Tıp Fakültesi / Faculty of Medicine

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search.filters.applied.f.language: search.filters.language.engSubject: search.filters.subject.Liver biopsy

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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.
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    Liver Stiffness Measurements Using Acoustic Radiation Force Impulse in Recipients of Living-Donor and Deceased-Donor Orthotopic Liver Transplant
    (2021) Haberal, Kemal Murat; Turnaoglu, Hale; Ozdemir, Adnan; Uslu, Nihal; Reyhan, Asuman Nihan Haberal; Moray, Gokhan; Haberal, Mehmet; 0000-0002-8211-4065; 0000-0002-3462-7632; 28836931; R-9398-2019; AAJ-8097-2021
    Objectives: The aim of this study was to evaluate the diagnostic efficiency of the acoustic radiation force impulse (Siemens Medical Solutions, Erlangen, Germany) elastography in assessment of fibrosis in orthotopic liver transplant patients. Materials and Methods: We enrolled 28 orthotopic liver transplant patients (5 deceased and 23 living donors), whose biopsy decision had been prospectively given clinically. Ten acoustic radiation force impulse elastographic measurements were applied before the biopsy or within 3 days after the biopsy by 2 radiologists. After the core tissue needle biopsy, specimens of all patients were analyzed according to the modified Ishak scoring system. Measurements of acoustic radiation force impulse elastography and pathology specimen results were compared. Results: From 28 biopsies, fibrosis scores of 4 biopsies were evaluated as F0 (14.3%), 16 as F1 (57.1%), 4 as F2 (14.3%), and 4 as F3 (14.3%). Mean results of acoustic radiation force impulse measurements were calculated as 1.4 +/- 0.07 in F0, 1.74 +/- 0.57 in F1, 2.19 +/- 0.7 in F2, and 2.18 +/- 0.35 in F3. There were no significant correlations of mean acoustic radiation force impulse values between the F0 versus F1 (P =.956) and F0 versus F2 stages (P =.234). A statistically significant correlation of mean acoustic radiation force impulse values was found between the F0 and F3 fibrosis stages (P =.046). Conclusions: Acoustic radiation force impulse imaging is a promising screening test for detecting significant liver fibrosis (>= F3 in modified Ishak) in living- donor or deceased-donor orthotopic liver transplant recipients.
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    Is Unenhanced Computed Tomography Reliable in the Assessment of Macrovesicular Steatosis in Living Liver Donors?
    (2019) Haberal, Kemal Murat; Turnaoglu, Hale; Reyhan, Asuman Nilhan Haberal; 31666000
    Objectives: In this retrospective study, we aimed to determine the diagnostic value of unenhanced computed tomography in the assessment of macro vesicular steatosis in potential living liver transplant donors by using biopsy as a reference standard. Materials and Methods:This retrospective study was approved by our institutional review board, and all included patients provided written informed consent. Our study group included 181 donor candidates (mean age of 35.9 +/- 9.3 y) who underwent unenhanced computed tomography and subsequent needle biopsy (mean period after scan of 12.74 d) in the right hepatic lobe (at least 2 samples per patient). Histologic degree of macrovesicular steatosis was determined. A radiologist with 10 years of experience assessed steatosis of the right hepatic lobe by using 2 methods: (1) a 4-point visual grading system that used attenuation comparison between the liver and hepatic vessels and (2) the liver attenuation index, which was calculated with region of interest measurements of hepatic attenuation. We used statistical analyses to compare accuracy in the diagnosis of macrovesicular steatosis. Results: Our study population was divided into 3 groups according to histologic steatosis grade. Group 1 consisted of 157 candidates with 0% to 5% steatosis, group 2 consisted of 11 candidates with 6% to 15% steatosis, and group 3 consisted of 13 candidates with 16% to 100% steatosis. Mean liver attenuation (in Hounsfield units standard deviation) was 58.93 +/- 5.07 for group 1, 47.8 +/- 4.17 for group 2, and 39.11 +/- 6.5 for group 3. Significant differences in liver attenuation were observed between groups using one-way analyses of variance (F = 107 307; P < .01). For visual grading, correlation coefficient for computed tomography was 0.959. Conclusions: Unenhanced computed tomography to assess liver attenuation represents an objective and noninvasive means for detection of hepatic steatosis. This method can prevent unnecessary biopsies.