Browsing by Author "Ocal, Serkan"

Now showing 1 - 20 of 28

ACUTE NECROTIZING PANCREATITIS AFTER TRANSARTERIAL CHEMOEMBOLIZATION IN A PATIENT WITH HEPATOCELLULAR CANCER: CASE REPORT AND REVIEW OF THE LITERATURE
(2019) Ocal, Serkan; Suna, Nuretdin; Etik, Digdem Ozer; Bovyat, Fatih; Selcuk, Haldun; 31574073
Anxiety, Depression, and Anger in Functional Gastrointestinal Disorders: A Cross-Sectional Observational Study
(2018) Cakmak, Berna Bulut; Ozkula, Guler; Isikli, Sedat; Goncuoglu, Ibrahim Ozkan; Ocal, Serkan; Altinoz, Ali Ercan; Takintuna, Nilgun; 0000-0003-3719-9482; 0000-0003-2233-2105; 30103181; E-7929-2013; ABH-4817-2020; J-4811-2014
Previous studies have identified a link between anger and somatization. However, little is known about the associations between anger and the development and progression of Functional Gastrointestinal Disorders (FGID). The study aim was to determine the associations between FGID and anger, anxiety, and depression. Participants in this cross-sectional observational study were 109 consecutive patients aged 18-64 years with FGID at Gastroenterology Clinic of Baskent University Hospital. A control group comprised of 96 individuals with no chronic gastrointestinal disorders recruited via snowball sampling. Sociodemographic and clinical information were obtained and participants completed the Hospital Anxiety and Depression Scale and the State-Trait Anger Expression Inventory-2. FGID participants scored higher than controls on depression, anxiety, state anger, and anger expression-in. When the FGID group was divided into upper and lower gastrointestinal symptom groups, the lower symptom group showed higher anger expression-out scores than the upper symptom group. Anger may contribute to the etiology and development of FGID. This is the first study to demonstrate a significant psychological difference between individuals with lower and upper FGID. Interdisciplinary collaboration with gastroenterologists and psychiatrists could strengthen FGID evaluation and may improve treatment compliance.
Complications of Liver Transplant in Adult Patients With the Hepatic Form of Wilson Disease
(2018) Ocal, Ruhsen; Ocal, Serkan; Kirnap, Mahir; Moray, Gokhan; Haberal, Mehmet; 0000-0003-3719-9482; 0000-0003-2498-7287; 0000-0002-3462-7632; 29527989; V-3553-2017; ABH-4817-2020; AAH-9198-2019; AAE-1041-2021; AAJ-8097-2021
Objectives: Wilson disease is an autosomal, recessive, inherited disorder of copper metabolism that results in the accumulation of copper in many organs and tissues. This disease is mainly characterized by dysfunction due to copper accumulation in the liver, kidney, brain, cornea, bone, heart, and blood cells. The clinical spectrum is broad in Wilson disease. Asymptomatic Wilson disease may be present, but findings related to the involvement of an individual organ or multiple organ failure can be seen. These findings can include neurologic and neuropsychiatric complications. Our aim here was to examine the neurologic complications and our clinical experience in patients who underwent liver transplant for Wilson disease in our clinic. Materials and Methods: We retrospectively reviewed the medical records of transplant patients with Wilson disease who were seen at Baskent University Faculty of Medicine Transplantation Science between 2005 and 2017. Patient demographics, neurologic complaints, findings from neurologic examinations, and imaging findings were recorded. We also recorded the presence of the Kayser-Fleischer ring, serum ceruloplasmin, 24-hour copper urine levels, and levels of dry copper in liver in each patient. Results: Our study included 19 patients who ranged in age range from 18 to 44 years (mean age of 26 years). Seven of 19 patients (36.8%) had neurologic symptoms, including epileptic seizures in 2 patients (10.5%), encephalopathy in 1 patient (5.2%), tremor in 3 patients (15.7%), and headache in 1 patient (5.2%).The cause of these long-term neurologic complications was the immunosuppressive drugs. Patients with epileptic seizures were provided with seizure control medication (levetiracetam).Tremor did not need treatment. Conclusions: In Wilson disease, neurologic complications can be severe. The most common complication seen in our patients was tremor. Early diagnosis and treatment may slow down neurologic disability.
The Correlation Between Platelet Counts and Spleen Size After Successful Liver Transplantation
(2016) Ensaroglu, Fatih; Ocal, Serkan; Boyacioglu, Ahmet Sedat; Selcuk, Haldun; Hilmiogluu, Fatih; Moray, Gokhan; Haberal, Mehmet; https://orcid.org/0000-0003-3719-9482; https://orcid.org/0000-0002-9370-1126; https://orcid.org/0000-0002-8445-6413; https://orcid.org/0000-0003-2498-7287; https://orcid.org/0000-0002-3462-7632; ABH-4817-2020; AAE-7637-2021; AAJ-6976-2021; AAE-1041-2021; AAJ-8097-2021
Crimean-Congo Hemorrhagic Fever Presented with Headache: A Case Report
(2014) Ocal, Ruhsen; Delikan, Okan; Cebi, Kazim; Ocal, Serkan; Bulut, Cemal; Bayazit, Tolga; https://orcid.org/0000-0003-3719-9482; ABH-4817-2020
Headache is one of the most common symptoms of patients applying to emergency departments. In the majority of these patients the cause is usually primary. Although secondary headaches are less common, the diagnosis of the underlying reasons is important since they may be due to a potentially dangerous cause. Headache is also a common symptom of infection. The first symptom of infection can be a serious headache. Headaches which do not respond to medical treatment usually suggest secondary headache. Crimean-Congo haemorrhagic fever (CCHF) is an endemic disease with high mortality. Timely diagnosis as well as treatment of patients with high rates of transmission is also important in terms of disease prevention measures. In this study, a patient diagnosed as CCHF as a cause of secondary headache has been reported.
Effect of HLA on Hepatitis C Virus Clearance and Persistence in Anti-HCV-positive End-stage Renal Disease Patients
(2014) Ocal, Serkan; Selcuk, Haldun; Korkmaz, Murat; Altun, Reskan; Yildirim, Abdullah E.; Akbas, Enver; 24976281
Background/Aims: The efficacy of immune response against hepatitis C virus (HCV) is determined by human leukocyte antigen (HLA) molecules of the host which present HCV antigens to CD4+ and CD8+ Tlymphocytes. In this study, we aimed to investigate the possible relationship between the frequencies of certain HLA class I-II alleles and the natural history of HCV in patients with end-stage renal disease (ESRD). Settings and Design: This is a retrospective cohort study conducted in a university hospital. Patients and Methods: The present study comprised 189 ESRD patients (candidates for renal transplantation) who had positive anti-HCV antibody test. The results concerning HCV and HLA status were gathered from patients files. The viral persistence was compared between the groups that were determined by HLA sub-typing. Statistical Analysis: Statistical evaluation was performed using Mann-Whitney U-test, Chi-square test, and Fisher's exact test. Level of error was set at 0.05 for all statistical evaluations, and P values < 0.05 were considered statistically significant. Results: We found possible association between the course of HCV infection and specific HLA alleles. HLA class I Cw*6 and HLA class II DRB*10 alleles were observed more frequently in the viral clearance group (P < 0.05). The HLA class I B*38 allele group was more prone to develop chronic hepatitis C (P < 0.01). Conclusions: These findings suggest that HLA class I Cw*6 and HLA class II DRB*10 alleles may be associated with immunological elimination of HCV in Turkish patients on hemodialysis. HLA sub-typing could help predict the prognosis of HCV infection.
EFFECT OF LIVER TRANSPLANTATION ON NEUROLOGICAL MANIFESTATIONS AND BRAIN MAGNETIC RESONANCE IMAGING FINDINGS IN WILSON DISEASE
(2019) Soy, Ebru H. Ayvazoglu; Ocal, Ruhsen; Benli, Sibel; Donmez, Fuldem; Agildere, Muhtesem; Ocal, Serkan; Haberal, Mehmet; 0000-0002-0993-9917; AAC-5566-2019; AAB-5802-2020
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.
Effect of Propranolol Treatment on the Incidence of Hepatocellular Carcinoma in Patients Waiting for Liver Transplant With Cirrhosis: A Retrospective, Surveillance Study in a Tertiary Center
(2019) Suna, Nuretdin; Etik, Digdem Ozer; Ocal, Serkan; Selcuk, Haldun; 31050621
Objectives: Hepatocellular carcinoma is the most frequent primary malignant tumor of the liver and the third most common cause of all cancer-related mortalities. There is a need to develop new strategies to prevent hepatocellular carcinoma, as the incidence of this cancer continues to increase despite all advancements. In this study, our aim was to determine the effects of propranolol treatment on the incidence of hepatocellular carcinoma in cirrhotic patients waiting for liver transplant. Materials and Methods: We retrospectively reviewed the data of patients waiting for liver transplant with cirrhosis due to various causes registered at the Hepatocellular Carcinoma Surveillance Program between June 2011 and December 2017 in our center. These data were compared between patients using propranolol and those not using propranolol. Results: Of the 231 patients, 135 (58.4%) were male and 96 (41.6%) were female. The mean age was 58.1 +/- 14 years. We noted that 153 of total patients (66.2%) were using propranolol. Three patients (2%) were using 20 mg propranolol, 125 (81.7%) were using 40 mg propranolol, 10 (6.5%) were using 60 mg propranolol, and 15 (9.8%) were using 80 mg propranolol. Of total patients, 36 (15.6%) developed hepatocellular carcinoma, including in 12 patients (7.8%) using propranolol and 24 patients (30.8%) who did not use this agent (P < .001).Thus, the hepatocellular carcinoma frequency was 5.22 times lower in patients receiving propranolol than in those not receiving propranolol. Conclusions: Although causes of cirrhosis and initial stages were similar in both groups using and not using propranolol, incidence of hepatocellular carcinoma was significantly lower in the propranolol group than in the group without propranolol. This result showed that propranolol treatment has a protective effect for hepatocellular carcinoma in patients waiting for liver transplant with cirrhosis.
Efficacy and Tolerability of Direct-Acting Antiviral Agents for Hepatitis C Virus Infection in Kidney Transplant Recipients
(2018) Suna, Nuretdin; Etik, Digdem Ozer; Ocal, Serkan; Selcuk, Haldun; Dagli, Ulku; Hilmioglu, Fatih; Boyacioglu, Sedat; Haberal, Mehmet; https://orcid.org/0000-0001-6234-7788; https://orcid.org/0000-0003-3719-9482; https://orcid.org/0000-0002-8445-6413; https://orcid.org/0000-0002-6440-5686; https://orcid.org/0000-0002-9370-1126; https://orcid.org/0000-0002-3462-7632; AAI-8822-2021; ABH-4817-2020; AAJ-6976-2021; AAJ-4437-2021; AAE-7637-2021; AAJ-8097-2021
Extraordinary biliary variant
(2017) Suna, Nuretdin; Etik, Digdem Ozer; Ocal, Serkan; Selcuk, Haldun; Hilmioglu, Fatih; Boyacioglu, Sedat; 0000-0003-3719-9482; 0000-0002-9370-1126; 0000-0002-6440-5686; 0000-0002-4724-0728; 0000-0002-8445-6413; 0000-0001-6234-7788; 28336501; ABH-4817-2020; AAE-7637-2021; AAJ-4437-2021; AAJ-4707-2021; AAJ-6976-2021; AAI-8822-2021
Factors Affecting Mortality and Morbidity of Patients With Cirrhosis Hospitalized for Spontaneous Bacterial Peritonitis
(2015) Ensaroglu, Fatih; Korkmaz, Murat; Geckil, Ali Umit; Ocal, Serkan; Koc, Bengisu; Yildiz, Ozgun; Atalay, Fatma Busra; Tas, Emine Gul; Haberal, Mehmet; 0000-0003-3719-9482; 0000-0002-9333-782X; 0000-0002-3462-7632; 26640933; ABH-4817-2020; AAM-1330-2020; AAJ-8097-2021
Objectives: Spontaneous bacterial peritonitis, unless originating from surgery or an intra-abdominal source, is an infection diagnosed by neutrophil counts greater than 250/mm(3) in ascites. Spontaneous bacterial peritonitis is the most common infection among patients hospitalized with cirrhosis, with a prevalence of 9% and a risk of development among all patients with cirrhosis within 1 year of 10%. No valid parameters have been defined to predict the mortality related to spontaneous bacterial peritonitis. Unless it is treated, the mortality rate as a result of spontaneous bacterial peritonitis is 50%, and serious complications may arise. Materials and Methods: Medical records from 29 patients on the deceased-donor transplant waiting list and receiving treatment at the Baskent University Hospital Gastroenterology Clinic for cirrhotic ascites infection between 1996 and 2013 were analyzed. Demographic information, para centesis findings, clinical follow-up, and treatment results were reviewed and collected from patient medical records, with data recorded to the research form. Results: In our patient group, 72.4% were men and the average age was 46.6 years. Most of our patients were at advanced stage, with 55.2% having a Child-Pugh score of C and an average Model for End-Stage Liver Disease score of 17 +/- 4.1. We found that 34.5% of the patients received prophylactic treatment for spontaneous bacterial peritonitis, 72.4% received a proton pump inhibitor, and 82.8% had treatment with intravenous albumin support at the time of diagnosis. Albumin treatment showed no effect on mortality. Mortality rate among patients with Child-Pugh score of C was 81.3%. Conclusions: Existence of chronic renal failure, liver graft surgery, and hepatocellular cancer did not seem to have a significant effect on patient mortality. The albumin treatment protocol showed no significant difference despite common belief among physicians.
Gastric outlet obstruction by polypoid tumors
(2018) Suna, Nurettin; Ocal, Serkan; Etik, Digdem Ozer; Boyacioglu, Seda; 29749338
Hepatitis B- and Hepatitis D-Virus Related Liver Transplant: Single-Center Data
(2015) Ocal, Serkan; Korkmaz, Murat; Harmanci, Ozgur; Ensaroglu, Fatih; Akdur, Aydincan; Selcuk, Haldun; Moray, Gokhan; Haberal, Mehmet; 0000-0002-3462-7632; 0000-0002-8726-3369; 0000-0003-3719-9482; 0000-0002-9333-782X; 0000-0003-2498-7287; 0000-0002-8445-6413; 0000-0002-0643-4980; 25894142; AAJ-8097-2021; AAA-3068-2021; ABH-4817-2020; AAM-1330-2020; AAE-1041-2021; AAJ-6976-2021
Objectives: Hepatitis B and D virus coinfection or superinfection lead to chronic liver disease and have poor treatment results and poor prognosis. After transplant, these patients have difficult problems. We aimed to report long-term data of liver transplant recipients who had hepatitis B and D virus-related chronic liver disease. Materials and Methods: This retrospective, longitudinal study included 25 consecutive hepatitis B surface antigen-positive patients with anti-hepatitis D virus antibodies. Patient data (age, sex, antiviral treatment, posttransplant use of hepatitis B hyperimmunoglobulin and/or nucleoside/nucleotide analogues, the presence of hepatocellular carcinoma, age at transplant, follow-up) were extracted from patient records. Results: Females comprised 32% patients. The median age was 44 years (range, 23-63 y). The serum Hepatitis B envelope antigen level was negative in all patients. At the time of transplant, 4 patients were positive for hepatitis B virus DNA and 11 patients also had hepatocellular carcinoma. Posttransplant follow-up was 59 months (range, 3-120 mo). During follow-up, 4 patients died, 4 patients were lost to follow-up, and 17 patients were alive. Posttransplant survival of patients with hepatocellular carcinoma was 50.45 months (range, 3-84 mo) and without hepatocellular carcinoma was 65.8 months (range, 4-120 mo). There were 3 patients who had acute rejection and were treated successfully with pulse doses of prednisolone. Hyperimmunoglobulin therapy was used in conjunction with oral nucleotide/nucleoside analogues for 12 months (range, 3-24 mo) and then stopped. After transplant, 4 patients had antiviral medicine changed to adefovir or entecavir because of drug resistance, and otherwise all patients remained negative for hepatitis B virus DNA during follow-up. Conclusions: Patients transplanted for hepatitis B and D virus cirrhosis, even with hepatocellular carcinoma, had favorable prognosis and good long-term results. Close follow-up of patients and effective viral suppression with suitable drugs were key factors for efficient patient care.
Hepatitis C infection in hemodialysis patients: A review
(2015) Etik, Digdem Ozer; Ocal, Serkan; Boyacioglu, Ahmet Sedat; 25937865
Hepatitis C virus (HCV)-related liver disease is a significant cause of morbidity and mortality in patients with end-stage renal disease (ESRD) who is treated with dialysis or kidney transplantation (KT). The survival rate for HCV-infected renal transplant recipients is better than that for HCV-infected hemodialysis patients on transplant waiting lists. Early diagnosis and treatment HCV infection prior to KT prevents complications post-transplantation and reduces mortality. In addition to screening for anti-HCV antibodies and detecting HCV RNA, percutaneous liver biopsy is particularly valuable for assessing the stage of liver damage in HCV-infected patients, because the stage of fibrosis is important determining optimal treatment for HCV. Studies have been demonstrated that with conventional interferon (IFN) monotherapy or pegylated IFN monotherapy are similar efficacy and safety in HCV-infected hemodialysis patients. Sustained viral responses (SVRs) with these monotherapies have ranged approximately 30% to 40%. Limited reports support the use of IFN and ribavirin combination therapy as antiviral treatment for ESRD patients or patients on hemodialysis. Ribavirin can be started at low dose and careful monitoring for side effects. Patients that show SVR after treatment are strong candidates for KT. It is also generally accepted that ESRD patients with decompensated cirrhosis and portal hypertension should be referred to the liver transplant team for consideration of combined liver-KT.
Hepatocellular Carcinoma with Cardiac Cirrhosis After the Fontan Procedure
(2018) Suna, Nuretdin; Etik, Digdem Ozer; Ocal, Serkan; Hilmioglu, Fatih; 0000-0001-6234-7788; 0000-0002-4724-0728; 0000-0002-6440-5686; 0000-0003-3719-9482; 29373356; AAI-8822-2021; AAJ-4707-2021; AAJ-4437-2021; ABH-4817-2020
Lansoprazole-induced Acute Pancreatitis
(2014) Ocal, Serkan; Korkmaz, Murat; Yildirim, Abdullah Emre; Altun, Reskan; Akbas, Enver; Selcuk, Haldun; https://orcid.org/0000-0003-3719-9482; https://orcid.org/0000-0002-9333-782X; https://orcid.org/0000-0002-4386-9297; https://orcid.org/0000-0002-8445-6413; 25417626; ABH-4817-2020; AAM-1330-2020; AAG-6561-2020; F-3628-2015; AAJ-6976-2021
Late-Onset Drug-Induced Cholestasis in a Living-Related Liver Transplant Donor With Progressive Familial Intrahepatic Cholestasis
(2015) Harmanci, Ozgur; Ensaroglu, Fatih; Ozcay, Figen; Ocal, Serkan; Korkmaz, Murat; Ozdemir, B. Handan; Selcuk, Haldun; Moray, Gokhan; Haberal, Mehmet; 0000-0002-7528-3557; 0000-0003-3719-9482; 0000-0002-9333-782X; 0000-0002-3462-7632; 0000-0002-8445-6413; 0000-0003-2498-7287; 0000-0002-5214-516X; 0000-0002-0643-4980; 26640927; X-8540-2019; ABH-4817-2020; AAM-1330-2020; AAJ-8097-2021; AAJ-6976-2021; AAE-1041-2021; ABG-5684-2020
We present a rare case of progressive familial intrahepatic cholestasis within a family. A 34-year-old female became a living-related liver transplant donor for her son, who had the disease. Nine years after the transplant, the mother developed severe intrahepatic cholestasis, for which she was evaluated after using an oral contraceptive drug. She presented with jaundice, pruritus, and increased bilirubin levels, together with elevated gamma glutamyl transferase and alkaline phosphatase levels. A liver biopsy revealed findings consistent with intrahepatic cholestasis. However, despite follow-up management and cessation of the insulting drug, her total bilirubin count continuously increased to 20 mg/dL and was accompanied by intractable pruritus. A total of 9 plasmapheresis sessions were performed, and she was started on a regimen of ursodeoxycholic acid (13 mg/kg/d) and cholestyramine (4 g, 3 times daily). The clinical and laboratory picture dramatically improved following cessation of the oral contraceptive, plasmapheresis sessions, and drug treatment. The patient's cholestasis normalized within 3 months, and she recovered uneventfully. A genetic analysis of the whole family revealed that both parents were heterozygous for the mutation c.124G>A in ABCB11, and the son was homozygous for this mutation. These findings supported varying degrees of bile salt export pump deficiency in the family members. Defective bile salt excretory system function can result in a wide spectrum of clinical presentations, ranging from progressive familial intrahepatic cholestasis requiring liver transplant to late-onset drug-induced cholestasis. Our findings suggest that, in a heterozygous carrier of a progressive familial intrahepatic cholestasis mutation, drug-induced cholestasis is responsive to treatment, after which the clinical picture can normalize within 3 months.
Panel Reactive Antibodies in Predicting Hepatitis C Virus Treatment Outcome in Kidney Transplant Candidates
(2015) Ocal, Serkan; Harmanci, Ozgur; Korkmaz, Murat; Ensaroglu, Fatih; Colak, Turan; Selcuk, Haldun; Moray, Gokhan; Haberal, Mehmet; 0000-0002-8372-7840; 0000-0002-8445-6413; 0000-0003-3719-9482; 0000-0002-9333-782X; 0000-0003-2498-7287; 0000-0002-3462-7632; 0000-0002-0643-4980; 25894153; AAJ-8554-2021; AAJ-6976-2021; ABH-4817-2020; AAM-1330-2020; AAE-1041-2021; AAJ-8097-2021
Objectives: Chronic hepatitis C virus infection compromises hemodialysis patients and increases liver-related mortality. Interferon treatment is associated with improved sustained virological response rates and increased risk of graft loss after kidney transplant. This may be related to the development of antihuman leukocyte antigen antibodies, which may be a surrogate marker of potent immune response. We evaluated panel reactive antibody 1 and 2 levels for prediction of sustained viral response in patients with kidney transplant. Materials and Methods: In this retrospective cohort study, we reviewed data from hepatitis C virus-infected hemodialysis patients who received interferon treatment before kidney transplant. Panel reactive antibody > 20% was considered positive. Sustained viral response rates for interferon treatment were obtained and compared with panel reactive antibody 1 and 2 values. Results: There were 40 patients (16 female and 24 male patients; mean age, 41.5 y; range, 18-65 y). Sustained viral response rate was 18/40 (45%). Panel reactive antibody 1 was negative in 31 patients and positive in 9 patients. Sustained viral response ratio was not correlated with panel reactive antibody 1 positivity. Panel reactive antibody 2 was negative in 31 patients (sustained viral response: present, 11 patients; absent, 20 patients) and positive in 9 patients (sustained viral response: present, 7 patients; absent, 2 patients). Sustained viral response ratio was significantly correlated with panel reactive antibody 2 positivity. Conclusions: We showed a correlation between panel reactive antibody 2 positivity and sustained viral response rates that may be a predictive tool for hepatitis C virus treatment response. In patients with other complications that compromise hepatitis C virus treatment, panel reactive antibody 2 may be a surrogate marker for sustained viral response prediction. The induction of cellular immunity may cause clearance of hepatitis C virus infection and formation of high panel reactive antibody 2 levels.
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.