Turkish Memorial Health Group is among the best transplant sites in the world
There is nothing more noble than donation. To give a part of yourself to another, or in a moment of unbearable grief for a loved one, to give life through them - this is the ultimate heroism. Yet it is only one of the steps necessary to save a human life. The others depend on the level of development of transplantology in a given country, the specialists and the technology used.
In Bulgaria, between 1000 and 1200 people are currently on the waiting list for transplantation. It is difficult to give an exact number as it changes almost every day. The largest number of people waiting for a kidney transplant is over 960. Over 40 need a new liver, 29 a new heart, 18 a new lung, 8 a pancreas, 1 a small intestine. But waiting in Bulgaria could cost these people their lives. Although the number of transplants has been increasing little by little in recent years, many factors are preventing them from becoming more widespread. This is why more and more Bulgarians are choosing to go through the process abroad.
The problems of transplantation in Bulgaria
Donation has not yet sufficiently established itself as a practice in our country. Statistics show that nearly 80% of donation situations remain unrealized, the main reason being the refusal of relatives to donate the organs of a deceased person. Less than 40% of Bulgarians, on the other hand, state that they would donate their organs, which puts us in the last five EU countries in this indicator. The number of organ donors in Bulgaria is about 20 per year, while in countries such as Belgium, Austria and the Netherlands, which are close in population to us - over 200. There is a lack of awareness in society, which makes it more difficult to convince it of the importance of the cause. Equally important, however, are the overall organisation and logistics of our health system, on which there is still much to be done. The development of emergency care in our country cannot boast of any particular results. Few hospitals in the country are actively committed to being donor bases. For years the bases themselves operated at a loss and conditioned patients with their own funds. To this day, the problem of insufficient funding for them remains. And from this follows logically the impossibility of using the most advanced technologies that reduce the risks of complications in transplantation.
Medical tourism
Given all these circumstances, it is no wonder that many Bulgarians choose to continue their struggle to live abroad. In the last 10 years, nearly 300 transplants of Bulgarian citizens have been performed abroad. Some are lung and pancreas transplants, which are simply not done at home. Most, however, are kidney transplants.
Where do Bulgarians most often choose to go? To Turkey - the undisputed leader in transplantation in the Balkans and one of the best examples of a working model in the world. In recent years, the country has introduced a number of improvements in its healthcare system and especially in the organisation of organ transplantation. World-renowned specialists work there with some of the latest methods and technologies, and all international requirements are observed. The quality of services exceeds that of Western European countries and is close to that of the US. At the same time, the price is at least 2-3 times lower, which makes the procedures accessible to people with more modest financial means.
In Turkey, nearly 80% of transplants are performed from living donors. The country is second only to the USA in performing liver and kidney transplants. Nearly 30,000 transplants are performed each year in the US, of which - 17,000 are kidney transplants and 6,000 are liver transplants. In Turkey, there are 15 000 kidney transplants and nearly 1200 liver transplants. In Russia, the total number of transplants per year is only 1,500, of which 1,000 are kidney transplants. In Bulgaria, on the other hand, only 74 transplants were performed in total in 2015, including 51 kidney, 16 liver and 7 heart transplants, according to the Executive Transplant Agency.
"Memorial - the Turkish champion in transplantation
Organ transplants can only be performed in medical centres offering the highest level of services. These are not simple operations, but lengthy processes for which coordination between hospitals, laboratories, imaging departments and many other units is important, as well as careful studies and case studies.
The good news is that there is such a centre very close to Bulgaria. As already mentioned, Turkey is a global leader in transplantology. In the country itself, the leader in the field is Memorial Health Group, Known worldwide for its chairs in IVF, cardiovascular surgery, cancer and more. "Memorial is the first healthcare group in Turkey to receive JCI (Joint Commission International) Quality Accreditation. Under its umbrella are 11 hospitals in Istanbul, Ankara, Antalya, Diyarbakir and Kayseri. It is "responsible" for introducing a number of innovations in Turkish healthcare and is visited by patients from over 92 countries, including Bulgaria, every year.
The Organ Transplant Centre "Memorial" is located in Istanbul and is cited as a reference in the world, especially for liver and kidney transplantation. It performs 234 liver transplants, 352 kidney transplants and 156 bone marrow transplants per year. The success rate of the interventions is 98%. The Turkish center is headed by the world-renowned Professor Munji Kalayoglu, who has performed over 45,000 operations in his career, including over 2,000 liver transplants. And despite his 70 years, he currently runs the general and pediatric surgery departments in parallel. His deputy is Professor Koray Azharli, who is called the doctor "with golden hands". His practice includes over 115 liver and 155 kidney transplants as well as 3 pancreas transplants.
The achievements of these and other specialists in "Memorial" speak for themselves. It was in one of these hospitals that, for the first time in the world, a 7-kilogram baby underwent a simultaneous liver and kidney transplant. Again in a health group Memorial Turkey's first pediatric liver transplant in the presence of blood incompatibility. These successes and the overall high quality also lead many young doctors from Europe and the USA to come for training in Turkish clinics, especially when it comes to living donor organ transplants.
Types of transplantation
Kidney transplants are also the most frequently performed transplantation in Turkey, with great success in transfers from regular donors and from donors with incompatible blood types. In this segment, the most famous specialist is Professor Burak Koçak. Doctors from "Memorial" have introduced a unique technique for transplanting a kidney from a living donor in a bloodless way - with laparoscopy. Dr. Koçak is the second surgeon in Turkey to apply this method. In laparoscopic surgery, an incision is made in the patient's body in the form of small holes in the abdomen. A camera is inserted through one of the openings, allowing the surgeon to observe the procedure; various surgical instruments are inserted through others. This method has become widespread throughout the world in the last 10 years. It is more acceptable to patients because it leaves minimal, almost invisible scars. Donors can walk and start drinking water in the evening on the day of surgery, and can eat and shower the next morning. They can also return home two days after the intervention. After about two weeks, both donor and recipient are back to their normal way of life.
The Organ Transplant Centre "Memorial" have long practiced virtuoso liver transplants from both deceased and living donors. The technology is so sophisticated that surgeons perform the operations successfully even if the donor and recipient have different blood types. So in 2007, 14-year-old Mohamed Izaadeen was given the chance of a full life through the liver of a 6-year-old. Although the children had different blood types, the clinic team was able to prevent the organ from being rejected, the intervention was successful and Mohamed quickly recovered. Today, dozens of such operations have already been performed.
Stem cell transplantation is used in the cancer centres of the health group Memorial for the treatment of blood cancer, diseases of the group of leukemias, lymphomas, multiple myeloma. Also for diseases that cause bone marrow failure, some organ cancers and thalassemia, a common hereditary disease in Bulgaria. Stem cells intended for transplantation can be taken from the patient (autologous) or from another person (allogeneic). In both cases, the patient must be given very high doses of chemotherapy and radiotherapy.
In the centre of "Memorial" a unique pancreas transplant operation is performed, which, in practice, is not done anywhere else in the world. The specialists of the medical institution plan to create a world center where transplantation of any organs will be possible - Multi Organ Transplant Center.
Who can be a donor?
In accordance with the regulations in Turkey, donors can be relatives up to the 4th knee. Wife and husband are also considered relatives. In order to confirm the relationship between the donor and the recipient, a birth certificate, marriage certificate, passport must be presented. The donor cannot be under 18 years of age. If the donor is married at the time of the transplant, the clinic requires notarized spousal consent. With the approval obtained from the regional ethics committees, transplantation may also be performed between unrelated persons. Donor exchange or so-called "cross-donation" in terms of organ transplants can also be implemented within the scope of the legal framework.
Unfortunately, foreign nationals in Turkey cannot receive organs from a deceased donor. Transplantation is only possible from a related donor who arrives with the patient. This is due to the large number of people waiting for donor organs among Turkish citizens.
Foreign patients and their relatives are supported by the Organ Transplantation Centre of the Memorial Hospitals Group provides a guest room whose level of comfort is not inferior to that of a five-star hotel. The donor and recipient can stay in the room for up to two months, but usually go home much sooner - up to 10 days after the intervention. The cost of the stay includes all supplies and medications, translation of medical records, airport pick-up and transfer. The mandatory pre-diagnosis is paid separately.
