Browsing by Author "Faki, Sevgul"

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    The Effect of Pretransplant Chronic Hepatitis C Virus Infection Treatment on Graft and Patient Survival in Renal Transplant Recipients
    (2015) Korkmaz, Murat; Faki, Sevgul; Ocal, Serkan; Harmanci, Ozgur; Ensaroglu, Fatih; Selcuk, Haldun; Haberal, Mehmet; 0000-0002-3462-7632; 0000-0002-8445-6413; 0000-0002-9333-782X; 0000-0003-3719-9482; 0000-0002-0643-4980; 25894152; AAJ-8097-2021; AAJ-6976-2021; AAM-1330-2020; ABH-4817-2020
    Objectives: Studies have demonstrated worse graft and patient survival among hepatitis C virus-positive patients following kidney transplant. Eradication of hepatitis C virus infection before renal transplant with interferon should be considered in hepatitis C virus-infected patients undergoing dialysis who are on the waiting list for transplant. We investigated whether pretransplant hepatitis C virus infection treatment affected graft and patient survival, and we evaluated other contributing factors to these outcomes. Materials and Methods: We enrolled 83 antihepatitis C virus-positive patients who were diagnosed with chronic hepatitis C virus infection by serology or histopathology and had renal transplant at Baskent University Ankara Hospital from 1982 to 2013. Data were obtained from patient medical files retrospectively. Patients were divided into 2 groups that had or did not have interferon treatment. Results: In 83 renal transplant patients with chronic hepatitis C virus infection (57 male [69%] and 26 female [31%]), median age was 46 years (range, 26 - 69 y), and most patients were genotype 1-dominant (92%). Interferon monotherapy was received by 30 patients before renal transplant and 28 of 30 patients had long-term follow-up data. There were 14 of 28 patients (50%) who achieved sustained virologic response, and only 1 patient had relapse. Graft survival was significantly lower in patients who had treatment (6 y vs 9 y; P <= .003). However, patient survival rates were similar between groups. Patients who had interferon were younger and had longer hemodialysis duration before renal transplant than patients without treatment. Higher viral load was associated with higher mortality which was caused by sepsis. Conclusions: Pretransplant hepatitis C virus infection treatment, although recommended before renal transplant, does not always have good outcomes. Pretransplant dialysis treatment period, age of recipient, and posttransplant higher viral replication rates may be important contributing factors related to graft and patient survival.
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    Progression of Hepatic Histopathology in Kidney Transplant Recipients With Chronic Hepatitis C Virus Infection and Effect of Immunosuppression on the Course of Hepatitis C Virus Infection
    (2015) Korkmaz, Murat; Faki, Sevgul; Ocal, Serkan; Harmanci, Ozgur; Selcuk, Haldun; Haberal, Mehmet; 0000-0003-3719-9482; 0000-0002-3462-7632; 0000-0002-8445-6413; 0000-0002-9333-782X; 0000-0002-0643-4980; 25894147; ABH-4817-2020; AAJ-8097-2021; AAJ-6976-2021; AAM-1330-2020
    Objectives: There is no correlation between alanine aminotransferase levels, viral load, and histologic findings at dialysis in patients with chronic hepatitis C virus infection. Identification of the severity of hepatitis C-related liver disease before transplant could provide valuable data about the risk for liver-related mortality after transplant. In this study, we aimed to identify the severity of liver disease in end-stage renal disease patients with chronic hepatitis C virus infection, the progression of hepatic histopathology after kidney transplant, and whether immunosuppressive therapy affected post-transplant viral replication and hepatic histology. Materials and Methods: Antihepatitis C virus-positive kidney transplant recipients (45 patients) enrolled in the study. Liver biopsy was performed in 45 patients before and 16 patients after kidney transplant. Interferon was given to 28 of 45 patients before kidney transplant. Biopsy before and after kidney transplant was performed in 5 of 14 patients. Results: Patients had higher viral load, with genotype 1 predominancy (91%). Sustained viral response was achieved in 14 of 28 patients (50%). The histopathologic features of 45 patients who had pretransplant liver biopsy were as follows: 22 patients had mild hepatocellular injury, 17 patients had mild chronic hepatitis, 5 patients had moderate chronic hepatitis, and 1 patient had serious hepatitis. Follow-up biopsy after kidney transplant (mean, 2 y) in 16 of 45 patients showed that 3 of 16 patients had mild hepatocellular injury, 4 of 16 patients had mild hepatitis, 6 of 16 patients had moderate hepatitis, 2 of 16 patients had serious hepatitis, and 1 patient had cirrhosis. Patients showed neither progression, regression, nor stable liver histology. Conclusions: Even with worse genotype profiles, chronic hepatitis C virus infection has an indolent progression in patients with end-stage renal disease and kidney transplant. Follow-up biopsies of kidney transplant recipients show reasonable progression during the first 2 years.