Frequently Asked Questions About Liver Transplantation

For the human body to function perfectly, many organs must work together in harmony. The heart pumps blood, the lungs transfer oxygen (O₂) into the blood and remove carbon dioxide (CO₂), the kidneys filter toxins and waste from the body, and the liver performs numerous biochemical reactions like a central laboratory—these are just a few examples of vital functions.

All of these organs, along with many others, work in coordination to sustain life—in other words, to keep the brain alive. Although the brain acts as a central control system, most organs perform the majority of their functions independently. In other words, while they operate collectively on behalf of the human body, each also maintains its own individual activity.

When any of these organs malfunction, diseases occur. If the dysfunction becomes irreversible or untreatable, it begins to pose a threat to life. As the loss of function progresses, life itself gradually comes to an end.

At this stage, a person can only survive with a new organ. If the affected organ is the kidney, the patient may spend the rest of their life dependent on dialysis machines. However, if the failing organ is the heart or liver, the person’s life is in serious danger. If a suitable organ is not found in time, unfortunately, all such patients eventually die.

Organ transplantation is currently the only treatment method that allows these patients to survive. Although research in areas such as genetic therapy and stem cell transplantation continues rapidly, it remains uncertain to what extent these developments will influence treatment programs in the near future.

No! In organ transplantation, tissue and organ compatibility is essential. Just as not everyone’s blood can be given to everyone else—and specific blood groups must be matched—the same principle applies to organ transplants. Since compatibility criteria vary depending on the organ to be transplanted, if these principles are ignored, the recipient’s body will perceive the transplanted organ as a foreign substance and reject it.

Especially since the 1960s, with the introduction of immunosuppressive drugs into medical practice, transplantation procedures have advanced rapidly. Even with all known tissue compatibility factors matched, the body still tends to recognize and reject a foreign organ due to many factors that remain unknown today. These medications help “trick” the immune system into accepting the transplanted organ. However, they cannot completely eliminate the need for tissue compatibility. Therefore, a successful transplantation requires both a compatible organ and a well-managed immunosuppressive therapy.

No — they cannot be sold. When a deceased person’s organs are donated, a coordination system is activated. Under this system, donated organs are reported to the Ministry of Health’s Regional Coordination Center (RCC) and then to the National Coordination Center (NCC). The allocation of organs to centers is determined based on these reports. In this way, every donated organ becomes a national resource and may only be transplanted into a recipient approved by the system. Within such a system, no one’s organ can be sold to someone else for money in secret.

The system is too complex to escape internal controls and requires a large team. There are so many people involved in the process that any attempted sale would be impossible to conceal. Therefore, abuse is essentially unimaginable in the case of deceased-donor organ donations. In fact, there are no recorded legal cases of such abuse. Abuses in living-donor transplants cannot be hidden either; they are carried out using legal loopholes and in ways that are already widely known.

This information is never sufficient to be used for transplantation. Apart from a few identification details that simply express the person’s intent to donate, it contains no medical or health-related information.

There is no difference. Although it is often discussed and causes confusion, human death occurs in only one way—and that is what we call brain death. A person who has not experienced brain death is not considered dead, even if their heart and all other organs stop functioning. During bypass surgeries, for example, patients’ hearts are stopped for several hours, but because their brains remain alive, they survive and their hearts are restarted after the operation. Conversely, in a person who has died (i.e., experienced brain death), other organs—including the heart—may continue to function for two or three days. It is the brain that determines life or death. If the brain is alive, the person is still alive. If the brain has died, the person is dead. The most important indicator of this condition is breathing. When breathing ceases, life ends, and this has nothing to do with whether the heart is beating. Interestingly, contrary to common belief, in our religion and in Sufi philosophy, death is symbolically associated with breath, not with the heartbeat.

As their names suggest, one represents life and the other represents death. A vegetative state, as the term implies, is a condition of living like a plant—the person is alive but has impaired brain functions. Although they may appear lifeless, they are fully alive and, in rare miraculous cases, may recover and regain consciousness even after many years. Brain death, on the other hand, signifies complete and absolute death, and as we all know, death is an irreversible condition.

Known in the West as "Donor Action," these organizations are established to increase the availability of cadaveric organs in the country.

The inability to perform transplants due to the lack of available organs is not only a problem in our country but a global issue. However, in terms of scale, the situation in our country is unfortunately disastrous. While the number of cadaver donors found annually per million people in European countries ranges between 35 and 55, this number is less than one in our country. This clearly shows how far we still are from solving the problem.

For this reason, similar organizations based on Western models have recently started operating in our country as well. The main goal is to save the lives of those who are forced to die while waiting, simply because suitable organs cannot be found.

The life of human organs and the life of a person are two different things. When patients lose one of their vital organs due to a chronic illness—provided that organ is not the brain—they can only survive for a limited period of time. During this period, the only way for them to recover is through organ transplantation. The diseased organ is replaced with a healthy one, and the patient returns to a normal life. If an organ cannot be found, the alternative for these patients is death. Although dialysis allows kidney patients to survive, their quality of life is difficult, and their lifespan is significantly shorter. In no other branch of medicine will you find such a striking contrast between life and death. In organ transplantation, a successfully performed transplant means a completely healthy patient, whereas failure to transplant results in loss of life.

The removal of organs from a cadaver is performed with the same level of care as any surgery on a living person. After the organs are removed, the body is sutured—preferably with aesthetic stitches—to ensure that no harm or disfigurement occurs. For the physicians who deeply understand the value of these organs, those bodies are sacred and deserve the utmost respect.

No, there isn’t. Although the donor’s age may pose certain risks depending on the organ to be used, for recipients whose illness is advanced and life-threatening, it may be possible to use organs of any age and condition.

Yes. It is sufficient to inform your family members, who will be the ones to decide on your donation when the time comes. Even if you have an organ donor card, your organs cannot be taken without your relatives’ consent.

Today, major organ transplants such as the heart, lungs, intestines, pancreas, kidneys, and liver are successfully performed worldwide. In addition, tissue transplants such as bone marrow, cornea, bone, and tendon have also found wide application. In our country, among major organ transplants, heart, liver, pancreas, and kidney transplants are the most common and successfully performed procedures.

That is absolutely not possible. The priority is always to save the patient’s life. The doctors and staff in the emergency room have no connection whatsoever with the organ transplant team. Their sole duty is to save the lives of the patients who come to them. They work in large, coordinated teams where everyone is aware of each other’s actions. Only after the patient has passed away does a separate system within the hospital notify the organ transplant teams. These teams cannot take any action before death occurs. Moreover, since organ retrieval requires family consent, if the relatives are not satisfied with the medical treatment provided, they are unlikely to agree to donation.

Organ transplants in our country are performed at world standards—and even exceed them in some cases. In major organ transplants such as liver and kidney, success rates are over 90%.

Questions such as “Is organ donation a sin?” and “If the person who receives a donated organ lives as an immoral person, will the donor be held accountable for those sins?” are among the most frequently asked at organ transplant centers.

According to Prof. Dr. Mehmet Bayraktar, Member of the High Council of Religious Affairs of the Presidency of Religious Affairs and Faculty Member at Ankara University Faculty of Theology, the answer is as follows: — “Islam views organ donation positively. In the Surah Al-Ma’idah, it is stated: ‘Whoever saves one life, it is as if he has saved all of mankind.’ From this perspective, donating an organ to save someone’s life is considered a virtuous act. Moreover, it is not the organs but the people who commit sins. Therefore, the donor of the organ is not responsible for the sins committed by the recipient.”

(SBK – As we all know, religion in Islam is associated with reason. A being without consciousness cannot bear sin. The organs transplanted between people belong to the body, which is merely a physical vessel—like clothing—and remains in this world. Just as when you give charity to a needy person, the responsibility for how it is used belongs to the recipient, both sin and virtue belong to the person possessing reason. Just as a weapon cannot be blamed for a murder committed with it, the physical body—our worldly garment—cannot bear responsibility. It is a gift you give; any future sin lies solely with the person who consciously chooses to act upon it.)

You can absolutely do so. Although cadaveric organ transplants are generally more ideal, the high number of living-donor transplants in our country has led to significant accumulated experience. Within this framework, the rate of health complications among those who donate an organ or part of an organ to a relative is very low in our country.

There are not yet sufficient laws on this matter. Problems related to hospital administration and the expenses of donors can still occur. Although the general practice is for the hospital administration to waive the donor’s expenses after the donation, issues may still arise in practice because this process largely depends on goodwill rather than strict regulations. The family of a patient whose organs have been donated never receives any payment.