Başkent Üniversitesi Dergileri

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search.filters.applied.f.language: search.filters.language.enSubject: search.filters.subject.Liver transplant

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    Liver Transplant for Mixed Capillary-cavernous Hemangioma Masquerading as Hepatocellular Carcinoma in a Patient With Hepatocellular Carcinoma
    (Başkent Üniversitesi, 2011-10) Unal, Ethem; Teperman, Lewis; Morgan, Glyn; Xu, Ruliang; Aquino, Alger; Francis, Franto
    Hemangioma is the most common benign tumor of the liver. Unlike cavernous hemangioma, hepatic capillary or mixed capillary-cavernous hemangioma is a rare type of tumor in adults. Clinical presentation of hemangioma may mimic that of hepatocellular carcinoma. Furthermore, radiologic features on computed tomography and magnetic resonance imaging may not be typical for hemangioma and can be confused with hepatocellular carcinoma. Symptomatic hemangiomas require some form of treatment, such as corticosteroids, interferon, radiation, arterial embolization, surgical resection, or liver transplant. In the present case study, we present a patient treated with liver transplant for hemangioma mimicking hepatocellular carcinoma. This case report illustrates the atypical imaging appearance of hemangioma and possible confusion it can cause in diagnosing hepatocellular carcinoma, especially in a hepatitis C carrier.
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    Lack of Association of the Polymorphism of the CCR5 Gene in Liver Recipients With Acute Rejection From China
    (Başkent Üniversitesi, 2011-08) Li, Hong; Zheng, Shu-Sen; Zhou, Lin; Xie, Hai-yang
    Objectives: This study sought to investigate the associations between polymorphisms in the chemokine receptor 5 gene and acute rejection in liver transplant. Materials and Methods: A total of 266 patients who underwent a liver transplant between January 2006 and March 2009 were enrolled in this study. Genomic DNA was extracted from whole blood, and chemokine receptor 5Δ32 was detected by polymerase chain reaction. Eight nucleotide polymorphism loci in the chemokine receptor 5 gene were detected by Applied Biosystems SNaP-Shot and TaqMan technologies. Results: Chemokine receptor 5Δ32 mutation was not detected in all the individuals from China. There was no significant association between the single nucleotide polymorphism in chemokine receptor 5 gene and acute rejection. Conclusions: Single nucleotide polymorphisms in a single gene of the chemokine receptor 5 might not play a role in acute rejection after liver transplant.
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    Hepatitis A Virus-related Late-onset Hepatic Failure: A Case Report
    (Başkent Üniversitesi, 2011-04) Hayashi, Michihiro; Tanigawa, Nobuhiko; Haga, Hironori; Takeshita, Atsushi; Asakuma, Mitsuhiro; Hirokawa, Fumitoshi; Tsunematsu, Ichiro; Shimizu, Tetsunosuke
    Late-onset hepatic failure, the least of the fulminant hepatic failures, has not occurred in patients with hepatitis A virus-related acute liver failure. We report a rare case of hepatitis A virus-related late-onset hepatic failure treated successfully by an emergent liver transplant. A 58-year-old Japanese woman who presented with fever and general malaise was diagnosed as having jaundice and liver dysfunction by a positive serum test for anti-hepatitis A virus IgM, which ultimately led to a diagnosis of acute hepatitis A virus-associated hepatitis. Despite intensive treatment, her general condition was poor, and she developed a hepatic coma 79 days from the onset of the disease. Under a diagnosis of hepatitis A virus-related late-onset hepatic failure, she was given a living-donor liver transplant 82 days from the start of the disease. The resected native liver revealed submassive necrosis with marked cholestasis, compatible with late-onset hepatic failure. Today, 5 years after the transplant, she is alive and well with no signs of recurrent hepatitis A virus-hepatitis. This case should alert the physician to the clinical management of a patient with hepatitis A virus-related acute liver failure.
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    Severe Hepatitis C Virus Recurrence Is Nearly Universal After Donation After Cardiac Death Liver Transplant
    (Başkent Üniversitesi, 2011-04) Ortiz, Jorge; Araya, Victor; Balasubramanian, Manjula; Zaki, Radi; Khanmoradi, Kamran; Campos, Stalin; Hashemi, Nikroo; Azhar, Ashaur; Parsikia, Afshin; Feyssa, Eyob L.
    Objectives: The rate of hepatitis C virus recurrence after donation after cardiac death liver transplant is not clearly defined. Materials and Methods: This is a retrospective review of 39 donations after cardiac death-liver transplant recipients. Biopsies were performed at 6, 12, 24, and 36 months for all hepatitis C virus positive donation after cardiac death recipients. Results: The 6-, 12-, 24-, and 36-month severe hepatitis C virus recurrence rates were 60%, 73%, 87%, and 94%. A histologic comparison group of 26 long-surviving hepatitis C virus positive donation after neurologic death recipients had severe hepatitis C virus recurrence 27%, 31%, 42%, and 52% of the time. Six of the 19 hepatitis C virus donation after cardiac death patients developed cirrhosis at a median of 56 months (range, 14-119 months). There was no significant 3-year allograft and patient survival difference between hepatitis C virus and nonhepatitis C virus donation after cardiac death recipients. The factors most associated with decreased survival in the entire cohort included biliary and vascular complications. Organs procured by our institution’s attending surgeons were associated with a better 3-year allograft survival. Conclusions: Severe hepatitis C virus recurrence was nearly universal but did not lead to increased graft loss when compared with nonhepatitis C virus donation after cardiac death at 3 years. These data may justify early interferon treatment in these at-risk patients.
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    Analysis of Right Lobe Living-Liver Donor Complications: A Single Center Experience
    (Başkent Üniversitesi, 2011-02) Yaprak, Onur; Tokat, Yaman; Yuzer, Yildiray; Tabendeh, Babek; Demirbas, B. Tolga; Dayangac, Murat
    Objectives: Living-donor liver transplant provides an alternative source of organ to patients with end-stage liver disease. This study sought to determine and classify the donor morbidities after right lobe donor hepatectomy in a single center. Materials and Methods: One-hundred eighty-one right lobe living-donor hepatectomy were performed in our center between January 2004 and December 2009. Of the 181 donors, 104 donors were men and 77 donors were women. Mean age of the donors was 38 years (range, 18-63 years). The mean follow-up was 33.3 months (range, 3-66 months). Complications after the operation were stratified according to the Clavien classification. Results: Eighty-one complications occurred in 73 of the 181 donors (40.3%). The most common complication was wound infection, which was seen in 14 of 181 donors (7.7%). Biliary complications were seen in 4.4% of donors. There was no postoperative mortality. Also, grade 4 complications, which are life-threatening, did not occur. Blood transfusion were not required during the operation. The incidence of reoperation was 1.6% in all donors. Conclusions: Living-donor liver transplant ensures a new graft to patients with end-stage liver disease. Donor morbidity is one of the realities of the donor hepatectomy procedure. Because the donors are healthy individuals, the aim of the process must be to eliminate the donor mortality while decreasing the complication rates.