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Graft-versus-host disease after liver transplantation:A comprehensive literature review

World Journal of Gastroenterology 2012年第37期18卷 5240-5248页

作者： sami akbulut Mehmet yilmaz sezai yilmaz Liver Trans plant Institute Inonu University Faculty of Medicine

AIM： To determine the factors affecting mortality in pa- tients who developed graft-versus-host disease （GvHD） after liver transplantation （LT）. METHODS： We performed a review of studies of GvHD following LT published in the English literature and ac- cessed the PubMed, Medline, EBSCO, EMBASE, and Google Scholar databases. Using relevant search phras- es, 88 articles were identified. Of these, 62 articles con- raining most of the study parameters were considered eligible for the study. Risk factors were first examined using a univariate Kaplan-Meier model, and variables with a significant association （P 〈 0.05） were then sub- jected to multivariate analyses using a Cox proportional- hazards model. RESULTS： The 61 articles reported 87 patients, 58 male and 29 female, mean age, 40.4 ± 15.5 years （range： 8 mo to 74 years）, who met the inclusion criteria for the present study. Deaths occurred in 59 （67.8%） patients, whereas 28 （32.2%） survived after a mean follow-up period of 280.8 ± 316.2 d （range： 27-2285 d）. Among the most frequent symptoms were rash （94.2%）, fever （66.6%）, diarrhea （54%）, and pancytopenia （54%）. The average time period between LT and first symptom on- set was 60.6 ± 190.1 d （range： 2-1865 d）. The Kaplan- Meier analysis revealed that pancytopenia （42.8% vs 59.3%, P = 0.03）, diarrhea （39.2% vs 61.0%, P = 0.04）, age difference between the recipient and the donor （14.6 ± 3.1 years vs 22.6 ± 2.7 years, P 〈 0.0001）, and time From first symptom occurrence to diagnosis or treatment （13.3 ± 2.6 mo vs 15.0 ± 2.3 mo, P 〈 0.0001） were significant factors affecting mortality, whereas age, sex, presence of rash and fever, use of immunosuppressive agents, acute rejection before GvHD, etiological causes, time of onset, and donor type were not associated with mortality risk. The Cox proportional-hazards model, de- termined that an age difference between the recipient and donor was an independent risk Factor （P = 0.03; hazard ratio, 7.395, 95% confidence interval, 1.

关键词： Liver transplantation Graft-versus-host dis-ease Immunosuppression Rash Pancytopenia Diar-rhea Chimerism Age factors

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COVID-19 pandemic:Its impact on liver disease and liver transplantation

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World Journal of Gastroenterology 2020年第22期26卷 2987-2999页

作者： Tevfik Tolga Sahin sami akbulut.sezai yilmaz Deaprtment of Surgery and Liver Transplant Institute Inonu University Faculty of MedicineMalatya 244280Turkey

Severe pulmonary disease caused by the novel coronavirus[severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)],has devastated many countries around the *** has overwhelmed the medical *** priorities of many institutions have changed to manage critically ill corona virus infectious disease-2019(COVID-19)patients,which affected the working style of many *** and transplant surgeons look after a very sensitive patient *** with liver disease need special attention and continuous ***,transplant candidates also need special *** professionals in the field of hepatology face the overwhelming task of taking care of COVID-19 patients with hepatic complications,liver disease or transplant patients who are SARS-CoV-2 positive,and the patients on routine surveillance who do not have *** review will evaluate COVID-19 from the perspective of its effect on the liver and its possible effects on patients with liver ***,the level of care for liver transplant recipients during the pandemic will be discussed.

关键词： SARS-Cov-2 COVID-19 Acute liver injury Chronic liver disease Liver transplantation Risk factors

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Factors affecting anxiety, depression, and self-care ability in patients who have undergone liver transplantation

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World Journal of Gastroenterology 2021年第40期27卷 6967-6984页

作者： sami akbulut Ali Ozer Hasan Saritas sezai yilmaz Liver Transplant Institute Inonu University Faculty of MedicineMalatya 44280Turkey Department of Public Health Inonu University Faculty of MedicineMalatya 44280Turkey Department of Surgical Nursing Siirt University Faculty of NursingSiirt 56100Turkey

BACKGROUND Depression,anxiety,and altered self-care ability are among the most important factors affecting the quality of life of liver transplant *** on the severity of the underlying liver disease,signs and symptoms of anxiety and depression may become more *** To evaluate the factors affecting depression,anxiety and self-care abilities of liver transplant *** Recipients who are≥18 years and who underwent liver transplantation at Inonu University Liver Transplantation Institute were included in this descriptive and cross-sectional *** size analysis showed that the minimum number of recipients should be 301(confidence level=95%,confidence interval=2.5,population=1382).Three hundred and twenty recipients were interviewed and 316 recipients that have answered the questionnaires accurately were *** dependent variables were the Beck Depression Scale,State-Trait Anxiety Scale(Form I and II),and Self-Care Agency *** independent variables of the study were sociodemographic characteristics,biliary complications,hepatocellular carcinoma,recommending liver transplantation to other patients,and the interval of out-patient clinic *** Self-care ability scores were lower(P=0.002)and anxiety scores were higher(P=0.004)in recipients with biliary *** the other hand,in recipients with hepatocellular carcinoma,self-care scores were lower(P=0.006)while depression(P=0.003)and anxiety scores(P=0.009)were *** transplantation recipients with a monthly income<3000 Turkish liras had higher depression(P<0.001)and anxiety(P=0.003)*** recipients who stated that they would not recommend liver transplantation to others had lower self-care scores(P=0.002),higher depression(P<0.001),higher state anxiety(P=0.02),and trait anxiety(P<0.001)*** Presence of biliary complications and hepatocellular carcinoma,low income level,and an obligation for monthly visits to the outpatient clini

关键词： Liver transplantation Biliary complications Hepatocellular carcinoma Socioeconomic status Depression Anxiety Self-care capabilities

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Comment on pediatric living donor liver transplantation decade progress in Shanghai: Characteristics and risks factors of mortality

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World Journal of Gastroenterology 2020年第30期26卷 4564-4566页

作者： sami akbulut Tevfik Tolga Sahin sezai yilmaz Deaprtment of Surgery and Liver Transplant Institute Inonu University Faculty of MedicineMalatya 44280Turkey

Since the first successful liver transplantation was performed five decades ago,pediatric liver transplantation has become the gold standard treatment choice for pediatric liver disease,including metabolic diseases,liver tumors,and some acute liver *** improvements in immunosuppression,surgical techniques,and postoperative medical care,long-term outcomes of patients after liver transplantation have markedly improved,especially in pediatric patients.

关键词： Pediatric end stage liver disease Living donor pediatric liver transplantation Survival analysis Risk factors Living donor liver transplantation Outcomes

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In memoriam of Thomas Earl Starzl,the pioneer of liver transplantation

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World Journal of Transplantation 2022年第3期12卷 55-58页

作者： sezai yilmaz sami akbulut Surgery and Liver Transplant Institute Inonu UniversityMalatya 44280Turkey

Starzl’s nearly 3000 publications that contribute to the science of transplantation in every field have been the most important resources for every scientist working in this *** those of us who work in the liver transplant field,his contributions throughout his life have shaped our career and passion,even for those who have never met,spoken to,or worked with *** we are able to help patients with liver failure today by offering them the chance of transplantation,it is because of Starzl’s passionate work and *** to Starzl’s scientific legacy,hundreds of scientists serve humanity and thousands of patients can hold on to *** has been an honor for us to write this article about Professor Starzl.

关键词： Liver transplantation Thomas Earl Starzl Pioneer of liver transplantation

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Impact of COVID-19 pandemic on clinicopathological features of transplant recipients with hepatocellular carcinoma:A case-control study

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World Journal of Clinical Cases 2022年第15期10卷 4785-4798页

作者： sami akbulut Tevfik Tolga Sahin Volkan Ince sezai yilmaz Surgery and Liver Transplant Institute Inonu University Faculty of MedicineMalatya 44280Turkey

BACKGROUND The coronavirus disease 2019(COVID-19)pandemic had a significant impact on the management of all *** diseases such as cancer have a higher risk of COVID-19-related *** this fact,any delay or alteration in treatment of cancer may have fatal *** carcinoma(HCC)is an aggressive liver cancer that requires multimodality treatment to improve *** To evaluate the impact of COVID-19 on the management of patients with HCC by determining changes in demographic,clinical and histopathological *** Demographic,clinical and pathological variables of patients with HCC who had undergone liver transplantation between March 2020 and June 2021(Pandemic group,n=48)were retrospectively compared with that of the patients with HCC transplanted between November 2018 and March 2020(Pre-pandemic group,n=61).RESULTS The median age of the patients in the study was 56(interquartile range=15).Ninety-seven patients(89%)were male and 12 were female(11%).The most common etiology of liver disease was hepatitis B virus(n=52,47.7%).According to our results,there was a 21.3% drop in the number of patients transplanted for *** was no difference in the demographic,clinical and pathological characteristics of the patients except blood alkaline phosphatase levels(P=0.029),lymphovascular invasion(P=0.019)and type of the liver graft that was transplanted(P=0.017).CONCLUSION It is important to develop a surveillance strategy for liver transplant *** liver transplantation for HCC is justified and safe provided that strict surveillance protocols are applied.

关键词： COVID-19 pandemic Liver transplantation Hepatocellular carcinoma Biological behavior

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How to reduce and manage hepatic arterial complications in living and deceased donor liver transplantations

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Hepatobiliary Surgery and Nutrition 2021年第5期10卷 731-733页

作者： Emrah Otan sami akbulut.sezai yilmaz Department of Surgery and Liver Transplant Institute Inonu University Faculty of MedicineMalatyaTurkey

Hepatic arterial complications include hepatic artery thrombosis(HAT),stenosis,and *** may occur in the early as well as the late *** HAT has typically been associated with less severe complications and may even be **... 详细信息

关键词： hepatic complications arterial

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Liver transplantation for hepatocellular carcinoma:Historical evolution of transplantation criteria

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World Journal of Clinical Cases 2022年第29期10卷 10413-10427页

作者： Volkan Ince Tevfik Tolga Sahin sami akbulut.sezai yilmaz Surgery and Liver Transplant Institute Inonu University Faculty of MedicineMalatya 44280Turkey Biostatistics and Medical Informatics Inonu University Faculty of MedicineMalatya 44280Turkey

Liver transplantation(LT) for hepatocellular carcinoma is still a hot topic,and the main factor that is associated with the success of treatment is to determine the patients who will benefit from *** criteria have been defined 25 years ago and still is being used for patient selection for ***,in living donor LT,the Milan criteria is being *** criteria for patient selection do not only consider morphologic characteristics such as tumor size and number of tumor nodules but also biologic markers that show tumor aggressiveness is also being *** the present review article,we have summarized all the criteria and scoring systems regarding LT for hepatocellular *** criteria have 5-year overall survival rates that were comparable to the Milan Criteria and ranged between 60%-85%.On the other hand,it was seen that the recurrence rates had increased as the Milan criteria were exceeded;the 5-year recurrence rates ranged between 4.9% to 39.9%.Treatment of hepatocellular carcinoma needs a multidisciplinary *** selection criteria are yet to be *** same is true for treatment *** goal will be achieved by a harmonic interplay between basic science researchers and clinicians.

关键词： Liver transplantation Hepatocellular carcinoma Milan criteria Expanded Malatya criteria

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Hepatic artery reconstruction technique in liver transplantation:experience with 3,000 cases

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Hepatobiliary Surgery and Nutrition 2021年第2期10卷 281-283页

作者： sami akbulut Koray Kutluturk sezai yilmaz Department of Surgery and Liver Transplant Institute Inonu University Faculty of MedicineMalatyaTurkey

Hepatic artery reconstruction(HAR)is the most valuable step in correcting graft and recipient survival after liver transplantation(LT).Hepatic artery thrombosis(HAT)in immediate postoperative period may lead to fatal *** allograft is partial in a living donor liver transplantation(LDLT),and HAR is technically much more difficult than deceased donor liver transplantation(DDLT).The likelihood of HAT in LDLT is higher due to the narrower diameters of arterial vessels.

关键词： Hepatic donor narrow

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Attitudes,awareness,and knowledge levels of the Turkish adult population toward organ donation:Study of a nationwide survey

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World Journal of Clinical Cases 2020年第11期8卷 2235-2245页

作者： sami akbulut Ali Ozer Ayse Gokce Khaled Demyati Hasan Saritas sezai yilmaz Department of Public Health Inonu University Faculty of MedicineMalatya 44280Turkey Liver Transplant Institute Inonu UniversityMalatya 44280Turkey Department of Surgery An-Najah National University HospitalAn-Najah National UniversityNablus 11941Palestine Department of Surgical Nursing Inonu University Faculty of NursingMalatya 44280Turkey

BACKGROUND The most important factors affecting attitudes on organ donation are socioeconomic, educational, cultural, and religious factors in many *** To evaluate the attitudes, awareness, and knowledge levels of the Turkish adult population toward organ *** This nationwide study surveyed 3000 adults(≥ 18 years) in Turkey. To ensure a representative sample, the Nomenclature of Territorial Units for Statistics-Ⅱ(modified for Turkey) was used. Turkey was divided into 26 regions based on social, economic, and geographic criteria as identified by the Turkish Statistical Institute. A stratified sampling method was used with an even distribution of adults across cities and towns based on population data. Data were collected by the PRP Research and Consultancy Company using computer-assisted personal *** Out of 3000 individuals represented in the study population, 1465(48.8%) were male and 1535(51.2%) female. The results showed that most participants were under 45 years(59.0%) and married(72.1%), some had a bachelor’s degree or higher(21.9%), and very few(1.5%) had any direct experience with organ transplantation-whether in the family, or a family member on a transplantation waiting list. Most of the study population(88.3%) had not considered donating an organ, however, most(87.9%) said that they would accept an organ from a donor if they needed one. Among the individuals surveyed, 67% were willing to donate an organ to a close relative, while 26.8% would donate an organ to an unrelated person. Only 47.2% said they had adequate information about brain death, and 85.2% refused to consent to donating organs of family members declared brain dead. Only 33.9% thought they had adequate information about organ donation. The main source of information was the television. The two main reasons for refusing organ donation were that it was too soon to think about organ donation and the importance of retaining the integrity of the dead person’s bo

关键词： Organ donation Adult population Attitudes Knowledge levels Awareness Barriers to the organ donation

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