Pub Date : 2022-09-23eCollection Date: 2022-09-01DOI: 10.14744/hf.2022.2022.0019
Ankoor H Patel, Rajan Amin, Alexander T Lalos
IgG4-related disease (IgG4-RD) is a fibro-inflammatory disease that can affect multiple organs. Autoimmune pancreatitis type 1 is a manifestation of IgG4-RD and can often mimic tumor-like masses. Autoimmune phenomena following COVID-19 mRNA vaccination are being increasingly reported. Currently, there are no cases in which IgG4-RD involving the hepatobiliary system has been reported following the COVID-19 vaccination. We present the first case of IgG4-RD and AIP type 1 to be associated with the mRNA-based COVID-19 vaccination.
{"title":"Acute liver injury and IgG4-related autoimmune pancreatitis following mRNA-based COVID-19 vaccination.","authors":"Ankoor H Patel, Rajan Amin, Alexander T Lalos","doi":"10.14744/hf.2022.2022.0019","DOIUrl":"https://doi.org/10.14744/hf.2022.2022.0019","url":null,"abstract":"<p><p>IgG4-related disease (IgG4-RD) is a fibro-inflammatory disease that can affect multiple organs. Autoimmune pancreatitis type 1 is a manifestation of IgG4-RD and can often mimic tumor-like masses. Autoimmune phenomena following COVID-19 mRNA vaccination are being increasingly reported. Currently, there are no cases in which IgG4-RD involving the hepatobiliary system has been reported following the COVID-19 vaccination. We present the first case of IgG4-RD and AIP type 1 to be associated with the mRNA-based COVID-19 vaccination.</p>","PeriodicalId":29722,"journal":{"name":"Hepatology Forum","volume":"3 3","pages":"97-99"},"PeriodicalIF":0.8,"publicationDate":"2022-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b1/60/hf-3-097.PMC9510734.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40384373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background and aim: Portal vein thrombosis (PVT) is particularly detected in advanced liver cirrhosis patients. We aimed to analyze the risk factors for PVT in liver transplant candidates.
Materials and methods: Dataset for consecutive 165 cirrhotic patients who were evaluated for liver transplantation (LT) were retrospectively analyzed. We sorted patients into two groups: patients with PVT and patients without PVT. Included variables were age, sex, etiology of liver disease, body mass index, MELD-Na score, Child-Pugh score, clinical variables reflecting portal hypertension, and hepatocellular carcinoma. Univariate and multivariate logistic regression analyses were used to identify risk factors of PVT.
Results: Of 165 LT candidates, 46 had PVT (27.9%). Ascites, thrombocytopenia, history of variceal bleeding, and band ligation were risk factors for PVT in univariate analysis. In multivariate analysis, only a history of variceal bleeding (OR 3.45, 95% CI 1.02-11.6, p=0.046) significantly increased the risk of PVT.
Conclusion: The previous history of variceal bleeding predicts PVT development in cirrhosis, suggesting that the severity of portal hypertension is a major predictive factor for PVT in patients with cirrhosis. Future prospective studies are needed to risk stratifying cirrhosis patients prior to LT for future PVT development and to define the prophylactic role of anticoagulation in these patients.
背景与目的:门静脉血栓形成(PVT)在晚期肝硬化患者中尤为常见。我们的目的是分析肝移植候选人PVT的危险因素。资料和方法:回顾性分析连续165例评估肝移植(LT)的肝硬化患者的数据集。我们将患者分为两组:PVT患者和无PVT患者，纳入的变量包括年龄、性别、肝病病因、体重指数、MELD-Na评分、Child-Pugh评分、反映门脉高压的临床变量和肝细胞癌。采用单因素和多因素logistic回归分析确定PVT的危险因素。结果:165例LT患者中，46例有PVT(27.9%)。在单因素分析中，腹水、血小板减少、静脉曲张出血史和绑扎是PVT的危险因素。在多因素分析中，只有静脉曲张出血史(OR 3.45, 95% CI 1.02-11.6, p=0.046)显著增加了PVT的风险。结论:既往静脉曲张出血史可预测肝硬化患者PVT的发展，提示门脉高压的严重程度是肝硬化患者PVT的主要预测因素。未来的前瞻性研究需要对肝移植前肝硬化患者进行风险分层，以预防未来PVT的发展，并确定抗凝治疗在这些患者中的预防作用。
{"title":"Portal vein thrombosis risk factors in liver transplant candidates.","authors":"Cagatay Ak, Gupse Adali, Suleyman Sayar, Abdulbaki Agackiran, Fatma Kulali, Resul Kahraman, Oguzhan Ozturk, Kamil Ozdil","doi":"10.14744/hf.2022.2022.0005","DOIUrl":"https://doi.org/10.14744/hf.2022.2022.0005","url":null,"abstract":"<p><strong>Background and aim: </strong>Portal vein thrombosis (PVT) is particularly detected in advanced liver cirrhosis patients. We aimed to analyze the risk factors for PVT in liver transplant candidates.</p><p><strong>Materials and methods: </strong>Dataset for consecutive 165 cirrhotic patients who were evaluated for liver transplantation (LT) were retrospectively analyzed. We sorted patients into two groups: patients with PVT and patients without PVT. Included variables were age, sex, etiology of liver disease, body mass index, MELD-Na score, Child-Pugh score, clinical variables reflecting portal hypertension, and hepatocellular carcinoma. Univariate and multivariate logistic regression analyses were used to identify risk factors of PVT.</p><p><strong>Results: </strong>Of 165 LT candidates, 46 had PVT (27.9%). Ascites, thrombocytopenia, history of variceal bleeding, and band ligation were risk factors for PVT in univariate analysis. In multivariate analysis, only a history of variceal bleeding (OR 3.45, 95% CI 1.02-11.6, p=0.046) significantly increased the risk of PVT.</p><p><strong>Conclusion: </strong>The previous history of variceal bleeding predicts PVT development in cirrhosis, suggesting that the severity of portal hypertension is a major predictive factor for PVT in patients with cirrhosis. Future prospective studies are needed to risk stratifying cirrhosis patients prior to LT for future PVT development and to define the prophylactic role of anticoagulation in these patients.</p>","PeriodicalId":29722,"journal":{"name":"Hepatology Forum","volume":"3 3","pages":"88-92"},"PeriodicalIF":0.8,"publicationDate":"2022-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b2/8a/hf-3-088.PMC9510737.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40382860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-23eCollection Date: 2022-09-01DOI: 10.14744/hf.2022.2022.0016
Berat Ebik, Mustafa Aygan, Elif Tugba Tuncel, Huseyin Kacmaz, Nazim Ekin, Medeni Arpa, Kendal Yalcin
Background and aim: Several studies have suggested that treatment with direct-acting antivirals (DAAs) in patients with chronic hepatitis C virus (HCV) may be associated with an increased risk of developing hepatocellular carcinoma (HCC). We investigated the incidence and risk factors of HCC in HCV patients who achieved a sustained virologic response (SVR) following DAA therapies.
Materials and methods: The medical data of patients who were diagnosed with HCV and received DAA therapy in two tertiary centers in Turkey were retrospectively collected.
Results: Among them, 75 patients (52.4%) were noncirrhotic and 68 patients (47.6%) were cirrhotic. The overall SVR rate was 97.2% (139/143). It was 100% in noncirrhotic and 94.1% in cirrhotic patients. HCC was developed in 5 (7.4%) patients, all of whom had baseline cirrhosis. The annual rate of HCC occurrence was 2.94%, and the 5-year cumulative incidence of HCC was 7.3%. The mean Child-Pugh score (CPS) and Model for End-Stage Liver Disease (MELD) score significantly decreased after DAA treatment (CPS 7.0 vs 5.9, p=0.001; MELD 10.8 vs 9.5, p=0.003).
Conclusion: There was no significant increase in the rate of HCC in cirrhotic HCV patients treated with DAAs. This treatment led to a remarkably high SVR rate and lowered CPS and MELD scores in cirrhotic HCV patients.
背景和目的:几项研究表明，直接作用抗病毒药物(DAAs)治疗慢性丙型肝炎病毒(HCV)患者可能与发生肝细胞癌(HCC)的风险增加有关。我们调查了在接受DAA治疗后获得持续病毒学应答(SVR)的HCV患者中HCC的发生率和危险因素。材料与方法:回顾性收集土耳其两所三级中心诊断为HCV并接受DAA治疗的患者的医疗资料。结果:其中无肝硬化75例(52.4%)，肝硬化68例(47.6%)。总SVR率为97.2%(139/143)。非肝硬化患者为100%，肝硬化患者为94.1%。5例(7.4%)患者发生HCC，均为基线肝硬化。HCC年发生率为2.94%，5年累计发病率为7.3%。DAA治疗后平均Child-Pugh评分(CPS)和终末期肝病模型(MELD)评分显著降低(CPS 7.0 vs 5.9, p=0.001;MELD 10.8 vs 9.5, p=0.003)。结论:接受DAAs治疗的肝硬化HCV患者HCC发生率无显著升高。这种治疗可显著提高肝硬化HCV患者的SVR率，降低CPS和MELD评分。
{"title":"Development of hepatocellular carcinoma in patients with chronic hepatitis C who had sustained viral response following direct-acting antiviral therapy.","authors":"Berat Ebik, Mustafa Aygan, Elif Tugba Tuncel, Huseyin Kacmaz, Nazim Ekin, Medeni Arpa, Kendal Yalcin","doi":"10.14744/hf.2022.2022.0016","DOIUrl":"https://doi.org/10.14744/hf.2022.2022.0016","url":null,"abstract":"<p><strong>Background and aim: </strong>Several studies have suggested that treatment with direct-acting antivirals (DAAs) in patients with chronic hepatitis C virus (HCV) may be associated with an increased risk of developing hepatocellular carcinoma (HCC). We investigated the incidence and risk factors of HCC in HCV patients who achieved a sustained virologic response (SVR) following DAA therapies.</p><p><strong>Materials and methods: </strong>The medical data of patients who were diagnosed with HCV and received DAA therapy in two tertiary centers in Turkey were retrospectively collected.</p><p><strong>Results: </strong>Among them, 75 patients (52.4%) were noncirrhotic and 68 patients (47.6%) were cirrhotic. The overall SVR rate was 97.2% (139/143). It was 100% in noncirrhotic and 94.1% in cirrhotic patients. HCC was developed in 5 (7.4%) patients, all of whom had baseline cirrhosis. The annual rate of HCC occurrence was 2.94%, and the 5-year cumulative incidence of HCC was 7.3%. The mean Child-Pugh score (CPS) and Model for End-Stage Liver Disease (MELD) score significantly decreased after DAA treatment (CPS 7.0 vs 5.9, p=0.001; MELD 10.8 vs 9.5, p=0.003).</p><p><strong>Conclusion: </strong>There was no significant increase in the rate of HCC in cirrhotic HCV patients treated with DAAs. This treatment led to a remarkably high SVR rate and lowered CPS and MELD scores in cirrhotic HCV patients.</p>","PeriodicalId":29722,"journal":{"name":"Hepatology Forum","volume":"3 3","pages":"82-87"},"PeriodicalIF":0.8,"publicationDate":"2022-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/25/d2/hf-3-082.PMC9510740.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40382864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-23eCollection Date: 2022-09-01DOI: 10.14744/hf.2021.2021.0050
Mesut Gumussoy, Hale Gokcan, Emin Bodakci, Saba Kiremitci, Berna Savas, Ramazan Idilman
Case Report A 43-year-old male patient was admitted to the outpatient clinic for nausea, jaundice, and dark-colored urine in July 2019. He has been taking dexketoprofen/diclofenac sodium twice a week for headaches. He consumed 25 packs of cigarettes per year and 60–70 g of alcohol per week for 2 years. On his physical examination, he was icteric and had mild epigastric tenderness. At that time, his serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were 897 U/L (0–50) and 1799 U/L (0–50), respectively. His serum alkaline phosphatase (ALP) level was 141 U/L (40–130), gammaglutamyl transferase (GGT) 158 U/L (10–71), total bilirubin 7.4 mg/dL (0.1–1.2), direct bilirubin 4.3 mg/dL, and albumin 2.7 g/dL (3.5–5.2). INR was 1.32. Serological studies for viral hepatitis, autoimmune panel, and metabolic panel were all normal. We diagnosed NSAID-induced toxic hepatitis. After the drug was discontinued, his laboratory values returned to the normal range. He was discharged with normal liver tests. The patient was admitted to our clinic with jaundice 45 days after he was discharged. He was on intermittent NSAIDs. His serum AST and ALT levels were 1391 U/L and 1680 U/L, respectively. His serum ALP level was 113 U/L, GGT 104 U/L, total bilirubin 18.2 mg/dL, and direct bilirubin 14.2 mg/dL. His INR was 3.1. Medical supportive treatment was initiated. Hepatic encephalopathy was developed on the seventh day of hospitalization, and INR was 5.0. Plasmapheresis was started. His clinical status and encephalopathy worsened. Living donor liver transplantation was performed on the 16th day of admission. Explant liver pathology was revealed with submassive necrosis characterized by severe liver parenchyma loss accompanied by a marked ductular reaction and regenerative nodule (Fig. 1a, b). He was discharged from the hospital in Oct 2019. During the posttransplant follow-up period, liver test abnormality was detected. His serum AST, ALT, ALP, and GGT levels were 407 U/L, 729 U/L, 250 U/L, and GGT 280 U/L, respectively. His total bilirubin level was 2.1 mg/dL. He was on flurbiprofen 2–3 times a month for headaches. Liver biopsy was performed. Liver biopsy revealed mild portal and lobular inflammatory lesion combined with a cholestatic reaction was remarkable biopsy findings were primarily compatible with drug-induced injury (Fig. 2). Methylprednisolone was started with a dose of 1 mg/kg per day. His aminotransferase levels were decreased, but cholestatic parameters were stable. Magnetic resonance cholangiopancreatography revealed biliary stenosis on the anastomotic site. A plastic biliary stent was placed during endoscopic retrograde cholangiopancreatography. The patient is currently very well with normal liver tests. Dear Editor,
{"title":"NSAID-associated drug-induced liver injury prior to and following liver transplantation.","authors":"Mesut Gumussoy, Hale Gokcan, Emin Bodakci, Saba Kiremitci, Berna Savas, Ramazan Idilman","doi":"10.14744/hf.2021.2021.0050","DOIUrl":"https://doi.org/10.14744/hf.2021.2021.0050","url":null,"abstract":"Case Report A 43-year-old male patient was admitted to the outpatient clinic for nausea, jaundice, and dark-colored urine in July 2019. He has been taking dexketoprofen/diclofenac sodium twice a week for headaches. He consumed 25 packs of cigarettes per year and 60–70 g of alcohol per week for 2 years. On his physical examination, he was icteric and had mild epigastric tenderness. At that time, his serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were 897 U/L (0–50) and 1799 U/L (0–50), respectively. His serum alkaline phosphatase (ALP) level was 141 U/L (40–130), gammaglutamyl transferase (GGT) 158 U/L (10–71), total bilirubin 7.4 mg/dL (0.1–1.2), direct bilirubin 4.3 mg/dL, and albumin 2.7 g/dL (3.5–5.2). INR was 1.32. Serological studies for viral hepatitis, autoimmune panel, and metabolic panel were all normal. We diagnosed NSAID-induced toxic hepatitis. After the drug was discontinued, his laboratory values returned to the normal range. He was discharged with normal liver tests. The patient was admitted to our clinic with jaundice 45 days after he was discharged. He was on intermittent NSAIDs. His serum AST and ALT levels were 1391 U/L and 1680 U/L, respectively. His serum ALP level was 113 U/L, GGT 104 U/L, total bilirubin 18.2 mg/dL, and direct bilirubin 14.2 mg/dL. His INR was 3.1. Medical supportive treatment was initiated. Hepatic encephalopathy was developed on the seventh day of hospitalization, and INR was 5.0. Plasmapheresis was started. His clinical status and encephalopathy worsened. Living donor liver transplantation was performed on the 16th day of admission. Explant liver pathology was revealed with submassive necrosis characterized by severe liver parenchyma loss accompanied by a marked ductular reaction and regenerative nodule (Fig. 1a, b). He was discharged from the hospital in Oct 2019. During the posttransplant follow-up period, liver test abnormality was detected. His serum AST, ALT, ALP, and GGT levels were 407 U/L, 729 U/L, 250 U/L, and GGT 280 U/L, respectively. His total bilirubin level was 2.1 mg/dL. He was on flurbiprofen 2–3 times a month for headaches. Liver biopsy was performed. Liver biopsy revealed mild portal and lobular inflammatory lesion combined with a cholestatic reaction was remarkable biopsy findings were primarily compatible with drug-induced injury (Fig. 2). Methylprednisolone was started with a dose of 1 mg/kg per day. His aminotransferase levels were decreased, but cholestatic parameters were stable. Magnetic resonance cholangiopancreatography revealed biliary stenosis on the anastomotic site. A plastic biliary stent was placed during endoscopic retrograde cholangiopancreatography. The patient is currently very well with normal liver tests. Dear Editor,","PeriodicalId":29722,"journal":{"name":"Hepatology Forum","volume":"3 3","pages":"108-109"},"PeriodicalIF":0.8,"publicationDate":"2022-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8d/5d/hf-3-108.PMC9510739.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40382863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-23eCollection Date: 2022-09-01DOI: 10.14744/hf.2022.2022.0021
Pelin Telli, Nazli Begum Ozturk, Mehmet Tolgahan Hakan, Bilger Cavus, Asli Cifcibasi Ormeci, Aysun Yakut, Volkan Senkal, Ziya Imanov, Arzu Poyanli, Emine Goknur Isik, Kadir Demir, Fatih Besisik, Sabahattin Kaymakoglu, Ilhan Yaylim, Filiz Akyuz
Background and aim: Chronic hepatitis B virus (HBV) infection is a major cause of hepatocellular carcinoma (HCC). Circulating cell-free DNA (cfDNA) methylation of tumor suppressor genes are emerging potential biomarkers in HCC. We aimed to evaluate the cfDNA methylation status of RASSF1 and CDKN2AIP genes in patients with liver cirrhosis (LC) with or without HCC caused by HBV.
Materials and methods: A total of 47 patients with HBV cirrhosis were included in the study. Patients were divided into two groups: HCC and LC (HCC+LC, n=22) and HBV cirrhosis only (LC, n=25). cfDNA was isolated from the plasma samples of the patients. Methylation analysis was performed for RASSF1 and CDKN2AIP genes.
Results: Mean methylation percentage of CDKN2AIP gene was 0.001±0.004% in the HCC+LC group and 0.008±0.004 % in the LC only group. The mean methylation percentage of RASSF1 gene was 5.1±16.1% in the HCC+LC group and 9.7±25.9% in the LC only group. The methylation rate of CDKN2AIP was significantly lower in the HCC+LC group (p=0.027). A positive correlation was found with the absence of cfDNA methylation of CDKN2AIP gene in the presence of HCC (R=0.667, p=0.018).
Conclusion: cfDNA methylation of CDKN2AIP and RASSF1 genes may provide important diagnostic information regarding the development of HCC in the setting of HBV cirrhosis.
{"title":"Cell-free methylation of RASSF1 and CDKN2AIP genes in the diagnosis of hepatocellular carcinoma associated with hepatitis B virus cirrhosis.","authors":"Pelin Telli, Nazli Begum Ozturk, Mehmet Tolgahan Hakan, Bilger Cavus, Asli Cifcibasi Ormeci, Aysun Yakut, Volkan Senkal, Ziya Imanov, Arzu Poyanli, Emine Goknur Isik, Kadir Demir, Fatih Besisik, Sabahattin Kaymakoglu, Ilhan Yaylim, Filiz Akyuz","doi":"10.14744/hf.2022.2022.0021","DOIUrl":"https://doi.org/10.14744/hf.2022.2022.0021","url":null,"abstract":"<p><strong>Background and aim: </strong>Chronic hepatitis B virus (HBV) infection is a major cause of hepatocellular carcinoma (HCC). Circulating cell-free DNA (cfDNA) methylation of tumor suppressor genes are emerging potential biomarkers in HCC. We aimed to evaluate the cfDNA methylation status of RASSF1 and CDKN2AIP genes in patients with liver cirrhosis (LC) with or without HCC caused by HBV.</p><p><strong>Materials and methods: </strong>A total of 47 patients with HBV cirrhosis were included in the study. Patients were divided into two groups: HCC and LC (HCC+LC, n=22) and HBV cirrhosis only (LC, n=25). cfDNA was isolated from the plasma samples of the patients. Methylation analysis was performed for RASSF1 and CDKN2AIP genes.</p><p><strong>Results: </strong>Mean methylation percentage of CDKN2AIP gene was 0.001±0.004% in the HCC+LC group and 0.008±0.004 % in the LC only group. The mean methylation percentage of RASSF1 gene was 5.1±16.1% in the HCC+LC group and 9.7±25.9% in the LC only group. The methylation rate of CDKN2AIP was significantly lower in the HCC+LC group (p=0.027). A positive correlation was found with the absence of cfDNA methylation of CDKN2AIP gene in the presence of HCC (R=0.667, p=0.018).</p><p><strong>Conclusion: </strong>cfDNA methylation of CDKN2AIP and RASSF1 genes may provide important diagnostic information regarding the development of HCC in the setting of HBV cirrhosis.</p>","PeriodicalId":29722,"journal":{"name":"Hepatology Forum","volume":"3 3","pages":"77-81"},"PeriodicalIF":0.8,"publicationDate":"2022-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/73/f2/hf-3-077.PMC9510732.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40384372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-23eCollection Date: 2022-09-01DOI: 10.14744/hf.2022.2022.0014
Nazli Begum Ozturk, Haris Muhammad, Merve Gurakar, Alperen Aslan, Ahmet Gurakar, Doan Dao
With the increasing incidence and prevalence of end-stage liver disease, demand for donor grafts continues to increase. Approaches on maximizing the potential donor grafts vary depending on the region. This review aims to summarize the current practice of liver transplantation with an emphasis on challenges encountered in developing countries.
{"title":"Liver transplantation in developing countries.","authors":"Nazli Begum Ozturk, Haris Muhammad, Merve Gurakar, Alperen Aslan, Ahmet Gurakar, Doan Dao","doi":"10.14744/hf.2022.2022.0014","DOIUrl":"https://doi.org/10.14744/hf.2022.2022.0014","url":null,"abstract":"<p><p>With the increasing incidence and prevalence of end-stage liver disease, demand for donor grafts continues to increase. Approaches on maximizing the potential donor grafts vary depending on the region. This review aims to summarize the current practice of liver transplantation with an emphasis on challenges encountered in developing countries.</p>","PeriodicalId":29722,"journal":{"name":"Hepatology Forum","volume":"3 3","pages":"103-107"},"PeriodicalIF":0.8,"publicationDate":"2022-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/74/86/hf-3-103.PMC9510741.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40384371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-23eCollection Date: 2022-09-01DOI: 10.14744/hf.2022.2022.0028
Fatih Guzelbulut, Umit Karaogullarindan, Hikmet Akkiz, Engin Altintas, Coskun Ozer Demirtas, Ozgur Bahadir, Caglayan Keklikkiran, Abdullah Emre Yildirim, Mesut Gumussoy, Hatice Rizaoglu Balci, Pinar Gokcen, Dilara Turan Gokce, Cem Simsek, Ilker Turan, Guray Can, Volkan Gokbulut, Serkan Yaras, Gupse Adali, Remzi Adnan Akdogan, Ufuk Avcioglu, Mehmet Demir, Hamdi Levent Doganay, Sezgin Vatansever, Hale Sumer, Feyza Dilber, Meral Akdogan Kayhan, Hatice Yasemin Balaban, Halis Simsek, Osman Cavit Ozdogan, Ulus Salih Akarca, Zeki Karasu, Fulya Gunsar, Ramazan Idilman
Background and aim: The aim of the present study was to examine the etiology of hepatocellular carcinoma (HCC) by underlying cause and determine the characteristics and clinical features of patients with HCC.
Materials and methods: The study comprised 1802 HCC patients diagnosed and followed up by Liver Diseases Outpatient Clinics in 14 tertiary centers in Turkey between 2001 and 2020.
Results: The mean age was 62.3±10.7 years, and 78% of them were males. Of the patients, 82% had cirrhosis. Hepatitis B virus (HBV) infection was the most common etiology (54%), followed by hepatitis C virus (HCV) infection (19%) and nonalcoholic fatty liver disease (NAFLD) (10%). Of the patients, 56% had a single lesion. Macrovascular invasion and extrahepatic spread were present in 15% and 12% of the patients, respectively. The median serum alpha-fetoprotein level was 25.4 ng/mL. In total, 39% of the patients fulfilled the Milan Criteria. When we compared the characteristics of patients diagnosed before and after January 2016, the proportion of NAFLD-related HCC cases increased after 2016, from 6.6% to 13.4%.
Conclusion: Chronic HBV and HCV infections remain the main causes of HCC in Turkey. The importance of NAFLD as a cause of HCC is increasing.
{"title":"Characteristics of patients with hepatocellular carcinoma: A multicenter study.","authors":"Fatih Guzelbulut, Umit Karaogullarindan, Hikmet Akkiz, Engin Altintas, Coskun Ozer Demirtas, Ozgur Bahadir, Caglayan Keklikkiran, Abdullah Emre Yildirim, Mesut Gumussoy, Hatice Rizaoglu Balci, Pinar Gokcen, Dilara Turan Gokce, Cem Simsek, Ilker Turan, Guray Can, Volkan Gokbulut, Serkan Yaras, Gupse Adali, Remzi Adnan Akdogan, Ufuk Avcioglu, Mehmet Demir, Hamdi Levent Doganay, Sezgin Vatansever, Hale Sumer, Feyza Dilber, Meral Akdogan Kayhan, Hatice Yasemin Balaban, Halis Simsek, Osman Cavit Ozdogan, Ulus Salih Akarca, Zeki Karasu, Fulya Gunsar, Ramazan Idilman","doi":"10.14744/hf.2022.2022.0028","DOIUrl":"https://doi.org/10.14744/hf.2022.2022.0028","url":null,"abstract":"<p><strong>Background and aim: </strong>The aim of the present study was to examine the etiology of hepatocellular carcinoma (HCC) by underlying cause and determine the characteristics and clinical features of patients with HCC.</p><p><strong>Materials and methods: </strong>The study comprised 1802 HCC patients diagnosed and followed up by Liver Diseases Outpatient Clinics in 14 tertiary centers in Turkey between 2001 and 2020.</p><p><strong>Results: </strong>The mean age was 62.3±10.7 years, and 78% of them were males. Of the patients, 82% had cirrhosis. Hepatitis B virus (HBV) infection was the most common etiology (54%), followed by hepatitis C virus (HCV) infection (19%) and nonalcoholic fatty liver disease (NAFLD) (10%). Of the patients, 56% had a single lesion. Macrovascular invasion and extrahepatic spread were present in 15% and 12% of the patients, respectively. The median serum alpha-fetoprotein level was 25.4 ng/mL. In total, 39% of the patients fulfilled the Milan Criteria. When we compared the characteristics of patients diagnosed before and after January 2016, the proportion of NAFLD-related HCC cases increased after 2016, from 6.6% to 13.4%.</p><p><strong>Conclusion: </strong>Chronic HBV and HCV infections remain the main causes of HCC in Turkey. The importance of NAFLD as a cause of HCC is increasing.</p>","PeriodicalId":29722,"journal":{"name":"Hepatology Forum","volume":"3 3","pages":"71-76"},"PeriodicalIF":0.8,"publicationDate":"2022-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ef/74/hf-3-071.PMC9510736.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40382862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-23eCollection Date: 2022-09-01DOI: 10.14744/hf.2022.2022.0023
Osman Cavit Ozdogan
Palliative care in decompensated cirrhotic patients is a developing concept which should be used in cirrhotic patients during the advanced and terminal stages. Hepatologists and liver transplant teams mostly ignore the patients palliative care issues while intensively dealing with the liver diseases and its complications. This review is a brief summary of the recently published guidance discussing the palliative care, symptom based treatments and end of life with a collaborative and standartized approach which is recommended to all health care workers of cirrhotic patients.
{"title":"Palliative care in cirrhotic patients: Brief summary of recent AASLD guidance.","authors":"Osman Cavit Ozdogan","doi":"10.14744/hf.2022.2022.0023","DOIUrl":"https://doi.org/10.14744/hf.2022.2022.0023","url":null,"abstract":"<p><p>Palliative care in decompensated cirrhotic patients is a developing concept which should be used in cirrhotic patients during the advanced and terminal stages. Hepatologists and liver transplant teams mostly ignore the patients palliative care issues while intensively dealing with the liver diseases and its complications. This review is a brief summary of the recently published guidance discussing the palliative care, symptom based treatments and end of life with a collaborative and standartized approach which is recommended to all health care workers of cirrhotic patients.</p>","PeriodicalId":29722,"journal":{"name":"Hepatology Forum","volume":"3 3","pages":"100-102"},"PeriodicalIF":0.8,"publicationDate":"2022-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/40/07/hf-3-100.PMC9510738.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40384369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-23eCollection Date: 2022-09-01DOI: 10.14744/hf.2022.2021.0047
Veysel Umman, Murat Zeytunlu, Zeki Karasu, Bulent Aydinli, Fatih Kaciroglu, Yusuf Yavuz, Ahmet Tekin, Sukru Emre
Liver transplantation is successfully achieved all over the world and in Turkiye. Similar to many middle and far east countries, donation from deceased donors has not reached the desired level in Turkiye. Therefore, in Turkiye, living donors have been frequently used for liver transplantation. Although Turkiye is the leading country in Europe and one of the top three countries in the world executing LDLT, nationwide standardization of LDLT protocols, including donor and recipient evaluation and acceptance criteria, donor and recipient follow-up and reporting rules, and routine periodic audits by the ministry of health authorities, has not been established. Therefore, we created a working group to study reviewing regulations of LDLT operation in Europe and the USA. The establishment and implementation of standardization of LDLT operation will serve to improve the donor and recipient outcomes while preventing incomplete or incorrect practices. The guide prepared on this subject is presented in the Appendix.
{"title":"Preliminary Report of the ministry of health working group on standardization of living donor liver transplantation in Turkiye.","authors":"Veysel Umman, Murat Zeytunlu, Zeki Karasu, Bulent Aydinli, Fatih Kaciroglu, Yusuf Yavuz, Ahmet Tekin, Sukru Emre","doi":"10.14744/hf.2022.2021.0047","DOIUrl":"https://doi.org/10.14744/hf.2022.2021.0047","url":null,"abstract":"<p><p>Liver transplantation is successfully achieved all over the world and in Turkiye. Similar to many middle and far east countries, donation from deceased donors has not reached the desired level in Turkiye. Therefore, in Turkiye, living donors have been frequently used for liver transplantation. Although Turkiye is the leading country in Europe and one of the top three countries in the world executing LDLT, nationwide standardization of LDLT protocols, including donor and recipient evaluation and acceptance criteria, donor and recipient follow-up and reporting rules, and routine periodic audits by the ministry of health authorities, has not been established. Therefore, we created a working group to study reviewing regulations of LDLT operation in Europe and the USA. The establishment and implementation of standardization of LDLT operation will serve to improve the donor and recipient outcomes while preventing incomplete or incorrect practices. The guide prepared on this subject is presented in the Appendix.</p>","PeriodicalId":29722,"journal":{"name":"Hepatology Forum","volume":"3 3","pages":"93-94"},"PeriodicalIF":0.8,"publicationDate":"2022-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a7/b0/hf-3-093.PMC9510742.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40382865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-23eCollection Date: 2022-09-01DOI: 10.14744/hf.2022.2022.0007
Ramazan Yolacan, Umit Karabulut, Ali Uzel, Feyzullah Ucmak, Muhsin Kaya
Favipiravir (FPV) is an antiviral drug used in the treatment of severe acute respiratory syndrome coronavirus 2 infection. The main side effects of this drug are teratogenicity and hyperuricemia. Limited information is available on other side effects. Here, we aimed to present our toxic hepatitis case with prolonged jaundice after FPV treatment.
{"title":"Toxic hepatitis case with prolonged jaundice due to Favipiravir.","authors":"Ramazan Yolacan, Umit Karabulut, Ali Uzel, Feyzullah Ucmak, Muhsin Kaya","doi":"10.14744/hf.2022.2022.0007","DOIUrl":"https://doi.org/10.14744/hf.2022.2022.0007","url":null,"abstract":"<p><p>Favipiravir (FPV) is an antiviral drug used in the treatment of severe acute respiratory syndrome coronavirus 2 infection. The main side effects of this drug are teratogenicity and hyperuricemia. Limited information is available on other side effects. Here, we aimed to present our toxic hepatitis case with prolonged jaundice after FPV treatment.</p>","PeriodicalId":29722,"journal":{"name":"Hepatology Forum","volume":"3 3","pages":"95-96"},"PeriodicalIF":0.8,"publicationDate":"2022-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/10/68/hf-3-095.PMC9510735.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40384370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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