Turkey's liver transplants are changing lives beyond borders

Ala Mohammad Abdellatif  Qadomi, a 35-year-old Jordanian lecturer at the Hashemite University, felt very tired and exhausted at work back in 2013.  

Her sickness was diagnosed as primary sclerosing cholangitis + Celiac + Ulcerative colitis in medical terms. In other words, she was suffering from cirrhosis, which eventually stops the liver from functioning, leading to death. 

“My body colour began to become yellow, my face was very pale, my bones became weak and my blood was always decreasing,” Qadomi remembers. She stayed admitted in hospitals to prevent blood loss and to relieve other symptoms. 

But in May 2019, her condition worsened as the cirrhosis advanced, sending her to the emergency room in Jordan University Hospital. 

“They [doctors] told me that my life had become in danger and that I was in urgent need of a liver transplant, so Dr Tariq Al-Tamimi and Dr Yasser Rayan advised me to contact Professor Dr Yaman Tokat in Turkey,” Qadomi tells TRT World. 

She started searching for Dr Tokat's name through the Internet and contacted Istanbul’s Florence Nightingale Hospital, where Dr Yaman had been working since 2005. He now works at his own International Liver Transplant Center based in Fulya, a neighbourhood in Istanbul’s Besiktas district. 

Tokat has been recognised as one of Turkey’s finest liver transplant surgeons, gaining worldwide fame. In 1994, he executed Turkey’s first successful liver transplant operation with the patient living ten years post-operation. Before him, Turkey had had liver transplants, but patients did not survive for long after.

From 1994 to 1997, Tokat’s team had conducted ten back-to-back liver transplants —  each one showing successful results, making him a household name in Turkey. 

Under Tokat’s leadership, Turkey’s first successful deceased donor liver transplant (DDLT) program was established in 1994 in Izmir. Five years later, he also established the first live donor liver transplantation (LDLT) program in the Ege University in Izmir. 

From Jordan to Turkey

“He [Tokat] told me that he will come to Jordan in June 2019 for a medical conference. Then, I went to meet him. He saw my medical tests, CT [computerised tomography] scan and MRI [Magnetic resonance imaging].”

Tokat advised her that she was in dire need of a liver transplant, and soon, if she wants to live. 

Tokat’s method starts with the first interview where he meets his patient, as he met with Qadomi in 2019.

“Back in the day, one of my teachers [hoca in Turkish] asked me when I should begin planning for an operation. [Then, he made a wrong reply]. The right answer is when you see your patient. As soon as you see your patient, you start planning the operation,” Tokat says.  

“If you do enter a surgery without planning, you might lose your way,” he tells TRT World. 

Qadomi followed Tokat’s advice, travelling to Turkey in September 2019 to get treatment under Tokat and his team. After all necessary medical tests, her liver transplant operation was set for October 1, 2019, after Qadomi’s “dear aunt” was chosen to donate part of her liver to her niece. 

“Every transplant operation is a kind of adventure. You never know what you will confront during any operation. As a result, you have to do very good pre-surgery planning,” says Tokat, a native of Turkey’s western province of Izmir. 

Qadomi’s liver transplant operation took 10 hours and she stayed in the hospital for 23 days after the operation. 

“As soon as I woke up from the liver transplant operation, my yellow body color began to change gradually to normal,” she recalls.

“I began to feel life, and I began to sleep, move, jog and exercise without feeling any pain or fatigue. I went back to my work full of activity, vitality and hope. My friends could not recognise me when I returned to Jordan and were astonished because of the notable and great improvement that happened to me,” she says. 

Professionalism

As a Jordanian, she was impressed with Turkey’s advanced liver transplant industry and its medical professionalism. 

“I did not expect to see this [much] progress and the great medical attention in Turkey. I was afraid at the beginning, but all this fear disappeared as soon as I saw the high-class treatment of doctors, nurses, translators and hospital workers,” she says. 

Since the 1990s, Turkey has taken leaps in the liver transplant industry, where the country is now counted among the top three countries in the world in terms of recording the most liver transplant operations along with India and South Korea. Every year, Turkey completes as many as 1,400 to 1,500 liver transplant operations. 

Turkey’s success rate is also quite high in terms of live donor liver transplantation (LDLT), reaching 80 to 90 percent, according to Tokat. With the help of the Turkish health ministry, which accelerated its support to the industry in 2010, 49 liver transplant departments continue to operate across the country with varying degrees of success. 

Still after a year or so, Qadomi, remembers all the names of the people who played a crucial role in helping her heal from her sickness, and she recounts them one by one. She names Dr Birkan Bozkurt, Dr Sadik Server, Dr Ayfer Serin, Dr Ender Anilir, her nurse Ayse Gole, Tokat’s international coordinator Hilal Demircan and the translator Ibrahim Metehan among many others, she says. 

But her particular thanks go to Tokat. She could not forget his words leading up to the operation. 

“Do not be afraid, ‘my daughter’. The operation of the liver transplant will take place and will be successful,” Tokat told her, prior to the operation, she recalls. 

Tokat has earned the reputation of being a fearless surgeon. Since 1994, he has done more than 1,500 liver transplants. He once performed 143 surgeries in a year, Tokat recalls. 

“He is a great doctor, compassionate, distinguished, and supportive. He always follows his patients himself, with high accuracy and great confidence, so that until this moment he is following me while I am in my country as if I am in Turkey and even more,” she says. 

“You will not do an operation, which you would not do to any of your relatives or lovers,” Tokat explains.

“In medical sciences, the first rule is primum non nocere, a Latin phrase, which means ‘first, do no harm’. But I believe that this ethical understanding of ‘You will not do things which you would not allow others to do to you’ carries even more importance than anything else,” he says.