Organ transplantation is a medical procedure in which an organ is removed from one body and placed in the body of a recipient, to replace a damaged or missing organ. The donor and recipient may be at the same location, or organs may be transported from a donor site to another location. Except for the heart transplantation, a significant part of the transplantation can be performed from living donors to recipients.
Liver, kidney, pancreas, small intestine, and heart can be taken from the cadaver and transplanted to the patient.
In Turkey, 75-80% of organ transplants are carried out using the healthy organs obtained from living donors. In such transplantations, a person who is completely healthy is operated and a part or half of the organ is taken. Although this is an undesirable situation, we have to do it to keep people alive, but there is a reverse situation in other countries. The organ transplantations from living donors and cadavers (dead people) are at the rate of 25% and 75-80%, respectively, and these are the differences between transplantation process in Turkey with the process in Europe and in the USA. However, as long as the transplantations are done in good hands, there is no statistical difference between the success rate. Organ Transplant Surgery in Turkey is performed with modern technology and techniques. In 2017, a total of 4860 organ transplantations were performed in Turkey, and 4536 of them were Turkish citizens, and 324 of them were foreign nationals.
Organ transplantation operations are important and sensitive operations; however, with modern surgical technology and techniques, transplantation operations can be completely safe and non-bleeding. For instance; with laparoscopic surgeries (closed surgeries), people continue their normal lives after 1 week or 10 days; In terms of daily life, they never have any physical obstacles.
Who can be organ donors?
According to the regulation of the Ministry of health, organ transplantations can be done among relatives till fourth degree. With the approval of the Regional Ethics Committees, organ transplantations from non-relative donors may also be done. In terms of organ transplants, donor changes which are called as cross-transplantation can also be done within the legal framework. The health institution chosen for transplantation is important. In order to perform organ transplantation in a hospital, the center should be at a high level of service. Organ transplantation is not only a process related to surgery. For the pre and post processes of organ transplantation, it is very important to ensure the collaboration of the polyclinics, laboratories, imaging units, and many clinics. You can be a very good surgeon, you can have a very good anesthesia team, your operating room conditions can be great, but that doesn’t always mean you’ll get successful results. Organ transplantation is a multidisciplinary study. Therefore, only the health institutions that have completed this study can apply organ transplantation.
Today, kidney, liver, heart, lung, pancreas and small bowel transplantations are successfully performed. There are currently a total of 24 787 patients waiting for organ transplants in Turkey, and 87% of these patients are waiting for kidney transplantation and 9% are waiting for liver transplantation.
Organ donation and transplantation in Turkey is carried out within the framework of the laws, regulations and the legislation of the Ministry of Health.
If the cadaver will be used in organ transplantation, the time passed between the remove of the organ from the cadaver and the transplantation is very important. There is more time for kidney transplantation operations compared to other organs. It is allowed to pass 36 hours between the rescue and transplantation of the organ. A liver should be transplanted within 8 to 9 hours. Later, the hospital conducts a number of tests to ensure that the organ transplantation does not adversely affect the patient’s health status. The patient takes a few medications before the operation. Since they suppress the body’s natural immune response rejecting the foreign organs, so they are called immunosuppressive drugs.
In kidney transplant operations, the patient’s own dysfunctional kidneys are usually left in the body. The donated organ is transplanted into the lower abdomen and then attached to the main blood vessels in the pelvis. The ureter is sutured to the bladder to allow the urine to flow out of the new kidney.
The liver is completely removed during transplantation. The transplanted organ may be a part of a liver or a complete liver. Partial organ grows into the original size within a few months. The donated organ is placed in place of the removed organ and then the blood vessels and bile ducts are connected.
Last month with the last transplantation, Inonu University Turgut Ozal Medical Center Liver Institute in Malatya was on the first rank in Europe and second rank in the world. The institute which has started to the liver transplantation 15 years ago, performed 747 transplantation in the first 10 years and performed its 2017th liver transplantation at 27/8/2017. It is on the first rank in Europe and second rank in the world according to the number of annual liver transplantation.
First lung transplant operation in Turkey was performed to a patient with lung cancer in 2009. With the first successful lung transplant in Turkey which was performed by the team under the presidency of Prof. Dr. Cemal Asım Kutlu, Turkey’s name was among the few countries that perform successful practices in this area. Successful lung transplantations continued to be performed in later years. According to a statement of the Organ Transplantation Department of the Ministry of Health, 42 lung transplantations were performed in Turkey in 2017.
Heart transplantation is a process of replacing the patient’s dysfunctional heart with a healthy human heart. After the development of brain death, healthy heart received from people whose organs have been donated is transplanted to the recipient patients who had previously been decided to have a heart transplant.