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Article: Liver Transplantation in Chronic Liver Disease and Acute on Chronic Liver Failure- Indication, Timing and Practices.

Choudhury, Ashok / Adali, Gupse / Kaewdech, Apichat / Giri, Suprabhat / Kumar, Rahul

Journal of clinical and experimental hepatology

2024 Volume 14, Issue 3, Page(s) 101347

Abstract: Liver transplantation (LT) is the second most common solid organ transplantation worldwide. LT is considered the best and most definitive therapeutic option for patients with decompensated chronic liver disease (CLD), hepatocellular carcinoma (HCC), ... ...

Abstract	Liver transplantation (LT) is the second most common solid organ transplantation worldwide. LT is considered the best and most definitive therapeutic option for patients with decompensated chronic liver disease (CLD), hepatocellular carcinoma (HCC), acute liver failure (ALF), and acute-on-chronic liver failure (ACLF). The etiology of CLD shows wide geographical variation, with viral hepatitis being the major etiology in the east and alcohol-related liver disease (ALD) in the west. Non-alcoholic fatty liver disease (NAFLD) is on an increasing trend and is expected to be the most common etiology on a global scale. Since the first successful LT, there have been radical changes in the indications for LT. In many circumstances, not just the liver disease itself but factors such as extra-hepatic organ dysfunction or failures necessitate LT. ACLF is a dynamic syndrome that has extremely high short-term mortality. Currently, there is no single approved therapy for ACLF, and LT seems to be the only feasible therapeutic option for selected patients at high risk of mortality. Early identification of ACLF, stratification of patients according to disease severity, aggressive organ support, and etiology-specific treatment approaches have a significant impact on post-transplant outcomes. This review briefly describes the indications, timing, and referral practices for LT in patients with CLD and ACLF.
Language	English
Publishing date	2024-01-26
Publishing country	India
Document type	Journal Article ; Review
ISSN	0973-6883
ISSN	0973-6883
DOI	10.1016/j.jceh.2024.101347
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Article: Acute Severe Ulcerative Colitis After mRNA Coronavirus Disease 2019 Vaccination: Can mRNA Vaccines Unmask Inflammatory Bowel Diseases?

Ak, Çağatay / Sayar, Süleyman / Adalı, Gupse / Özdil, Kamil

ACG case reports journal

2022 Volume 9, Issue 7, Page(s) e00806

Abstract: BNT162b2 is a messenger RNA vaccine for the prevention of the novel coronavirus disease 2019 caused by severe acute respiratory syndrome coronavirus 2 infection. The widespread use of this vaccination has brought along several adverse events. We present ... ...

Abstract	BNT162b2 is a messenger RNA vaccine for the prevention of the novel coronavirus disease 2019 caused by severe acute respiratory syndrome coronavirus 2 infection. The widespread use of this vaccination has brought along several adverse events. We present a patient with newly diagnosed ulcerative colitis after BNT162b2 vaccine.
Language	English
Publishing date	2022-07-01
Publishing country	United States
Document type	Case Reports
ZDB-ID	2814825-3
ISSN	2326-3253
ISSN	2326-3253
DOI	10.14309/crj.0000000000000806
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Article: Prediction of Prognosis Acute Pancreatitis with Inflammatory Markers and Patient Characteristics Compared to the Scoring System: Real-Life Data.

Ak, Cagatay / Kahraman, Resul / Sayar, Suleyman / Kilic, Ebru Tarikci / Adali, Gupse / Ozdil, Kamil

Sisli Etfal Hastanesi tip bulteni

2023 Volume 57, Issue 2, Page(s) 182–188

Abstract: Objectives: Acute pancreatitis (AP) is an inflammatory disease with a high morbidity and mortality rate. It is one of the most common causes of hospitalization among gastrointestinal system diseases. Inflammatory and other factors that predict the ... ...

Abstract	Objectives: Acute pancreatitis (AP) is an inflammatory disease with a high morbidity and mortality rate. It is one of the most common causes of hospitalization among gastrointestinal system diseases. Inflammatory and other factors that predict the severity of AP are very important for patient management. This study will analyze the factors associated with the severity of AP. Methods: The sample consisted of 514 patients. Demographic characteristics, comorbid diseases, causes of AP, body mass index (BMI), tobacco use, blood at admission, amylase, lipase, leukocyte, neutrophil, lymphocyte, C-reactive protein (CRP), mean platelet volume, red cell distribution width, albumin, calcium, and CRP values at 48th h were recorded. The bedside index of severity in AP (BISAP), Ranson score, neutrophil-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) values was calculated and recorded. The relationship between these parameters and the severity of AP was analyzed according to the Atlanta classification. Results: Participants had a mean age of 55±17.8 years. More than half the participants were women (n=272, 52.9%). Biliary causes were the most common etiological causes (n=299, 58.2%). Most participants had mild pancreatitis (n=416, 80.9%). The severity of AP was associated with tobacco use, high BMI, thrombocytosis, high NLR, high PLR, high 48 Conclusion: Biochemical markers that give rapid results in the early period can provide information about the severity of AP. We may develop new scores by combining these parameters.
Language	English
Publishing date	2023-06-20
Publishing country	Turkey
Document type	Journal Article
ZDB-ID	3026862-X
ISSN	1308-5123 ; 1302-7123
ISSN (online)	1308-5123
ISSN	1302-7123
DOI	10.14744/SEMB.2022.42966
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Article ; Online: Prevalence and predictors of metabolic-associated fatty liver disease in liver transplant recipients: A cross-sectional prospective study.

Adali, Gupse / Bilgic, Nermin Mutlu / Kalaman, Ahmet Emre / Ozturk, Oguzhan / Ozdil, Kamil

Hepatology forum

2023 Volume 4, Issue 3, Page(s) 129–134

Abstract: Background and aim: Metabolic-associated fatty liver disease (MAFLD) has emerged as a significant global health concern. However, the prevalence and predictors of MAFLD in post-liver transplantation (LT) patients remain uncertain. This study aimed to ... ...

Abstract	Background and aim: Metabolic-associated fatty liver disease (MAFLD) has emerged as a significant global health concern. However, the prevalence and predictors of MAFLD in post-liver transplantation (LT) patients remain uncertain. This study aimed to determine the prevalence and predictors of MAFLD in LT recipients and to assess the effectiveness of controlled attenuation parameter (CAP) values in diagnosing post-transplant MAFLD. Materials and methods: A cross-sectional prospective study was conducted involving 128 adult patients who had undergone LT, and had received liver imaging, and vibration-controlled transient elastography (VCTE). MAFLD was diagnosed on the basis of the presence of liver steatosis detected through imaging and specific metabolic risk abnormalities. Results: The prevalence of MAFLD after LT was 34.4%, with 22.1% categorized as de novo MAFLD, and 12.3% as recurrent MAFLD. Posttransplant diabetes (OR: 4.88; 95% CI 1.30-18.34; p=0.019) and higher CAP values (OR: 1.04; 95% CI 1.02-1.06; p=0000) were identified as independent predictors of post-LT MAFLD. A CAP cutoff value of 270 dB/m exhibited an area under the receiver operating curve of 0.84 in detecting MAFLD. Conclusion: These findings underscore the notable prevalence of MAFLD in liver transplant recipients and suggest the potential utility of VCTE as a non-invasive tool for its detection.
Language	English
Publishing date	2023-09-20
Publishing country	Turkey
Document type	Journal Article
ISSN	2757-7392
ISSN (online)	2757-7392
DOI	10.14744/hf.2023.2023.0032
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Article ; Online: Outcomes of right lobe donors with BMI≥30 for living donor liver transplantation.

Andacoglu, Oya / Tokat, Yaman / Malamutmann, Eugen / Adali, Gupse / Emre, Anilalp / Oezcelik, Arzu

Clinical transplantation

2022 Volume 36, Issue 7, Page(s) e14698

Abstract: Background: Donor BMI above 30 is generally considered contraindication for donor hepatectomy. We compared the donor outcomes based on BMI threshold and weight loss.: Patients and methods: All potential donors were identified and data were collected ... ...

Abstract	Background: Donor BMI above 30 is generally considered contraindication for donor hepatectomy. We compared the donor outcomes based on BMI threshold and weight loss. Patients and methods: All potential donors were identified and data were collected retrospectively. Steatosis was assessed based on liver-spleen Hounsfield unit difference and absolute liver intensity values. We compared BMI≥30 (n = 53) and BMI < 30 (n = 64) donor outcomes. Donors with weight loss (WL) prior to surgery were also analyzed separately. Complications were graded by Clavien-Dindo classification. Results: All donors underwent open right donor hepatectomy. There was no difference between BMI≥30 and < 30 groups except female predominance in BMI≥30 group (P = .006). Both groups had similar rates of complication rates in all categories, similar remnant volume, operative time, length of stay and similar postoperative liver function recovery (all P > .05). On the other hand, donors with WL were more commonly male, had smaller graft size, and higher biliary complications rates compared to no-WL donors (all P < .05). Multivariate binary logistics regression analysis revealed no association between BMI or WL and outcomes. Conclusion: We demonstrate that donors with BMI≥30 have similar outcomes compared to BMI < 30 donors with our defined selection criterion, therefore BMI≥30 is not an absolute contraindication to donate right liver, provided that there is no significant steatosis and remnant liver is satisfactory. For potential overweight donors, WL down to BMI < 30 is a reasonable target. Higher biliary complication rates after WL should be investigated further.
MeSH term(s)	Body Mass Index ; Fatty Liver/surgery ; Female ; Hepatectomy ; Humans ; Liver/surgery ; Liver Transplantation/adverse effects ; Living Donors ; Male ; Postoperative Complications/etiology ; Retrospective Studies ; Weight Loss
Language	English
Publishing date	2022-06-08
Publishing country	Denmark
Document type	Journal Article
ZDB-ID	639001-8
ISSN	1399-0012 ; 0902-0063
ISSN (online)	1399-0012
ISSN	0902-0063
DOI	10.1111/ctr.14698
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Article: Can simple Non-Invasive Fibrosis Models Determine Prognostic Indicators (Fibrosis and Treatment Response) of Primary Biliary Cholangitis?

Sayar, Suleyman / Gokcen, Pinar / Aykut, Huseyin / Adali, Gupse / Doganay, Hamdi Levent / Ozdil, Kamil

Sisli Etfal Hastanesi tip bulteni

2021 Volume 55, Issue 3, Page(s) 412–418

Abstract: Objective: The fibrosis stage during diagnosis and the response to ursodeoxycholic acid in the 1: Materials and methods: Data from patients with PBC were screened retrospectively. Patients were divided into early (≤2) and advanced (≥3) fibrosis ... ...

Abstract	Objective: The fibrosis stage during diagnosis and the response to ursodeoxycholic acid in the 1 Materials and methods: Data from patients with PBC were screened retrospectively. Patients were divided into early (≤2) and advanced (≥3) fibrosis groups. In addition, treatment response status according to the Paris-II criteria and liver failure risk (LFR) according to the UK-PBC score were determined. The S-Index consisting of gamma-glutamyltransferase (GGT), platelets (PLT), and albumin, (S-index: 1000×GGT÷[PLT×Albumın2]), other non-invasive models were calculated. The diagnostic effectiveness of non-invasive indicators to determine the fibrosis stage, response to treatment, and low LFR was analyzed. Results: Fifty-three patients were included in the study. The overall mean age at diagnosis was 49.6±13.6 years and 86.8% of the patients ( Conclusion: S-index is a practical and inexpensive non-invasive model that can identify liver fibrosis and treatment response in patients with PBC. It can be used as a continuous variable prognostic model in PBC.
Language	English
Publishing date	2021-09-24
Publishing country	Turkey
Document type	Journal Article
ZDB-ID	3026862-X
ISSN	1308-5123 ; 1302-7123
ISSN (online)	1308-5123
ISSN	1302-7123
DOI	10.14744/SEMB.2021.95825
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Article ; Online: Portal vein thrombosis risk factors in liver transplant candidates.

Ak, Cagatay / Adali, Gupse / Sayar, Suleyman / Agackiran, Abdulbaki / Kulali, Fatma / Kahraman, Resul / Ozturk, Oguzhan / Ozdil, Kamil

Hepatology forum

2022 Volume 3, Issue 3, Page(s) 88–92

Abstract: Background and aim: Portal vein thrombosis (PVT) is particularly detected in advanced liver cirrhosis patients. We aimed to analyze the risk factors for PVT in liver transplant candidates.: Materials and methods: Dataset for consecutive 165 cirrhotic ...

Abstract	Background and aim: Portal vein thrombosis (PVT) is particularly detected in advanced liver cirrhosis patients. We aimed to analyze the risk factors for PVT in liver transplant candidates. Materials and methods: Dataset for consecutive 165 cirrhotic patients who were evaluated for liver transplantation (LT) were retrospectively analyzed. We sorted patients into two groups: patients with PVT and patients without PVT. Included variables were age, sex, etiology of liver disease, body mass index, MELD-Na score, Child-Pugh score, clinical variables reflecting portal hypertension, and hepatocellular carcinoma. Univariate and multivariate logistic regression analyses were used to identify risk factors of PVT. Results: Of 165 LT candidates, 46 had PVT (27.9%). Ascites, thrombocytopenia, history of variceal bleeding, and band ligation were risk factors for PVT in univariate analysis. In multivariate analysis, only a history of variceal bleeding (OR 3.45, 95% CI 1.02-11.6, p=0.046) significantly increased the risk of PVT. Conclusion: The previous history of variceal bleeding predicts PVT development in cirrhosis, suggesting that the severity of portal hypertension is a major predictive factor for PVT in patients with cirrhosis. Future prospective studies are needed to risk stratifying cirrhosis patients prior to LT for future PVT development and to define the prophylactic role of anticoagulation in these patients.
Language	English
Publishing date	2022-09-23
Publishing country	Turkey
Document type	Journal Article
ISSN	2757-7392
ISSN (online)	2757-7392
DOI	10.14744/hf.2022.2022.0005
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Article ; Online: Post-ERCP Complication Analysis of an Experienced Center.

Ak, Çağatay / Aykut, Hüseyin / Pala, Emin / Sayar, Süleyman / Tarikçi Kiliç, Ebru / Adali, Gupse / Kahraman, Resul / Öztürk, Oğuzhan / Özdil, Kamil

Surgical laparoscopy, endoscopy & percutaneous techniques

2022 Volume 32, Issue 6, Page(s) 707–713

Abstract: Background/aim: Post-ERCP pancreatitis (PEP), post-sphincterotomy bleeding (PSB), and Post-ERCP perforation are the most common complications of endoscopic retrograde cholangiopancreatography (ERCP). Identification of risk factors for post-ERCP ... ...

Abstract	Background/aim: Post-ERCP pancreatitis (PEP), post-sphincterotomy bleeding (PSB), and Post-ERCP perforation are the most common complications of endoscopic retrograde cholangiopancreatography (ERCP). Identification of risk factors for post-ERCP complications is critical for postoperative follow-up. This study aimed to evaluate the most common post-ERCP complication risk factors in an experienced center. Methods/design: The sample consisted of 1288 patients with naive papillae. Demographic characteristics, patient-related risk factors, procedure-related risk factors and postoperative complications were recorded. Results: Patients had a mean age of 61.5±18.4 years. The prevalence of PEP, PSB, and post-ERCP perforation was 7.9%, 11.9%, and 0.5%, respectively. Among patient-related factors, female sex (OR 1.672 95% Cl 1.046 to 2.672) and narrowing of the choledochal diameter (OR 2.910 95% Cl 1.830 to 4.626) were associated with PEP. From procedure-related factors; precut sphincterotomy (OR 2.172 95% Cl 1.182 to 3.994), difficult cannulation (OR 5.110 95% Cl 2.731 to 9.560), pancreatic cannulation (OR 5.692 95% Cl 0.994 to 32.602) and postprocedure residual stone (OR 2.252 95% Cl 1.403 to 3.614) were found to be associated with PEP. The successful procedure (OR 0.378 95% Cl 0.204 to 0.699) had a protective effect on PEP. Choledocholithiasis indication (OR 3.594 95% Cl 1.444 to 8.942) and small papilla (OR 2.042 95% Cl 1.170 to 3.562) were associated with the development of PSB. Choledochal stenosis, periampullary-diverticulum, oral anticoagulant, and oral antiaggregant use were not associated with the development of PSB. Of the patients with post-ERCP perforation, 85.7% had difficult cannulation, 57.1% had precut sphincterotomy, and 28.6% had periampullary-diverticulum. Conclusion: Female sex, biliary stricture, precut sphincterotomy, difficult cannulation, pancreatic cannulation, and postoperative residual stone were associated with PEP. Choledocholithiasis indication and the presence of small papilla were associated with PSB.
MeSH term(s)	Humans ; Female ; Adult ; Middle Aged ; Aged ; Cholangiopancreatography, Endoscopic Retrograde/adverse effects ; Cholangiopancreatography, Endoscopic Retrograde/methods ; Choledocholithiasis/surgery ; Sphincterotomy, Endoscopic/adverse effects ; Sphincterotomy, Endoscopic/methods ; Catheterization/methods ; Diverticulum
Language	English
Publishing date	2022-12-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	1475108-2
ISSN	1534-4908 ; 1530-4515 ; 1051-7200
ISSN (online)	1534-4908
ISSN	1530-4515 ; 1051-7200
DOI	10.1097/SLE.0000000000001113
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Article ; Online: High incidence of hepatitis B core antibody positivity in metabolic-associated fatty liver disease-related cirrhosis.

Ergenc, Ilkay / Gokcen, Pinar / Adali, Gupse / Tarik Kani, Haluk / Ozer Demirtas, Coskun / Gunduz, Feyza / Ataizi Celikel, Cigdem / Yilmaz, Yusuf

Hepatology forum

2021 Volume 2, Issue 1, Page(s) 20–25

Abstract: Background and aim: The coexistence of metabolic-associated fatty liver disease (MAFLD) in the course of chronic hepatitis B virus infection increases liver-related morbidity. A positive correlation was found between positive hepatitis B core antibody ( ... ...

Abstract	Background and aim: The coexistence of metabolic-associated fatty liver disease (MAFLD) in the course of chronic hepatitis B virus infection increases liver-related morbidity. A positive correlation was found between positive hepatitis B core antibody (anti-HBc) and the risk of cirrhosis and hepatocellular carcinoma (HCC) in MAFLD. The relationship between anti-HBc positivity and MAFLD progression to fibrosis, cirrhosis, and liver-related outcomes was determined. Materials and methods: This is a retrospective study including 242 patients with biopsy-proven MAFLD, 130 patients with clinically diagnosed MAFLD-related cirrhosis, and 62 patients with MAFLD-related or cryptogenic HCC. Anti-HBc antibody results were compared with clinical outcomes. Results: Anti-HBc positivity was associated with fibrosis severity (p=0.005). Anti-HBc was positive in 19 (20.2%), 33 (25.8%), 53 (35.3%), and 27 (43.5%) patients with F0-F1 fibrosis, F2-F3 fibrosis, cirrhosis (F4), and HCC, respectively. Median steatosis score was grade 3 in anti-HBc positive patients and grade 2 in negative patients (p=0.07). Anti-HBc positivity was not associated with significant fibrosis (≥F2), cirrhosis, and any liver related complications including HCC. Conclusion: Higher anti-HBc positivity was found in MAFLD patients with advanced fibrosis and cirrhosis compared to patients with early stage fibrosis. No relation was found between anti-HBc positivity and development of cirrhosis, HCC or other liver related complications.
Language	English
Publishing date	2021-01-08
Publishing country	Turkey
Document type	Journal Article
ISSN	2757-7392
ISSN (online)	2757-7392
DOI	10.14744/hf.2020.2020.0025
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Article ; Online: Are nucleos(t)ide analogues effective against severe outcomes in COVID-19 and hepatitis B virus coinfection?

Adali, Gupse / Gokcen, Pinar / Guzelbulut, Fatih / Gokcen Degirmenci Salturk, Ayca / Bugra Agaoglu, Nihat / Unal, Busra / Doganay, Levent / Ozdil, Kamil

Hepatology forum

2021 Volume 2, Issue 3, Page(s) 91–96

Abstract: Background and aim: The impact of chronic hepatitis B virus (HBV) infection and nucleos(t)ide analogue (NUC) treatment on disease severity and clinical outcomes in patients with coronavirus 2019 (COVID-19) is unknown. The objective of this study was to ... ...

Abstract	Background and aim: The impact of chronic hepatitis B virus (HBV) infection and nucleos(t)ide analogue (NUC) treatment on disease severity and clinical outcomes in patients with coronavirus 2019 (COVID-19) is unknown. The objective of this study was to determine whether HBV infection and the use of NUCs impacts mortality in patients with COVID-19. Materials and methods: A total of 231 adult patients (77 with COVID-19 and HBV coinfection) with a laboratory-confirmed diagnosis of COVID-19 were enrolled in this retrospective study. Univariate and binary logistic regression analysis were performed to evaluate the risk factors for mortality from COVID-19. Results: Patients with COVID-19 and HBV coinfection had a similar rate of mortality to those without HBV coinfection (7.8% vs 9.7%; p=0.627). Cardiovascular disease (odds ratio [OR]: 8.22, 95% confidence interval [CI]: 1.52-44.2; p=0.014) and a high basal aspartate transaminase level (OR: 7.94, 95% CI: 1.81-34.8; p=0.006) were independent predictors of mortality due to COVID-19. In the COVID-19 and HBV coinfection group, the patients who died had a significantly higher median level of HBV DNA than patients who survived (378 IU/mL vs 0 IU/mL; p=0.048). Thirty (39%) patients with HBV coinfection received NUC treatment, and none of these patients died. Conclusion: HBV infection was not associated with mortality in patients with COVID-19, and it seems that NUC treatment for HBV infection might have an antiviral effect on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.
Language	English
Publishing date	2021-09-15
Publishing country	Turkey
Document type	Journal Article
ISSN	2757-7392
ISSN (online)	2757-7392
DOI	10.14744/hf.2021.2021.0027
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