Referral and Evaluation:
At the time of the application or referral of a patient for liver transplant the transplant coordinators will collect the patient’s physical information, past medical history and results of any previous diagnostic tests and treatments as well as a description of his or her current condition and legal paperwork. A transplant evaluation will be scheduled for the patient, which will include;
Laboratory tests, including blood and urine tests to assess the health of donors and recipients organs, including the liver
Recipient: Hemogramm, Coagulation, Biochemistry, Liver Function tests, Kidney Function Test, Lipid Profile, Tumor Markers, Viral Markers,Metabolic and Vitamin, Endocrinology
Donor: Hemogramm, Coagulation, Biochemistry, Liver Function tests, Viral Markers, Metabolic and Vitamin, Endocrinology, Kidney Function, Lipid Profile, Tumor Markers,Viral scanning, Uriner tests
Radiological imaging tests, such as an ultrasound of donors and recipients liver
Recipient: Liver Vascular Doppler, CT& Angio CT, MRI, Breast USG or Mammography (if female)
Donor: CT&CT Angio, MRI, MRCP, ECG, Chest X- Ray, Liver Bx, Breast USG or Mammography (if female)
A general health exam, to consult donors and recipients overall health:
Infection Diseases and Microbiology
Supplementary consultations and interventions, necessary following all the examinations and imaging.
Recipient over age 40: Gynecology or urology, endoscopy and colonoscopy
Donor over age 40: Gynecology or urology, endoscopy and colonoscopy
Psychological evaluation to determine whether donor and recipients fully understand the risks of a liver transplant
In ACIBADEM Liver Transplant Center all liver transplants are done in an orthotopic fashion, that is, the native liver is removed and the new liver is placed in the same anatomic location. The transplant operation can be conceptualized as consisting of the hepatectomy (liver removal) phase, the anhepatic (no liver) phase, and the postimplantation phase. The operation is done through an incision in the upper abdomen. The hepatectomy involves division of all ligamentous attachments to the liver, as well as the common bile duct, hepatic artery, hepatic vein and portal vein.
The donor’s blood in the liver will be replaced by an ice-cold organ storage solution, until the allograft liver is implanted. Implantation involves connections of the inferior vena cava, portal vein, and hepatic artery. After blood flow is restored to the new liver, the biliary connection is constructed, either to the recipient’s own bile duct or to the small intestine. The surgery usually takes between five and six hours, but may be longer or shorter due to the difficulty of the operation.
Life after transplant involves continuous follow-up by a physician as well as certain measures to more easily adapt to daily life. The recipient would need follow-up outpatient visits to ensure his or her general health and the functioning of the transplanted organ. These follow-up visits get less frequent over time and the recipient can reach the transplant center via telephone or internet anytime the patient has a concern or question. The donor would get a physical examination prior to discharge from the hospital to ensure his or her general health and the functioning of the remaining organ. First follow-up visit would be in 6 months and then annually. Mindful physical activity, healthy and balanced nutrition, general hygiene and preventive measures for infections are important for organ recipients.