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Öğe Comparison of patients with hepatitis B virus-associated hepatocellular carcinoma: Data from two hospitals from Turkey and China(John Wiley and Sons Inc, 2023) Carr B.I.; Rui F.; Ince V.; Yilmaz S.; Zhao X.; Feng Y.; Li J.Aims: There are many studies on the incidence of hepatitis B virus (HBV)-associated hepatocellular carcinoma (HCC), but very little is known about the HCC features in different populations. The study aimed to compare characteristics in two cohorts of patients with HBV-associated hepatocellular carcinoma from Turkey and China. Methods: Data on patients with HBV-associated HCC diagnosed by imaging or liver biopsy were retrospectively collected from Shandong Provincial Hospital (n = 578) and Inonu University Hospital (n = 359) between January 2002 and December 2020, and the liver function and HCC characteristics were compared. Continuous variables were compared using Student's t-test or Mann–Whitney U test and categorical variables were compared using the ?² test or Fisher's exact test. Results: The patients in the Turkish cohort had significantly worse Child-Pugh scores (Child-Pugh A: 38.3% vs. 87.9%; Child-Pugh B: 40.3% vs. 11.1%; Child-Pugh C: 21.4% vs. 1.0%; p < 0.001) and significantly higher levels of aspartate aminotransferase (66.5 [38.0?126.0] vs. 36.0 [27.0?50.0] IU/L; p < 0.001), alanine aminotransferase (47.5 [30.0?87.3] vs. 33.0 [24.0?45.0] IU/L; p < 0.001), total bilirubin (20.8 [13.7?39.3] vs. 17.9 [13.8?24.0] mg/dL; p < 0.001), and lower albumin levels (32.0 [26.0?39.0] vs. 40.0 [36.1?43.8] g/L; p < 0.001) than patients in Chinese cohort. The tumor characteristics showed the Barcelona Clinic Liver Cancer (BCLC) score (BCLC 1: 5.1% vs. 71.8%; BCLC 2: 48.7% vs. 24.4%; BCLC 3: 24.4% vs. 3.8%; BCLC 4: 21.8% vs. 0; all p < 0.001), maximum tumor diameter (5.0 [3.0?9.0] vs. 3.5 [2.5?6.0] cm; p < 0.001), alpha-fetoprotein values (27.7 vs. 13.2 ng/mL; p < 0.001), and percentage of patients with portal vein tumor thrombus (33% vs. 6.1%; p < 0.001) were all significantly worse in the Turkish cohort compared with Chinese cohort. Conclusions: HBV-associated HCC from the Turkish cohort had worse liver function and more aggressive clinical characteristics than patients from the Chinese cohort. © 2023 The Authors. Portal Hypertension & Cirrhosis published by John Wiley & Sons Ltd on behalf of Chinese Medical Association.Öğe Enhanced role of multipair donor swaps in response to size incompatibility: The first two 5-way and the first 6-way liver paired exchanges(Elsevier B.V., 2024) Yilmaz S.; Sönmez T.; Ünver M.U.; Ince V.; Akbulut S.; Sarici K.B.; Isik B.A significant portion of liver transplantations in many countries is conducted via living-donor liver transplantation (LDLT). However, numerous potential donors are unable to donate to their intended recipients due to factors such as blood type incompatibility or size incompatibility. Despite this, an incompatible donor for one recipient may still be a viable donor for another patient. In recent decades, several transplant centers have introduced liver paired exchange (LPE) programs, facilitating donor exchanges between patients and their incompatible donors, thereby enabling compatible transplants. Initially, LPE programs in Asia primarily involved ABO-i pairs, resulting in 2-way exchanges mainly between blood type A and B recipients and donors. This practice has led to a modest 1% to 2% increase in LDLTs at some centers. Incorporating size incompatibility alongside blood type incompatibility further enhances the efficacy and significance of multiple-pair LPEs. Launched in July 2022, a single-center LPE program established at Inonu University Liver Transplant Institute in Malatya, Türkiye, has conducted thirteen 2-way, nine 3-way, four 4-way, two 5-way, and one 6-way LPEs until February 2024. In 2023 alone, this program facilitated 64 LDLTs, constituting 27.7% of the total 231 LDLTs performed. This paper presents the world's first two 5-way LPEs and the first 6-way LPE. © 2024 The AuthorsÖğe Living related donor liver transplantation with atrio-caval anastomosis of inferior vena cava graft stored in deep-freeze for budd-chiari syndrome(Iranian Society for Organ Transplantation, 2015) Yaylak F.; Ince V.; Barut B.; Unal B.; Kilic M.; Yilmaz S.We have previously reported our experience in inferior vena cava resection and reconstruction techniques during liver transplantation for Budd-Chiari syndrome. Herein, we present on a case that demonstrates the importance of experience in complex vascular reconstruction techniques for living donor liver transplantation. A 15-year-old boy was scheduled for living donor liver transplantation for Budd-Chiari syndrome. Venous occlusion was extended up to the right atrial orifice of the supra-hepatic vena cava. Retro- and supra-hepatic segments of the vena cava was resected. Inferior vena cava graft stored in deep-freeze was available. Venous reconstruction was performed with end-to-end atrio-caval anastomosis. Surgical treatment was completed with the implantation of the right liver lobe donated by the patient's mother. Post-surgical course was uneventful.Öğe Peritoneal encapsulation in a patient with incomplete situs inversus(2012) Ince V.; Dirican A.; Yilmaz M.; Barut B.; Ersan V.; Yilmaz S.Peritoneal encapsulation (PE) is an extremely rare congenital condition in which there is abnormal return of the midgut loop to the abdominal cavity in the early stages of development. It may be present in patients with congenital anomalies like incomplete situs inversus. Pre-operative diagnosis is possible with abdominal CT. A 71-year-old man with incomplete situs inversus was admitted to emergency department with symptoms and signs of peritonitis. Computed tomography (CT) of the abdomen showed characteristic features of the PE syndrome. He had exploratory laparotomy performed and arterial occlusion caused ileocaecal ischaemia and PE was observed. Capsule of PE and ileocaecal excision was done. Postoperative recovery was uneventful.
