What is liver and what vital functions does it perform?
Liver is an azygos organ located in the abdominal cavity in the area of the right hypochondrium; it is the biggest gland in the human body, its weight is about 2.5% of the body weight of an adult, that is about 1,5 kg.
Detoxication, synthesis of the most important protein substances of blood, glycogenesis, bilification is carried out in liver. Liver is involved in lymphogenesis, it also plays an essential role in metabolism
The most important functions of liver:
- bile production (circa 600 ml a day);
- detoxication and elimination of excessive agents (hormones, vitamins), of metabolic-waste products;
- hormones level regulation (e.g.: aldosterone, epinephrine (adrenaline), estrogen, insulin);
- participation in digestion;
- conversion of ammonia into urea;
- energetic reserves storage (glycogen);
- carbohydrate metabolism;
- accumulation, storage and delivery of certain vitamins;
- participation in vitamins metabolism (folic acid, А, С, В, D, К, E, РР); conversion of carotene into vitamin A;
- lipid, cholesterol synthesis, lipid metabolism regulation; fat energy restoration;
- synthesis of ferments, hormones which participate in food transformation;
- detoxication of endogenous and exogenous agents (alcohol, toxins, drugs);
- participation in immune functions;
- an important role in blood circulation;
- thermoregulation of body;
- plasma proteins and blood-coagulation factors production.
If liver stops orderly functioning, this leads to imbalance of functions of the whole organism:
- Disorder of the digestive function of the liver leads to reduction of the secreted bile amount, its profile changes and, as a result, the fat breakdown in the gastrointestinal tract is delayed and its absorption is interrupted. The main manifestations are diarrhea and flatulence. Nutritional substances malabsorption leads to metabolic alterations which are followed by weight loss or even cachexia.
- Disorder of the detoxicative (decontaminative) function of the liver leads to penetration in blood of toxic agents, both those coming from outside and those formed in the large intestine under the influence of microflora (indole, phenol, skatole). The listed above substances involve an irreversible damage of the central nervous system that is liver encephalopathy.
- Disorder of liver synthetic ability is followed by albumin synthesis inhibition, albumin being the most important plasma protein. Furthermore, production of blood-coagulation system proteins is reduced. Reference is made to hemostatic derangements where even a minor injury leads to a prolonged bleeding.
Liver disorders are virulent because of the fact, that without the necessary treatment they become chronic and irreversible and lead to the ulterior functional abnormality. Despite all the achievements of modern medicine, some liver disorders from time to time won’t respond to treatment. Sometimes in event of severe liver pathologies the only treatment option is a liver transplantation.
Different diseases and pathologies may serve as indications for liver transplantation:
- Oncological diseases. It should be specified that liver transplantation in case of cancer is indicated when the tumor is located only in liver and the metastases are not defined in other organs.
- Acute liver failure — e.g., as a result of intoxication.
- Severe viral hepatitides (except of hepatitis A).
- Hemochromatosis — a metabolic disturbance, in which iron begins to deposit oneself in liver cells and interferes with its normal functioning.
- Liver cirrhosis in advanced stages, especially if there is a risk of liver coma.
- Wilson’s disease — a disease, in which liver and some other internal organs are affected because of metabolic disturbance.
- Cirrhotic form of cystic fibrosis.
- Congenital malformations, etc.
Absolute contraindications for liver transplantation:
- uncorrectable dysfunctions of vital organs (heart, lungs, central nervous system diseases)
- infection process outside of liver (tuberculosis, HIV-infection, etc.) or any other treatment-resistant systemic or self-limiting infections
- oncological diseases of extrahepatic location
- malformations incompatible with a long-term life
- psychological non-readiness of the patient, his lack of understanding of operation nature, its necessity, risk and estimates
- active alcoholism
Relative contraindications are as follows:
- patient’s age over 60 years old
- liver and bile ducts operation made earlier
- portal vein thrombosis
- active replication of hepatitis B virus
- lack of psychological support of the patient on the part of his immediate relatives
What does a liver transplantation represent and what stages does it consist of?
Donor selection stage
A donor should comply with a number of requirements:
- age between 20 and 55 years old;
- blood group compatibility with the recipient’s blood group;
- lack of liver damages and pathologies;
- good general state of health.
A personal assistant supplied by Remed Assistance will welcome you at the airport, accompany you to the hospital and do the necessary translation in order to guarantee a worry-free medical trip experience in Turkey.
Preoperative stage and diagnostics
Currently, a part of an organ, taken from a healthy and living relative of the patient, is being increasingly used. Before the liver transplantation operation, the recipient and the donor undergo an extensive examination that includes as follows:
- Laboratory examination, by means of which the blood group, blood-coagulation factors, biochemical values, presence of hepatitis viruses and human immunodeficiency virus (HIV) is determined.
- Computer tomography, by means of which an image of liver is created, as well as is determined its size and form.
- Doppler ultrasonography, by means of which the state of liver blood vessels is determined.
- Electrocardiography and echocardiography – help to control the state of heart.
- Spirography, by means of which the lung function is determined.
- Psychologist consultation, etc.
In case of identification of any specific health problems, some additional examination methods may be assigned.
Liver transplantation from a living donor, especially from a relevant, is considered to be the most preferred version.
The liver transplantation operation is very complicated. First of all, the surgeon excises the affected organ together with the fragment of vena cava, blocks the blood vessels that nourish liver. After that, instead of the excised liver there shall be transplanted a part of a donor liver (in case of liver transplantation from a living donor). The surgeon reconnects the blood vessels in order to recover the organ’s blood supply. At the final stage the surgeon recovers the biliary ducts. The gall bladder won’t be transplanted into the patient’s body. A special device is used to remove blood and liquid from liver. Drainage tubes are inserted into the abdominal cavity and are left there sometimes for several days. A tube is inserted into the biliary duct of the patient in order to remove the gall. Very important for the doctors are both the volume of the effused gall and its color. It can be yellow or green. Sometimes the tube is left in the already endured organ for several months.
The whole operation lasts for circa 8 to 12 hours and involves a whole team of specialty doctors.
After liver transplantation, the patient usually stays for circa 2 to 5 days in the intensive care unit, and averagely in 15 to 20 days, under favorable postoperative period progress, is discharged from the in-patient department. Beginning with the post-transplantation day, the patient starts taking specific drugs – immunosuppressors – lifelong, in order to prevent a donor organ rejection. Every two weeks the patients visit the transplantation center to deliver medical tests and to carry out an abdominal ultrasonography.
Liver transplantation in Turkey
The transplantation issues in Turkey are settled in terms of legislation. The international patients in Turkey are allowed to transplant liver from living relative donor.
The advantages of treatment in Turkey:
You may get recommendations and treatment plan from the medical specialists of the top clinics of Turkey, as well as an alternative opinion regarding the provided or only assigned treatment from the medical specialists of the top clinics.
The advantages of treatment in Turkey are: top-class medical treatment and reasonable prices.
The clinics of Turkey work in accordance with global standards using the best practices of collegues from Europe and USA as well as their own unique experience. Turkey is among the countries that are top requested for treatment.
The citizens of a series of countries are attracted by reasonable prices and a high treatment level in Turkey.
In turkish clinics a psychological comfort and a real kindness of all the medical personnel is guaranteed to the patients.
Departure from airport
You will be accompanied to the airport by a personal assistance. By provided flight authorization and medical report, you will take your flight to home!
After your return, Remedhealth.com agents will be available for any future request.