Tıp Fakültesi / Faculty of Medicine

Permanent URI for this collectionhttps://hdl.handle.net/11727/1403

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Author: search.filters.author.Haberal, MehmetSubject: search.filters.subject.Cirrhosis

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    Locoregional Therapy and Recurrence of Hepatocellular Carcinoma After Liver Transplant
    (2014) Kirnap, Mahir; Boyvat, Fatih; Akdur, Aydincan; Karakayali, Feza; Arslan, Gulnaz; Moray, Gokhan; Haberal, Mehmet; https://orcid.org/0000-0002-8726-3369; https://orcid.org/0000-0002-1874-947X; https://orcid.org/0000-0003-2498-7287; https://orcid.org/0000-0002-3462-7632; 24635819; AAH-9198-2019; F-4230-2011; AAA-3068-2021; AAB-3888-2021; AAE-1041-2021; AAJ-8097-2021
    Objectives: Locoregional therapy may decrease the tumor stage and enable liver transplant in patients who have hepatocellular cancer. The purpose of the present study was to assess the relation between locoregional therapy and recurrence of hepatocellular carcinoma after transplant. Materials and Methods: In 50 patients who had liver transplant for treatment of end-stage liver disease from hepatocellular carcinoma and cirrhosis, outcomes were evaluated for associations with locoregional therapy before transplant and Milan criteria. Results: Most patients had locoregional therapy before transplant (31 patients [62%]: transarterial catheter radiofrequency ablation alone, 16 patients; chemoembolization alone, 10 patients; both transarterial catheter radiofrequency ablation and chemoembolization, 5 patients). Follow-up at median 90 months after transplant showed that 9 patients (18%) had recurrence at median 45 months (range, 120 +/- 12 mo) (recurrence: locoregional therapy, 5 of 31 patients [16%]; no locoregional therapy, 4 of 19 patients [21%]; not significant). Locoregional therapy was associated with a significantly lower frequency of recurrence in patients who were outside the Milan criteria. Conclusions: In patients who have liver transplant for treatment of hepatocellular carcinoma, preoperative locoregional therapy may decrease recurrence in patients who are outside the Milan criteria.
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    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.