E-ISSN 2980-2059
Volume: 2  Issue: 1 - April 2024
1.Front Matters

Pages I - IX

2.Liver Transplantation Management from Anti HBc Positive Donors to HBV Negative Recipients in Liver Transplantation
Yılmaz Bilgiç
doi: 10.14744/jilti.2024.91300  Pages 1 - 5
Anti HBc + people are in the marginal donor group. It is considered as a donor source, especially in places where Hepatitis B is endemic. In endemic areas, 21.4% of donors are HBcAb positive. In regions where HBV is not endemic, it is 4.75%-7%. Anti-HBc is a 'non-neutralizing' antibody that does not provide immune protection. In other words, it is 'serological scar', that is the evidence of previous exposure to HBV). De novo hepatitis may develop in liver transplants from anti-HBc positive donors. The most important factors for de novo hepatitis are the presence or absence of anti-HBc and anti-HBs positivity. If both antibodies are positive, the risk of denovo hepatitis is least and if both antibodies are negative, it is highest. High genetic barrier antivirals alone are recommended for the treatment and prophylaxis of developing de novo hepatitis. Hepatitis B immune globulin has no place in de novo treatment and prevention.

3.Inonu University Experience in Hepatitis B Recurrence After Liver Transplantation
Deniz Yavuz Baskiran, Sena Güzel Karahan, Ipek Balikci Cicek, Sezai Yilmaz
doi: 10.14744/jilti.2024.99609  Pages 6 - 10
Objectives: Hepatitis B virus (HBV), one of the biggest health problems of the world and our country, still constitutes the largest cause of liver failure and liver transplantation in the world. Here, we will introduce the HBV virus closely and share the health prob-lems of HBV in the world and in our country in the literature data.
Methods: İnönü University Liver Transplant Institute Patients who underwent liver transplantation due to any reason related to HBV were included in the study. Patients who underwent liver transplantation due to liver diseases caused by HBV in our institute between 2009 and 2023 were included in the study.. A total of 3679 patients underwent liver transplantation between 2002 and 2024. Of these patients, 1275 patients were operated on with the diagnosis of HBV. When 530 patients whose data were not avail-able and 49 patients who were retransplanted were excluded from the study, a total of 695 patients were included in the study. Results: Treatment is given in combination with antiviral and HBIG. It is available in centers where powerful antivirals are used alone. Although the approaches of the centers vary, patients who have had a liver transplant due to HBV definitely need postopera-tive medical treatment to prevent HBV recurrence.
Conclusion: Patients who have undergone liver transplantation due to HBV must have their Hbs-ag level checked when they are discharged from the hospital. Informing the patient about HBV recurrence and medical treatment provides a more meticulous medical treatment.

4.Liver Transplantation for Cryptogenic Cirrhosis: Where we are
Adil Baskiran, Metin Kement, Mehmet Zeki Ogut, Deniz Yavuz Baskiran, Volkan ince, Sezai Yilmaz
doi: 10.14744/jilti.2024.24633  Pages 11 - 15
Objectives: This study aimed to compare clinical and immunological features between patients undergoing liver transplantation with cryptogenic cirrhosis and those with determined etiologies.
Methods: Patients who underwent liver transplantation at our institute between March 2019 and March 2020 were retrospectively analyzed. Data including demographics, laboratory results, and post-transplant outcomes were collected from a prospectively maintained database. Immunoglobulin levels, autoantibodies, and pathological findings were evaluated.
Results: Of 201 patients, 24.4% had cryptogenic cirrhosis. These patients were older (mean age 54.8 years) and had higher BMI (mean 27.3) compared to those with determined etiologies. Immunological biomarkers did not significantly differ between groups. Autoimmune hepatitis was the most common diagnosis upon pathological examination of cryptogenic cases.
Conclusion: Immunological biomarkers did not differentiate cryptogenic cirrhosis from other etiologies in liver transplant patients. Higher BMI was associated with cryptogenic cirrhosis. Pathological examination frequently revealed autoimmune hepatitis in cryptogenic cases.

5.Effect of Bile on Fatty Liver and Metabolism in Rats
Mehmet Zeki Öğüt, Adem Tuncer, Engin Korkmaz, Onural Ozhan, Ayse Nur Akatlı, Yunus Önal, Adil Baskiran, Sezai Yilmaz
doi: 10.14744/jilti.2024.68442  Pages 16 - 23
Objectives: Non-alcoholic fatty liver disease (NAFLD) is a range of liver disorders ranging from accumulation of fat in the liver (steatosis) to non-alcoholic steatohepatitis (necrosis and inflammation), eventually progressing in some individuals to fibrosis, cir-rhosis, and liver failure, respectively.
Methods: The bile taken from the gallbladder, which was removed as a specimen from donor hepatectomy and living donor liver transplantation (LDLT) performed at Liver Transplantation Institute, was delivered daily to İnönü University Experimental Animal Production and Research Center under suitable conditions for use in the project. Monthly weights of all rats included in the study and the amount of bile consumed by rats in separate cages in the bile group were recorded.
Results: When the change in rat weights according to months was analyzed in the three groups 1st month, 2nd month, and 3rd month are made separately, the comparisons between the groups. Statistically significant differences were detected in the first month (p<0.001) and in the 3rd month (p=0.001).
Conclusion: This study aimed to determine whether bile contributes to the reduction of fatty liver. It was aimed to observe the effect of human bile fluid by giving it to study animals. In this study, by comparing the rats to which we gave bile by creating fatty liver, with the group with fatty liver damage and the control group, it was shown that bile improved fatty liver. In addition, it has been determined that bile has significant effects on routinely used laboratory tests such as ALT, ALP, cholesterol, triglyceride, HDL, and VLDL. When the results are evaluated, they make important contributions to the question of whether bile can be used by ex-ogenous administration in the human body.

6.Nodular Hyperplasia Mimicking Colon Cancer Liver Metastasis
Fatih Ozdemir
doi: 10.14744/jilti.2024.30502  Pages 24 - 27
Oxaliplatin-based chemotherapy protocols have improved survival in colorectal cancer as an adjuvant treatment. Nevertheless, sinusoidal obstruction syndrome (SOS) may occur during oxaliplatin therapy. Liver lesions related to sinusoidal obstruction syndrome can mimick liver metastasis. A 35-year-old female patient who has a history of right hemicolectomy due to colon adenocar-cinoma 10 years ago, received 9 cycles of 500 mg capecitabine and 100 mg oxaliplatin as an adjuvant chemotherapy. Suspicious nodules were diagnosed at the liver during magnetic resonance imaging (MRI) which was performed 10 years after right hemicolectomy. Surgical intervention was performed. Focal nodular hyperplasia was diagnosed for all the liver lesions after pathological evaluation. Patients with colorectal cancer who received oxaliplatin based chemotherapy with the new onset liver lesions should be examined carefully. Not only radiological evaluation but also core needle biopsy should be used for misdiagnosis and preventing overtreatment.

7.Major Liver Resection for Advanced Alveolar Echinococcosis: An alternative to Liver Transplantation
Cemalettin Koç, Sami Akbulut, Burak Isik, Ramazan Kutlu, Sezai Yilmaz
doi: 10.14744/jilti.2024.95967  Pages 28 - 30
Alveolar Echinococcosis (AE) is a zoonotic infestation with aggressive behavior1. Most patients are asymptomatic in the early period, and therefore they are often detected incidentally during radiological examinations performed for other reasons.[1] AE is considered a tumor-like disease because the disease grows in the liver by invading the surrounding tissue and metastasizes to distant organs in some patients.[2] Therefore, resection is recommended in surgical treatment according to oncological principles, that is, with clean surgical margins.[3] The present report aims to present our approach to a patient diagnosed with alveolar echino-coccosis, which occupied the right lobe of the liver and included the part of the left hepatic vein flowing into the IVC, was prepared for liver transplantation and was saved from liver transplantation by liver resection.

8.Are In Situ Double Portal Vein Anastomosis or Unification ideal for Anomalous Portal Vein Reconstruction in Right Lobe Living Donor Liver Transplantation?
Sertac Usta, Sami Akbulut, Sezai Yilmaz
doi: 10.14744/jilti.2024.85057  Pages 31 - 33
Abstract |Full Text PDF

9.Inonu University Liver Transplant Institute Liver Transplantation and Hepatitis B Symposium - 1 March 2024

Pages 34 - 45
Abstract |Full Text PDF

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