Why Türkiye Leads the World in Living-Donor Liver Transplants
Quick answer
Why Türkiye Leads the World in Living-Donor Liver Transplants
- Türkiye's liver programme runs on living donors, not deceased ones. At the Liver Transplantation Institute in Malatya, 86.8% of 4,011 transplants performed between March 2002 and March 2025 came from a living donor and 13.2% from a deceased one. Nationally the living-donor share is around 80%.
- That ratio is a shortage, not a boast — and it is exactly what built the expertise. Living-donor liver transplant is the harder operation: two patients, two theatres, and one of them a healthy person who walked in well. A country without a deceased-donor pipeline has no choice but to become good at it.
- The clearest evidence is liver paired exchange, where two families whose own donors do not match swap donors. The Malatya institute performed the world's first 4-way exchange in 2022, the first two 5-way and the first 6-way by early 2024, and the first simultaneous 8-way — 16 operations, 22 hours, 150 staff — in June 2026.
- The scale is what should matter to a patient rather than the record. In 2023 exchange produced 64 of that institute's 231 living-donor liver transplants, 27.7% of them. Earlier programmes elsewhere, swapping only in pairs and only on blood type, reported gains of 1% to 2%.
- None of this helps someone who arrives without a donor. Turkish law limits living donation to a spouse of at least two years and to relatives up to the fourth degree; everything else goes before a provincial ethics commission. The first question is not which hospital — it is who your donor is.
- Five surgeons named by their own hospital, university or hospital group as heads of Turkish transplant centres are Prof. Dr. Koray Acarlı (Memorial Şişli), Prof. Dr. Ayhan Dinçkan (İstinye University Liv Hospital Bahçeşehir), Prof. Dr. Kamil Yalçın Polat (Memorial Bahçelievler), Prof. Dr. Onur Yaprak (Medipol Mega) and Prof. Dr. Sezai Yılmaz (İnönü University, Malatya). They are listed alphabetically, not ranked: three of the five have no Google rating for this site's formula to score.
· Ratings from Google; ranking formula published on /how-we-rank
"Organ transplant" is not one thing, and Türkiye is not equally good at all of it. There is one field where its record is documented, peer-reviewed and genuinely world-leading, and this page is about that one: liver transplant from a living donor.
The reason it turned out that way is not flattering, which is what makes it believable.
Two ways to get a liver
A liver comes from one of two places.
From a deceased donor. Someone dies, their family consents, and an organ enters a national pool. You join a waiting list and you wait. This is the main road in the United States and across most of Europe.
From a living donor. A healthy person gives up part of their liver. The liver is the only organ that regrows — over the following months both the donor's and the recipient's return to close to normal volume.
The second is far harder to do. It is two operations on the same day, two patients, and one of them arrived healthy. There is no version of that where a surgeon gets to be roughly right.
The number that explains everything else
A 23-year review of the Liver Transplantation Institute at İnönü University in Malatya covers 4,011 transplants performed between March 2002 and March 2025. Of those, 3,481 — 86.8% — came from living donors. Deceased donors accounted for 530, or 13.2%.
Source: Healthcare (Basel), Yavuz Başkıran & Yılmaz, 2026
Nationally the picture is the same shape: around 80% of liver transplants in Türkiye come from living donors.
Source: Anadolu Ajansi, 16 June 2026
Turn that ratio over and it stops sounding like an achievement. In most of Europe the numbers run the other way, because most of Europe has a deceased-donor system that supplies the majority of its organs. Türkiye's does not. The waiting list was there; the organs were not.
So Turkish centres stopped waiting, and went down the harder road — thousands of times.
That is the whole answer to "why Türkiye". Not cheaper, not looser rules, not a shortcut. A structural shortage that forced an entire national programme to specialise in the operation everyone else does occasionally.
What a shortage builds
Here is the problem that shortage creates next, and it is the interesting part.
Most patients who need a liver have someone willing to donate — a sibling, a child, a spouse. Willing is not the same as able. The donor's blood type may not match. Or, just as often, their liver is the wrong size for the recipient: too small a graft is dangerous for the patient, too large a resection is dangerous for the donor.
So you have two families, each with a donor who cannot help their own relative. Swap them, and both patients get a transplant. That is a paired exchange, and it has been done in pairs for years in several countries.
Malatya took it much further than pairs.
- 2022 — the world's first 4-way exchange. Four donors, four recipients, one interlocking chain. That single match run produced transplants for six patients; with two-way swaps only, four of them would have got one.
- By early 2024 — the world's first two 5-way exchanges and the first 6-way. By then the programme had completed thirteen 2-way, nine 3-way, four 4-way, two 5-way and one 6-way exchange.
- June 2026 — the world's first simultaneous 8-way. Sixteen operations running at once, 22 hours, 150 surgeons, anaesthetists and nurses. The match was found inside a pool of 24 patients and 29 donors.
Source: American Journal of Transplantation, Yilmaz, Sonmez, Unver et al., 2023
Source: American Journal of Transplantation, Yilmaz, Sonmez, Unver et al., 2024
They run simultaneously for a reason that is easy to miss: the chain is dominoes. If one donor changes their mind at the last moment, every pairing downstream of them collapses. So all of them start together.
The number that matters more than the record
Firsts are good headlines and weak evidence. This is the figure to look at instead.
In 2023, exchange produced 64 of that institute's 231 living-donor liver transplants — 27.7%. More than a quarter of a year's transplants existed only because donors were swapped between families.
Earlier exchange programmes elsewhere, working in pairs and only around blood type, reported increases of 1% to 2%.
Source: American Journal of Transplantation, Yilmaz, Sonmez, Unver et al., 2024
That is the difference between a technique a centre has tried and a technique a centre has industrialised.
The part that is genuinely strange
The matching is not done by the surgeons.
It runs on a model built by two economists at Boston College, Tayfun Sönmez and Utku Ünver — market design specialists whose field is matching problems, of which kidney exchange is the famous case. They are co-authors on the surgical papers. The algorithm weighs blood type, liver volume, anatomy and donor safety across the whole pool and finds the set of swaps that produces the most transplants.
A shortage in Malatya, solved with economics from Massachusetts, in an operating theatre with 150 people in it. That is a more accurate picture of modern transplant medicine than any brochure.
What this means if you are the patient
Now the hard part, because everything above can be true and still not apply to you.
You need a donor. Turkish law limits living donation to a spouse of at least two years and to blood and marriage relatives up to and including the fourth degree. Anything outside that goes to a provincial Organ Transplant Assessment Ethics Commission, which meets within fifteen days — immediately in urgent cases — and decides by majority.
Source: Law 2238 on the Harvesting, Storage, Grafting and Transplantation of Organs and Tissues
So the first question is not "which hospital". It is "who is my donor". If a broker offers you a transplant without one, what is being described to you is not a treatment.
Bringing a donor is also what keeps this ethical. The Declaration of Istanbul draws the line clearly: crossing a border for a transplant is simply travel for transplantation. It becomes transplant tourism — and unethical — if it involves trafficking, or if the resources devoted to non-resident patients undermine a country's ability to serve its own population.
Source: Declaration of Istanbul on Organ Trafficking and Transplant Tourism, 2018 edition
A patient who arrives with their own donor adds a liver to the system. A patient who arrives expecting to find one takes a place from someone on a Turkish list. The two are not the same trip.
Five surgeons who lead Türkiye's transplant centres
This is not a ranking, and the order is alphabetical. Every other list on this site is scored by a published formula that reads public Google ratings, and in this field that formula would give you a false picture: three of the five surgeons below have no Google rating this site could find. A ranking built on that data would put whoever markets hardest at the top, and leave out the director of the institute this article is about.
So these five were chosen by one checkable fact instead. Each is named as the head or director of a transplant centre by their own hospital, university or hospital group. It is not a complete list — Türkiye has dozens of licensed transplant centres — and nothing about the order is a judgement of one surgeon against another.
| Surgeon | Leads | City |
|---|---|---|
| Prof. Dr. Koray Acarlı | Organ Transplant Centre, Memorial Şişli Hospital | İstanbul |
| Prof. Dr. Ayhan Dinçkan | Organ Transplant Centre, İstinye University Liv Hospital Bahçeşehir | İstanbul |
| Prof. Dr. Kamil Yalçın Polat | Organ Transplant Centre, Memorial Bahçelievler Hospital | İstanbul |
| Prof. Dr. Onur Yaprak | Liver Transplant Centre, Medipol Mega University Hospital | İstanbul |
| Prof. Dr. Sezai Yılmaz | Liver Transplant Institute, İnönü University | Malatya |
Source: Memorial Şişli Hospital, Organ Transplant Centre
Source: Liv Hospital Group, official YouTube channel
Source: Memorial Health Group, doctor profile
Source: Medipol Health Group, doctor profile
Source: İnönü University Liver Transplant Institute
A conflict to state before you read anything into this list. Two of these five, Prof. Acarlı and Prof. Polat, work at Memorial hospitals. So do all five of this site's medical reviewers — four of them at hospitals where Prof. Acarlı or Prof. Polat hold posts — and one of them, Doç. Dr. Vahit Mutlu, who reviews the obesity surgery guides, is a general surgeon at Memorial Ataşehir, where Prof. Polat heads the general surgery centre. No reviewer had any part in choosing these names or in writing this page. The rule above is what put each name here, not an affiliation.
Five questions before you book anything
- Is my donor suitable? Blood type, liver volume, anatomy, general health. This gets settled before the choice of hospital, not after.
- How many living-donor transplants does this centre do a year? The annual figure, not the lifetime total. Experience lives in the rate.
- Who operates on the donor, and who follows them afterwards? A programme that cannot answer this crisply about the healthy person in the room is answering the wrong question.
- What happens after I fly home? Immunosuppression and monitoring are lifelong. Line up the doctor at home before you travel, not after.
- What is actually in the price? The donor's operation, intensive care, medication, and the cost if something goes wrong. Ask for it in writing.
What this page cannot tell you
Whether any of this is right for you. Your MELD score, how fast your disease is moving, whether your donor is genuinely suitable, and where you stand on your own country's list will each weigh more heavily than anything written here — and none of them can be read off a web page.
What it can tell you is that the expertise is real, measured and published, and that it grew out of a shortage rather than an advantage. Read how we rank for what this site does and does not claim to measure, and the editorial policy for how these sources were chosen.
Frequently asked questions
- Is this page medically reviewed?
- No, and it should not be read as though it were. This site's five medical reviewers are a general surgeon, an ENT specialist, a plastic surgeon, an orthopaedic surgeon and a dentist, and none of them works in transplantation — putting one of their names on this page would be decoration rather than review. What the page does instead is source every factual claim to something you can open yourself: two papers in the American Journal of Transplantation, a 23-year case series, the statute, and the Declaration of Istanbul. Nothing here is medical advice, and no part of it substitutes for a hepatologist who has seen your own results.
- You said organ transplant. Why is this page only about livers?
- Because that is where the evidence actually is. "Organ transplant" is not one field — kidney, liver, heart and lung are different specialities with different centres and different track records, and a page claiming Türkiye leads at all of them would be a marketing claim rather than a finding. The living-donor liver programme is the one with a documented, peer-reviewed international record, so it is the one this page makes a claim about. Where we have not checked, we do not say.
- Can I come to Türkiye for a transplant without a donor?
- No, and anyone telling you otherwise is describing something illegal. Additional Article 2 of Law 2238 limits living donation to the recipient's spouse of at least two years and to blood and marriage relatives up to the fourth degree; every case outside that goes to a provincial Organ Transplant Assessment Ethics Commission, which convenes within fifteen days and decides by majority. The restriction reads like an obstacle and is in fact the thing protecting you: a patient who accepts an off-books offer also has to go home afterwards and find a doctor willing to manage the follow-up.
- Isn't travelling abroad for a transplant unethical?
- Not in itself, and the distinction is drawn precisely. The Declaration of Istanbul defines travel for transplantation as simply crossing a border for that purpose. It becomes transplant tourism, and unethical, when it involves trafficking in persons or organs, or when the resources given to non-resident patients undermine a country's ability to serve its own population. A patient who brings their own donor adds an organ to the system rather than removing one from a domestic waiting list. A patient who expects to find an organ waiting is the case the Declaration exists to stop.
- Does a high-volume centre mean a better outcome for me?
- It changes the odds, not the answer. Volume matters most where the learning curve is steep, and living-donor liver transplant is about as steep as surgery gets — so a team doing this weekly is in a different position from one doing it a few times a year. But your MELD score, the cause and stage of your disease, and whether your donor is actually suitable will each decide more about your outcome than the choice of centre. Ask for the annual living-donor figure rather than the lifetime total, and ask who operates on the donor.
- Why are these five surgeons listed rather than ranked?
- Because the data that orders every other list on this site does not exist for most of them. The formula this site publishes scores public Google ratings, and three of the five surgeons named here have no Google rating it could find. Ranking the two who do would have produced a list ordered by marketing rather than by work, and would have left out the director of the institute this article is about. The names are alphabetical, each there because their own hospital, university or hospital group names them as head of a transplant centre, and the order is not a judgement.