General information and epidemiology
• The final and usually curative treatment for cirrhosis and all its complications is liver transplantation.• Liver transplantation is ideally performed from a suitable cadaver. However, since there are not enough cadavers, transplantation can be made from living beings. For this purpose, an anatomically appropriate part of the liver is taken from the donor and attached to the patient (split liver).
• MELD score is preferred over Child score for liver transplantation indication and priority.
• There is a risk of recurrence in cirrhosis due to viral hepatitis, therefore, post-transplant viral load-suppressing treatments are applied to the patients.
• In patients who underwent liver transplantation due to alpha-1 antitrypsin and Wilson's disease, recurrence of the disease is not observed after transplantation.
• Liver transplantation can be applied in non-metastatic hepatobiliary tumors.
• While hepatic vein thrombosis is an indication for liver transplantation, portal vein thrombosis is a relative contraindication for liver transplantation.
Transplantation indications
• Advanced liver cirrhosis (having one of the following)MELD score > 15
sign of decompensation
Child C or selected Child B cirrhosis
• Symptoms and complications that do not respond to medical treatment in chronic liver disease
• Criteria hepatocellular carcinoma confined to the liver
• Acute fulminant liver failure
• Budd-Chiari syndrome unresponsive to medical treatment
• Primary sclerosing cholangitis with recurrent infections
Liver transplantation contraindications
