|2.||Surgical Experiences from Europe's Largest Liver Transplant Institute during the February 6, 2023 Cataclysmic Turkish Earthquake|
Sezai Yilmaz, Burak Isik, Adil Baskiran, Sami Akbulut, Ahmet Kizilay, Brian I Carr
doi: 10.14744/jilti.2023.25744 Pages 2 - 4
From disasters, we have to deduce some lessons to implement in centers where major surgeries are performed.
The Inonu University Liver Transplant Institute is located in the province of Malatya in southeast Turkey. On February 6, 2023, Malatya suffered two devastating earthquakes, one with a magnitude of 7.8 and another 10 h later, with a magnitude of 7.6, and subsequently thousands of aftershocks, some greater than magnitude 6. The city center looked like a complete rubble with ruined buildings and main roads. From this disaster, we deduced some lessons such as emergency action plans and psychological support programs should be done, people in senior management must be at work and should not leave the hospital, and etc.
This was a significant disaster. As the largest transplant center in Europe, the Inonu University Liver Transplantation Institute has attempted to survive. We now need to move quickly to regain the quality of our previous services.
|3.||Risk Prediction of Liver Cancer based on the Proposed Artificial Intelligence Approach|
Zeynep Kucukakcali, Ipek Balikci Cicek, Fatma Hilal Yagin, Sami Akbulut, Cemil Colak
doi: 10.14744/jilti.2022.21931 Pages 5 - 9
INTRODUCTION: Liver cancer is a primary worldwide public health concern, and it is critical to understand the disease's physiology and create therapies. The aim of this study is to classify open access liver cancer data and identify important risk factors with the Random Forest method.
METHODS: The open-access liver cancer dataset was used to construct a predive model in the study. Random Forest was used to classify the disease. Balanced accuracy, accuracy, sensitivity, specificity, positive/negative predictive values were evaluated for model performance. In addition, risk factors were assessed with the logistic regression model.
RESULTS: The accuracy, balanced accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and F1 score metrics obtained with the Random Forest model were 98.9%, 97.9%, 95.8%, 100%, 100%, and 98.3%, and 95.7% respectively. Also, the importance of the variables obtained, the most important risk factors for liver cancer were total proteins, albumin and globulin ratio, albumin, age, total bilirubin, aspartate aminotransferase, direct bilirubin, alamine aminotransferase, alkaline phosphatase, respectively. According to the logistic regression model results, age, direct bilirubin, and albumin variables were statistically sig-nificant.
DISCUSSION AND CONCLUSION: According to the study results, with the machine learning model Random forest used, patients with and without liver cancer were classified with high accuracy, and the importance of the variables related to cancer status was determined. Factors with high variable importance can be considered potential risk factors associated with cancer status and can play an essential role in disease diagnosis.
|4.||The Faculty of Theology Students' Attitudes, Knowledge Levels and Behaviours on Organ Donation and Xenotransplantation|
Murat Deniz, Adil Baskiran, Brian Carr, Sezai Yilmaz
doi: 10.14744/jilti.2023.87597 Pages 10 - 14
INTRODUCTION: It is known that people's religious beliefs affect the interest in organ donation positively or negatively. This study aimed to evaluate the education level, thinking and behavior styles of the students of the Faculty of Theology, who will be the religious services workers of the future, on organ transplantation, organ donation and xenotransplantation (XTx).
METHODS: Data were obtained by conducting a survey from quantitative research methods in order to reveal their knowledge, at-titudes and thoughts on organ donation and XTx on 282 Theology Faculty students between 2020 June 2021 December.
RESULTS: A total of 278 students answered the questions and about half of them stated that they would consider organ donation. About 1/3 of the participants who thought negatively about organ donation, but probably 3/4 of them, did so for religious reasons. Less than 9% of the participants had an information on XTx. In general, questions about XTx revealed that students had extremely inadequate knowledge about it. According to the participants, the society was uninterested and ignorant about XTx. Only 9% of the students stated that they would prefer XTx if they had to.
DISCUSSION AND CONCLUSION: It would be very useful in their hands to inform the public about the acceptance of therapies using animal or trans-genic components. However, it is not clear whether the general public accepts therapy with animal organs. Measures to increase the knowledge level of theology faculty students, who will guide the society in the future on organ donation/transplantation and XTx, should be taken in advance.
|5.||Biliary Drainage Impairment After Liver Transplantation As a Result of Adhesive Small-Bowel Obstruction|
Alper Varman, Arslan Hasan Kocamaz, Selman Alkan, Mustafa Şentürk, Tevfik Küçükkartallar, Süleyman Bakdık
doi: 10.14744/jilti.2022.21931 Pages 15 - 17
With the improvements of surgical techniques, favorable results in orthotopic liver transplantation surgeries have increased in recent years. Biliary complications are common after liver transplantation. We aimed to discuss a case that developed adhesive small bowel obstruction -related jaundice after liver transplantation and underwent adhesiolysis by surgery in the light of the literature. The patient, who underwent right lobe liver transplantation with a living donor 7 years ago due to chronic liver damage by hepatitis B, was examined with sudden onset of abdominal pain and jaundice. It was determined that the current situation was con-nected to the postoperative adhesion and that the adhesion disrupted the biliary drainage and then surgical intervention was performed. It should always be kept in mind that the increase of serum bilirubin levels in patients with liver transplantation may also be caused by any mechanical obstruction in the roux leg of Roux-en Y hepaticojejunostomy.
|6.||Living Donor Liver Transplantation for Erytropoietic Protoporphyria Liver Disease|
Sertac Usta, Kuntay Kaplan, Ayse Nur Akatlı, Volkan Ince, Cemalettin Koc, Cemalettin Aydın, Sezai Yilmaz
doi: 10.14744/jilti.2023.47966 Pages 18 - 22
Porphyrias are an inherited group of diseases caused by the deficiency of enzymes in the heme synthesis pathway. Erytropoietic protoporphyria is associated with a deficiency of ferrochelatase activity.
Liver transplantation is the most effective treatment in cases of liver failure due to EPP. In this study, a case who underwent LDLT goes liver failure due to EPP is presented.
A 15-year-old boy who had had recurrent photosensitive skin reactions due to erythropoietic protoporphyria since the age of 1 year. The patient had elevated liver enzymes, coagulopathy, advanced jaundice, low ferrochelatase activity, and high erythrocyte protoporphyrin activity. Liver biopsy confirmed extensive protoporphyrin deposition with cirrhosis, and so living donor liver transplantation was performed. The clinical and laboratory course of the patient in the early post-transplant period was quite normal. But, on the 12th posttransplant day, there was duodenal perforation, possibly due to burns caused by reduced headlights or surgeons' headlights during the operation. The patient, who had a very complicated course, died on the 43rd day after LT.
LT is lifesaving if acute or chronic liver disease has developed in EPP. Special precautions are required to protect these patients from porphyric crises and phototoxic reaction. Bone marrow transplantation can be performed after LT to eliminate the cause.
|LETTER TO THE EDITOR|
|7.||Comment on The Transition to Microsurgical Technique for Hepatic Artery Reconstruction in Pediatric Liver Transplantation|
Sami Akbulut, Sezai Yilmaz, Koray Kutlutürk
doi: 10.14744/jilti.2023.77486 Pages 23 - 24
|8.||Comment on Impact of Middle Hepatic Artery Reconstruction after Living Donor Liver Transplantation using the Left Lobe|
Sami Akbulut, Tevfik Tolga Sahin, Sezai Yilmaz
doi: 10.14744/jilti.2023.32042 Pages 25 - 26
|9.||Comment on the First Two Liver Transplantations in Syria|
Sami Akbulut, Sezai Yilmaz
doi: 10.14744/jilti.2023.98608 Pages 27 - 28