The liver is the largest organ in the body and is responsible for several functions such as,
- Removal of infection-causing agents and enhance the immune system.
- Production of bile to facilitate absorption of fats, cholesterol and fat-soluble vitamins.
- Production of proteins that are responsible for clotting of blood.
- Processing hormones, nutrients and oral medications.
- Removal of bacteria and other toxins from the blood.
What is a Liver transplant?
Liver transplant is a surgical procedure that involves removal of the diseased or damaged liver and replacing it with a healthy liver from a living or deceased donor. It is only done in cases of irreversible damage to the liver such as end-stage chronic liver disease. The human liver has the ability to regenerate and return to its normal size even after the surgical removal.
Countries providing liver transplants in the world
The top 10 destinations known for the best medical treatment, especially liver transplant are mentioned below:
Studies have indicated a steep increase in medical tourism in the United States. This is because an increased number of international patients are coming to the US for their treatment. The US is known for offering higher-quality treatment than any other country in the world and also the access to certain procedures that are not available at other places. Also, one does not have to wait for a long time for one’s appointment. Currently, 58% of the hospitals in the United States are non-profitable, and 21% are owned by the government.
Turkey is one of the leading countries when it comes to providing medical services on an international level. With each passing year, it is becoming a destination of choice for most of the people across the people. It has several hospitals which are accredited with ophthalmic surgeries, cosmetic surgeries, cancer treatment, fertility treatment etc. According to a study, about 6 to 7 lacs people visit Turkey for medical treatment each year.
India is also one of the greatest competence in the medical tourism industry. It is widely known for providing the latest infrastructure and cutting-edge technology treatments at budget-friendly costs. Most of the hospitals in India are accredited with NABH (National Accreditation Board for Hospitals and Healthcare Providers), NABL (National Accreditation Board for Testing and Calibration Laboratories), and JCI (Joint Commission International). Other than good hospital care, it also provides pickups and drop-offs to the airport, good accommodations, great food etc.
Thailand is worldwide known for its hospitality and scenic beauty. It has the highest number of internationally accredited hospitals in the entire South-Asia. Typically, the country is known for dental services, cosmetic and skin-related treatment. It attracts nearly 4,00,000 medical tourists each year across the world. In addition to the health care services, it is also known for massages and relaxation therapies.
As per the World Health Organization, Brazil is amongst the best countries for healthcare services in Latin America. It has nearly 43 hospitals, which are accredited by JCI. Brazil is a nerve centre for cosmetic and plastic surgery. It offers high-quality treatment at affordable prices. Within Brazil, Florianopolis and Sao Paulo are the best-known cities for medical advances and innovations.
What makes Turkey one of the best destinations for a liver transplant?
Turkey has a great infrastructure when it comes to medical tourism in the world. It also has the largest number of hospitals that are accredited with JCI-accredited hospitals after the USA. It has 28,000 medical centres spread across Asian and the European region. The best hospitals, however, are located in cities like Istanbul, Ankara, Antalya and Bodrum.
Moreover, the cost of liver transplant in Turkey pocket-friendly and starts from 70,000 USD. Whereas in countries like Germany and the United States, the cost is three times than that in Turkey. The hospitals have highly skilled surgeons for a liver transplant, who hold rich experience of several decades. Not just this, Turkey is also known as the largest region for organ preservation and organ donation.
At present, there are 45 centres for liver transplantation in Turkey out of which there are 25 state-level universities, 8 foundation universities, 3 research centres and training hospitals, and 9 other private universities.
Other than providing great healthcare services, Turkey is known for its spices, street food, traditions and picturesque views. It is surrounded by three different seas such as The black sea, The Aegean Sea, and the Mediterranean sea.
The cost incurred for the surgery
In general, a liver transplant is one of the most expensive procedures. Its cost ranges between 150,000 USD to 500,000 USD in most of the western countries such as the United States. However, in Turkey, this cost drops to around 70,000 USD to 80,000 USD. It offers the transplant by highly skilled surgeons and high-quality treatment despite the low costs.
Stay in Turkey
- The duration for which a patient is advised to stay in the hospitals is covered in the treatment cost. However, in complex cases where the patients need to stay in Turkey for more duration and also includes followup visits, there is a need to find suitable accommodation.
- Turkey is full of accommodation places from inexpensive apartments to luxury hotels. When it comes to food, it is easily available at every nook and corner. Most of the places in Turkey serve multi-cuisine food at affordable prices. It also has cafes and clubs which offer a wide variety of food and drinks.
- The hospitals and the hotels are well-connected to the airport. Taxis and other modes of transplant are available at the click of a button to commute from one place to another.
Steps involved for a liver transplant surgery in Turkey
Once it is decided that the only treatment option left for you is a liver transplant, and once you decide to visit Turkey, the following steps are needed to be followed:
Get yourself registered with the transplant centre’s selection committee. The organization with reviewing your reports and decide whether you are eligible for a liver transplant. Every organization has its own guidelines to identify the individuals. You can also choose not to have a liver transplant even if you are approved for it.
Next step is to have your name placed on the national waiting list if you do not have a living donor. The national waiting list will place your name on the waiting list for a deceased living donor.
After that, you have to wait for your turn. You may need to wait from less than 30 days to more than 5 years. It depends on how urgent is it for you to get the liver, your age, location, blood type etc.
You will be called immediately after your match is found for the liver donation.
If you already have a living donor:
If you have a family member or any other person who is ready to be a living donor, you should coordinate with the hospital and the team will conduct the tests to check whether he or she is suitable to donate the liver.
After you have a donor's liver, you should call the hospital and get the appointment. You also need to apply for a medical visa for Turkey. After you receive the visa, you book your tickets and reach Turkey.
The overall stay required in Turkey is for about 20 days. The exact length of stay depends on several factors such as the condition of the patient, the body’s response to the transplant and many more.
If you consult Vaidam Health for this, the team will help you in choosing the best hospital for your treatment and provide the treatment at the best price. Not just this, the team will arrange a place of accommodation before your arrival as per your preferences along with the airport pick up and drop off. Vaidam health team makes sure you have a pleasant experience in Turkey during your treatment.
Read more about liver transplantation in Turkey.
Striking facts about liver transplant in Turkey
- The first successful organ transplant in Turkey was done in 1975 by Dr. Haberal.
- The very first liver transplant in Turkey was also performed by Dr. Haberal in 1988.
- The first living-donor liver transplant on a pediatric patient in Turkey was done on April 24, 1990.
- At present, there are about 30 liver transplantation centres in Turkey.
- The studies from the Ministry of Health in Turkey states that currently, there are 2065 patients in Turkey who are on the waiting list for liver transplant surgery.
- Turkey is one of the countries with the highest volumes of liver transplant surgeries per population across the globe.
- The survival rates reached as high as 90 per cent within one year of the surgery.
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Medical tests before a liver transplant - The deciding factor
It is usually recommended by the doctors to bring along all your medical tests reports, x-rays, liver biopsy reports, list of ongoing and previous medications, and any other medical documents before going for the pre-evaluation tests for a liver transplant.
At the hospital, some further tests and investigations will be done to check the condition in detail. These tests are:
- Computed Tomography Scan or CT scan
- Magnetic Resonance Imaging (MRI) scan
- Chest x-ray
- Echocardiogram and stress test
- Doppler ultrasound
- Lung function test
- Blood tests including liver function test (LFT), blood type, clotting ability and serological screening, and biochemical status of blood.
- Dobutamine stress echocardiogram (DSE)
Conditions that may need a liver transplant
Usually, the patients needing a liver transplant can be categorized in the following ways:
- Patients with acute liver failure
- Patients with chronic liver failure
Acute Liver Failure
Acute liver failure occurs as a result of a major injury to the liver. In such cases, the patient’s liver is healthy and functions well and the damage takes places in a short time. The most common causes of acute liver failure include:
- Overdosage of medications like Tylenol (acetaminophen).
- Viral infections
- Intake of toxic substances such as poisonous mushrooms
- Any drug reaction
One of the typical signs for acute liver failure is jaundice followed by confusion. Confusion or encephalopathy occurs due to accumulation of toxins metabolized by the liver.
Unlike the patients with chronic liver failure, people having acute liver failure need an immediate liver transplant and hence are always listed on the highest priority of waiting list for a donor's liver.
Chronic liver failure
Chronic liver failure is a condition that occurs after repeated injury over several years or decades. To a small extent, the liver can repair itself in response to the injury. However, repeated damage can leave a permanent scar. The condition at which the liver loses its ability to self-repair is known as Cirrhosis. When this happens, the patient will notice signs of the malfunctioned liver. In chronic liver failure, the person can sustain to some extent with the help of medications. However, the ultimate and permanent solution is a liver transplant.
The most common causes of chronic liver failure are:
- Viral hepatitis B
- Hepatitis C
- Alcoholic liver disease
- Metabolic liver disease
- Budd-Chiari syndrome
- Hepatocellular carcinoma
Autoimmune liver diseases, such as
- Cholestatic liver disease
- Biliary atresia
- Primary Biliary Cirrhosis
- Autoimmune hepatitis
- Primary Sclerosing Cholangitis
- Neonatal sclerosing cholangitis
Genetic Liver disease
- Glycogen Storage disease
- Wilson’s disease
- Alpha-1 antitrypsin deficiency
Who is not the right candidate for a liver transplant?
Not everyone who has a malfunctioned liver or is suffering from liver cirrhosis is eligible for a liver transplant. It is important for the patient to be medically capable to survive the surgery and other related complications. The body should be able to face the organ-rejection symptoms and chances of infections. Other than this, people with the following conditions are not suitable and not recommended for liver transplant surgery:
- Metastatic cancer spread to other parts of the body.
- Systemic infection
- Severe cases of pulmonary hypertension
- Terminal illness
- Ongoing drug abuse
- Extreme cases of psychiatric illness
What to expect during the liver transplant?
Before the surgery
Most of the liver transplants are done by the deceased donors. There is a very small number of transplant procedures that are done from living donors. Because there is a huge limitation of donor's livers, patients have to wait for days or months to get a donor's liver. The donated organs are provided based on the MELD score, which the score for your liver prognosis. The patients with a higher MELD score come first on the priority list for a liver donation. Once the patient is allocated a donor's liver, the patient is prepared for the surgery. All the required investigations are done include complete blood count, liver function test etc.
During the surgery
Deceased-donor liver transplant is performed under general anaesthesia. A long incision is made across the abdomen to get access to the liver. The blood supply and bile ducts disconnected and removed from the damaged liver. After placing the new liver in the body, the blood vessels and bile ducts are reattached. This type of surgery takes about 12 hours.
In a living-donor liver transplant, the surgeons transplant a portion of the donor’s liver in the body. The first procedure is done on the donor for the removal of the required liver part. This is followed by placement of the donated liver part into the patient’s body, then connecting the blood vessels and bile ducts to the new liver.
After the surgery
- You will need to stay in the intensive care unit of the hospital for a few days where you will be monitored for any signs of complications.
- Once your condition is stable, you will be shifted to the transplant recovery area for recovery.
- After 5 -10 days of hospital stay, you will be discharged and asked for frequent checkups with the doctor. The doctor might recommend a few blood tests a few times every week and then less frequently.
- You will then need to take medications for the rest of your life. Medicines such as immunosuppressants help the immune system from attacking your liver. Other drugs are advised to prevent complications from a liver transplant.
The recovery period after the surgery
The body takes a few months right after the transplantation surgery to adjust with the new liver and the medications. In most of the cases, the patient is able to return back to work in 3-6 months after the transplant. Patients are also able to do most of the physical activities including travelling.
Relapse of liver disease
In a few cases, there are some chances of recurrence of the symptoms even after a liver transplant, for example in cases of chronic hepatitis. In such type of cases, the doctor will precisely explain you to monitor the symptoms and have regular checkups.
Pain and discomfort after the surgery
There is mild to moderate pain after surgery. This is due to the incision made during the surgery causing numbness of the skin around the abdomen. When these nerves regenerate, the sensations return back. In some cases, people may also experience back pain just after the surgery due to laying on the table for a long time.
Points that the liver donor must remember before the surgery
The living donor has to go through the following phases after he or she decides to donate the liver. It is important for the donor to be aware of all the risks and complications associated with it. Here's a list of steps that a donor goes through :
- Evaluation - The donor has to go through a series of evaluation tests such as:
- Blood group match
- General medical tests to check if he or she is fit for the donation
- Lab screening
- Urine tests
- Pap smear
- Mammogram (for women above the age of 40)
- Colonoscopy (for those above the age of 50)
Other than this, certain radio-imaging tests such as ultrasound scan, Computed Tomography etc.
After the evaluation, when the donation is approved, the surgery is performed. After the surgery, the donor has to stay in the hospital for seven days. The total recovery is around four to six weeks.
Best Liver Transplant Hospitals in Turkey
Here is a list of some of the best hospitals in Turkey for liver transplant:
Memorial Hospitals Group
Memorial Sisli Hospital is one of the largest multi-speciality hospitals in Istanbul. It is also the first hospital in Turkey to get accredited by the Joint Commission International (JCI), which ensures standardization in quality treatment. It is widely known for surgeries related to organ transplantation and claims a success rate of up to 90 % in most of the cases. Several patients from as many as 92 different countries visit the hospital each year.
To read more about the hospital, click here.
Acibadem International Hospital
Acibadem hospital is situated in Turkey. It is one of the largest hospitals in turkey with a 118-bed facility. It has 11 different hospitals under the group. The hospital is well-equipped with examination rooms, dialysis units, well-armed Intensive Care Units, and emergency observation units. It also has a specialized International Patient Centre, which is a “one-stop” centre for all kinds of queries of international patients. The doctors and other medical staff are well-versed in several languages like English, French, Spanish, Arabic etc.
Please click here to have a look at the hospital profile.
Medicana Hospitals Groups
The Medicana group of hospitals is a renowned healthcare organization known for meeting a maximum number of standards of treatments. It has nearly 12 clinics under the group and works with nearly 3500 medical professionals. The hospitals are well-equipped with modern equipment and experienced medical staff. It is known to meet the quality standards of the Turkish Ministry of Health and the Joint Commission International (JCI).
Read more about Medicana Hospitals Group.
Liv Hospital Ulus
The hospital is built in the city centre, spread across the area of 30,000 Square meter area. It has wide access to advanced diagnostics equipment and infrastructure, which makes sure that the patient gets the advantage of accurate diagnosis and precise treatment. LIV is also one of the first organizations outside the US, which is granted as The Center of Excellence Accreditation. The hospitals have great connectivity to most of the areas in the city. There is an ample number of options to stay at reasonable prices.
Have a look at the hospital’s profile.
Florence Nightingale Hospitals
Florence Nightingale hospital has been at a leading position since 1989. It has a record of 70,000 inpatients and 250,000 outpatients each year. Not just this, it has a capacity of 804 inpatient beds and 141 ICUs along with 40 surgery rooms. The hospital is also accredited with the Joint Commission International and has partnerships with some of the most prestigious medical institutions in the United States of America.
Click here to know more.
Best liver transplant doctors in Turkey
Dr. Alim is an eminent specialist for liver and kidney transplant, who has been practising for more than 17 years now. He is an expert in performing surgeries both in adults and children. He has received many awards and also attended several vocational training, courses, and congresses.
Dr. Kamil is a general surgeon and an organ transplantation specialist, practising for nearly 28 years now. He received awards such as TUBITAK gold medal in chemistry. He takes an interest in research and has published 28 articles in SCI-Expanded journals and over 100 articles in Turkey.
Dr. Koray Acarli is an overall experience of more than 33 years. He completed his education in 1981 and attended numerous conferences and seminars that include 37 National and International panels, Congresses and Conferences as Panellist and 6 National and International meetings as Moderator. He is also a member of 10 journals, associations and foundations.
How does Vaidam Health help you in getting the best treatment in Turkey?
Vaidam Health acts as a digital mediator helping you to get an accurate treatment in Turkey with a pleasant experience. Right from choosing the hospital and the best doctor to the drop off to the airport before you leave back to your home, Vaidam is here to assist you for everything. The patients need to post a query on the website, and they receive a call back by a case manager. Thereafter, the case manager will assist in everything.
Other than from accommodation options in the country, we also help in visa application, pick up and drop from the airport and keep a tab of all the recreations that you require on your medical tour to Turkey.