Hepatic transplant

learn more about liver transplant

The protocol for carrying out a transplant was developed in 1989, a year later, the liver transplant program started thanks to interdepartmental collaboration. Thus, along with the Surgery Department were Hepatology, Immunology, Clinical Pharmacology, Anatomic Pathology, Anaesthesia and Radiology. We also have a team of nurses specialised in the care and attention for transplant patients.

Liver transplant consists in the removal of the patient's diseased liver and substituting it for a either a whole or part of a healthy organ from a deceased or living donor.

It is the only therapeutic treatment for chronic and irreversible liver diseases. Patients with terminal liver diseases, even those in old age, whose only alternative is a transplant, come to the Clínica Universidad de Navarra to have this operation, whose survival rate after 5 years is 85%

Imagen preview del infográfico sobre el trasplante hepático de donante vivo
Learn more about hepatic transplant from a living donor. [Infography only available in Spanish]
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El Dr. Sangro habla sobre la incidencia del  hepatocarcinoma y los tratamientos disponibles tanto quirúgicos como  farmacológicos.  Además de la terapéutica habitual, en la Clínica ofrecemos tratamientos innovadores como la aplicación de microesferas de Ytrio90 con excelentes resultados y se están desarrollando nuevas líneas de investigación que nos ayudarán a encontrar nuevas terapias para tratar este tipo de tumor.
Surgical and pharmacological treatments against liver cancer. [Video only available in Spanish]
Jose María fue diagnosticado de cáncer de hígado. Estuvo mucho tiempo esperando un órgano adecuado. La solución a su caso le llegó cuando le trasplantaron parte del hígado de su hija Ainhoa. A pesar de que España es el país del mundo con mayor índice de  donaciones de órganos, el número de receptores supera al de donantes.  Por esta  razón, en los últimos años se vienen realizando trasplantes hepáticos de donante de donante vivo,   en los que se extirpa una parte del hígado del donante (generalmente   será un familiar del receptor) y se le implanta al enfermo.
Story of a patient of the Clínica, receptor from a living donor transplant. [Video only available in Spanish]

It is the removal of someone's liver (deceased or living) which is implanted into another person with a serious liver disease. We call the person from who we extract the tissue or organ the donor and the patient who receives it, the recipient.

Spain has the highest organ donation rate in the world. Despite this, the number of recipients exceeds that of donors. As a result, in the last few years we have begun doing liver transplants from living donors, in which we remove a part of the donor's liver (usually they are a family member of the recipient) and we implant it in the patient.

Often, the transplant is necessary for the patient to survive; this procedure is essential in the case of fulminant liver failure, cirrhosis of the liver, liver tumours and metabolic disease.

For the majority of transplants, the patient's quality of life is very good. The improvements in the immunosuppressive treatment and the technique, as well as the cumulative experience of the medical team, have resulted in a higher survival rate.

The candidate patient for a transplant must undergo the evaluation process.

This protocol measures the patient ́s condition with various tests:

  • Thorough physical exam
  • Chest x-ray
  • Respiratory function test
  • Abdominal CT Scan
  • Electrocardiogram
  • Echocardiogram
  • Abdominal ultrasound
  • Etc

The medical team – surgeons, heptologists and other doctors collaborating in the evaluation of treatment – assess the analysis, tests and exams included in the evaluation protocol for a transplant candidate. With all of this, they decide if the patient is a candidate for a liver transplant.

In general, the contraindications are considered to be absolute for liver transplant in those situations that technically impede the transplant or greatly diminish the possibilities of survival or functional recuperation afterwards.

Liver transplant is absolutely not to be performed if the patient has symptoms that are not due to the liver disease or when they have other diseases that have a bad prognosis or no treatment.

There are a few relative reasons to not have a liver transplant: old age, diabetes and renal failure that increase the risk of a transplant. When there are a number of relative contraindications, the transplant is also not carried out.

So that a liver transplant between living people is viable, their blood groups must be compatible, the donor must be healthy – which is confirmed by exhaustive medical testing and anatomical requirements – Thus, the most appropriate moment for the transplant is chosen when the risk for the donor will be the closest to zero as possible.

The improvements in the immunosuppressive treatment and the technique, as well as the cumulative experience, have resulted in a higher.

Rejection is a very serious complication after a liver transplant. However, we currently have a wide variety of immunosuppressive drugs. These drugs diminish the body´s immune system´s reaction when faced with foreign tissue, which can provoke infections or the development of tumours. The most used immunosuppressive drugs are cyclosporine, tacrolimus, azathioprine, mycophenolate mofetil and glucocorticoids.

Along with pharmalogical treatments, it's important to take care with your diet and lead an active life with regular physical exercise.

The survival rate one year after the transplant, in over 400 transplants that the Clínica Universidad de Navarra has carried out is 90% (and at five years, 80%), 10% above the national average, according to the Spanish Liver Transplant Registry.

One of the main advances for hepatic transplants has been lie the experience of the health teams in the administering medication and using the new drugs that we now have at our disposal."

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