Liver Transplant (Living Related Donor) at Group Florence Nightingale Hospitals

Liver Transplantation Center

Liver Transplantation Center at Group Florence Nightingale Hospitals is highly specialized and experienced in “Living Liver Donor Transplant” for both adult and pediatric patients. Moreover, the center is elected as the one and only living donor liver transplant training center by the European Society for Organ Transplant (ESOT).

Directed by Prof. Yıldıray Yüzer, MD, the transplant team performs more than 100 transplants per year, and has been accomplished more than 1500 transplant since 2004. Each year more than 80% of transplants are being performed from living donors.

Our liver transplant team is the first to perform adult-to-adult right lobe living donor liver transplant, split liver transplant to two adults at the same time, domino liver transplant, and dual left lobe liver transplant.

Based on annual reports of the Turkish Republic, the Ministry of Health, more than 95% of our liver transplant patients are able to live a normal daily life after transplant.

To fulfill our mission about being a pioneering institution which is innovative and continuously improving, we are honored to train not only surgeons but also hepatologists, anesthesiologists, radiologists, intensivists, nurses, coordinators and technicians from all over Europe.

What do we offer for our patients?

• Group Florence Nightingale Hospitals provides healthcare service at international standards. Therefore, it has been entitled to competency certificate of Joint Commission International (JCI). Our Transplant Center is registered to European Database of Liver Transplant. The successful outcomes beyond European standards are shared with other European countries on behalf of Turkey.
• Dedicated teamwork in challenging liver conditions: Our transplant team is composed of experienced hepatologists, gastroenterologists, anesthesiologists, radiologists, oncologists, psychiatrists, pathologists, and nurses apart from our distinguished transplant surgeons. After years of close team-work, they have built up a seamless, individualized quality care for each patient and provide high-quality service for diagnosis, treatment and monitoring of any liver diseases.
  Acknowledging that liver transplant is a comprehensive and multidisciplinary procedure, our experts work in collaboration with other specialties for better process management and to improve patient outcome.

• High-tech facilities. Liver Transplant Center offers advanced technology for diagnosis, treatment, and follow-up of our liver transplant patients. Over 30 years of experience in healthcare field, Group Florence Nightingale Hospitals has been recognized as a pioneering institution that has closely followed up recent improvements in healthcare technology, and unique contributions in the scientific literature.

What are our services?

Besides living donor liver transplant, our experts render services in:

• Adult-to-adult right lobe living donor liver transplant,
• Split liver transplant to two adults at the same time,
• Domino liver transplant,
• Dual left lobe liver transplant.
• Swap liver transplant,
• Liver resection in challenging patients
• Hepatobiliary surgeries

Stages of liver transplantation journey

Preparation for the transplant

After a patient is diagnosed as a candidate for transplantation (recipient), it is time to determine a donor (a healthy person who is willing to give a part of his/her liver). Since it is prohibited to have a cadaveric transplant from a Turkish citizen, all of our patients from overseas should have live or swap liver transplant legally.

The recipient (patient) is evaluated for transplantation in 3 stages; it will take 5-7-day’s hospitalization.

Stage 1:  Definite diagnosis; determination of liver disease intensity, and emergency of transplant.

Stage 2: Multiple systemic evaluation for transplant such as heart, lungs, kidneys, total blood count. If there is any pathology such as infection, treatment of it. Our experts on the transplant team perform necessary work-ups to estimate transplant success depending on patient’s condition, underlying cause, and disease intensity.

Stage 3: Psychological and mental preparation of patient for transplant. Patient and the family members are informed about the procedure, hospitalization, possible progression after surgery, and healthcare issues.

Donor is evaluated for match with the patient.

Transplantation

From the living donor

In the transplant of the liver from the living donor, the liver part taken from the live donor is transplanted to the recipient immediately after the patient’s liver has been completely removed.

The liver, unlike any other organ in the body, is capable of regeneration and growth making live donor liver transplant possible. The liver’s self-feeding starts immediately and lasts for six months. This is why when surgeons remove part of the liver from the donor, the remaining part of the donor and the part placed on the recipient are quickly returned to its original dimensions.

A living donor liver transplant can be performed without waiting the deceased donor list. Since organ donation is not widespread enough in our country, patients in the list have to wait long time.

In this process, the patient’s condition may deteriorate, so the rate of success after transplant may decrease as complication risks will increase in the early period after transplant.

Swap Liver Transplant

Swap liver transplant is performed when blood type of donor is incompatible with the recipient.

For long years, the organs needed for organ transplantation are obtained from a donor with brain death whose family gives consent or from close relatives who donate a part of their liver. A large number of people in the world has a chance to live and can go back to their active and healthy life through liver transplantation.

Recently, the success rate of liver transplant has rapidly improved with the new drugs and improved surgical techniques and the postoperative patient survival rate and life of quality has been increased.

Swap liver transplantations, thus, is possible to save many people’s life. Many patients are waiting for the cadaver lists unaware of each other, and eventually die. Our purpose is to bring these people together via our network and enable liver transplant by matching the compatible donors.

After transplantation

The patient is transferred to the intensive care unit (ICU), and is connected to respiratory assisted device for approximately 26-48 hours. According to his/her general condition, the patient is transferred to the ward. He/she is followed up for fever, jaundice (yellowish coloring of mucosa and skin), pain, fluid accumulation, and transplanted liver functions.

Our patients attend intensive physical and mental rehabilitation program developed to speed up their recovery.

After discharge from our institution, transplant patients are scheduled for follow up visits at outpatient clinic of our center.

What to care after discharge?

You should care for

• your surgical wound as it is explained to you by our nurses,
• T-tube that drains your intra-abdominal spaces (clean the insertion site with antiseptic soap; do not remove or dislocate the tube)

Please get in touch with your transplant team if:

• there is redness around the insertion site of the tube,
• there is increased heat at the insertion site,
• there is any discharge at the insertion site,
• the suture at the insertion is detached,
• the length of tube is increased (it may be a sign of dislocation)
• you have fever higher than 38°C,
• you feel as if you will have fever or tremor, and/or chills or pain

Do not use any drugs before our team examines/recommends you!

• your blood pressure and pulse rate,
• your teeth and mouth hygiene by regular tooth brushing with a soft toothbrush,

Beware that you should start antibiotics 24 hours before, and 48 hours after any tooth operation. This is called prophylaxis.

• General body clean up,
• Skin and hair care, because under cortisone treatment you may have simple or infected pimples (acne) on your skin,
• About thickened unwanted hair during immunosuppression (ask your physician what to do during immunosuppression),
• About skin under sunlight, and avoid solarium.