanted tissue or organ and the body tissues of the organ recipient patient, and the development of various problems as a result. Preventing a possible incompatibility as much as possible is the main goal of the transplantation process. In order to prevent incompatibility, transplant centers determine and record the biochemical markers called antigens, which are responsible for the incompatibility of the patients’ blood groups and tissues.

Patients who need liver transplantation apply to a suitable transplant center and start the process. The necessary research is done in terms of the criteria determined by the transplant centers. If the patient is found to meet the transplant center criteria, he/she is placed on the transplant list. The patient’s priority in transplantation is determined according to various risk scores calculated in the evaluation made before the transplant. Donors are searched on the list according to this priority.

Liver transplantation can generally be performed in two types: from a living donor or from a person who has recently passed away. In transplants performed from a living donor, a small piece of the liver is taken and transplanted. The transplanted tissue develops over time and becomes a whole liver. If the person who donated an organ and lost it is suitable for transplantation, the patient is called to the health center and the liver is transplanted with an operation.

In Which Diseases Is Liver Transplantation Applied?

Liver transplantation is the process of replacing the insufficient liver tissue with a healthy one. Thus, successful results can be achieved in liver failures that cannot be treated with other medical methods. Although there are different diseases that cause liver failure, one of the most common pathologies that occur due to liver failure is cirrhosis. Diseases that cause cirrhosis, which is a chronic disease, include infections, NASH, alcoholism, autoimmune diseases, Budd Chiari syndrome, epitoid hemangionemdothelioma and alveolar hydatid cyst, hepatocellular carcinoma and acute liver failure.

The only definitive solution for the treatment of liver failure is organ transplantation. It is possible for every individual with liver failure to benefit from organ transplantation. People who meet the eligibility criteria for transplant surgery can regain normal liver functions thanks to liver transplant.

How is Liver Transplant Performed?

Liver transplant can be performed in two different ways: with a cadaver donor or with a living liver donor. A cadaver donor with a healthy liver that has experienced brain death is required for cadaver donor transplant offered in organ donation. The surgery is performed with preparations made under emergency conditions.

In living donor liver transplants, detailed examinations and evaluations are made for both the recipient and the donor. Problems that may be encountered after the surgery are minimized in this way. Within the scope of living donor liver transplant surgery, the right, left or, especially for child recipients, a part of the left lobe of the liver is taken from the donor according to the needs of the recipient candidate.

Within the scope of the recipient’s surgery, the diseased liver is completely removed along with the gallbladder. The liver of appropriate volume taken from a cadaver or living donor is placed in the same place.