Tıp Fakültesi / Faculty of Medicine

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Author: search.filters.author.Selcuk, HaldunSubject: search.filters.subject.Hepatocellular carcinoma

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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.
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    Prognostic Factors and Staging Systems in Hepatocellular Carcinoma
    (2017) Selcuk, Haldun; 0000-0002-8445-6413; 28301998; AAJ-6976-2021
    There are a number of factors that should be taken into consideration when predicting the outcomes and prognosis of hepatocellular carcinoma. Four of the most important factors in determining survival are the severity of the accompanying liver disease, tumor size and number, extension of the tumor into other structures, and presence of metastases. The most common and widely accepted tumor staging systems include these 4 prognostic factors. The staging systems are (1) the tumor-node-metastasis system of the American Joint Committee on cancer, (2) the Okuda system, (3) the Barcelona Clinic Liver Cancer system, (4) the Cancer of the Liver Italian Program score; (5) the recent albumin-bilirubin grading system, and finally (6) the Hong Kong Liver Cancer staging system. The successful staging of patients with hepatocellular carcinoma is difficult because of the many contributing factors to disease. Therefore, in clinical practice, there is no ideal system that can be applicable to every patient in predicting survival. As a general rule, patient and treatment modality selection criteria should be individualized for every patient and should not use an algorithmic approach because aggressive treatments in properly selected patients with hepatocellular carcinoma offer good results. A better approach for increased treatment success is one that is multidisciplinary, that is, one that considers the different variables.