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Öğe Acute Pancreatitis: A Rare but Serious Complication for Living Liver Donors; Risk Factors and Outcomes(Baskent Univ, 2022) Baskiran, Adil; Kement, Metin; Barut, Bora; Ozsay, Oguzhan; Karakas, Serdar; Koc, Cemalettin; Yilmaz, SezaiObjectives: The purposes of this study were to determine the incidence of acute pancreatitis after living donor hepatectomy and to investigate potential risk factors and outcomes. Materials and Methods: Clinical data of all donors who underwent donor hepatectomy between January 2015 and December 2016 in our liver transplant institute were reviewed. Donor data were obtained from a prospectively maintained database. The donors were divided into 2 groups according to whether they developed postoperative pancreatitis. The following data were compared between the 2 groups: demo graphic information (age, sex), body mass index, type of hepatectomy (right, left, or left lateral), intraoperative cholangiographic findings, operative time, blood loss, graft data (graft weight, remnant liver ratio), duration of postoperative hospital stay, and postoperative morbidity and mortality (if any). Pancreatitis severity and treatment outcomes were also examined in patients with postoperative pancreatitis. Results: Our study included 348 donors who underwent donor hepatectomy for living-donor liver transplant. Postoperative pancreatitis developed in 6 donors (1.7%). We found no statistical differences between patients with and without postoperative pancreatitis in terms of demographic and intraoperative findings. Neither loco-regional nor systemic complications of pancreatitis developed in any of the patients. Therefore, all were classified as having mild pancreatitis according to revised Atlanta classification. The mean APACHE II score was 5.2 +/- 1.2 points (range, 4-7 points). All patients with postoperative pancreatitis received conservative-supportive treatment. Conclusions: Although postoperative pancreatitis is a rarely reported complication in living liver donors, it should always be considered, especially in patients who unpredictably deteriorate in the postoperative period. Proper recognition and timely treatment can help avoid serious consequences.Öğe Can Preoperative Parameters of Inflammation be Used to Predict Acute Kidney Injury in Pediatric Liver Transplant Recipients? A Single-Center Retrospective Study(Galenos Publ House, 2024) Demiroz, Duygu; Ozdes, Oya Olcay; Colak, Yusuf Ziya; Erdogan, Mehmet Ali; Gazioglu, Tugce; Karakas, Serdar; Tasolar, Sevgi DemirozIntroduction: Inflammation is one of the factors involved in the occurrence and progression of acute kidney injury (AKI). We evaluated the relationship between preoperative systemic inflammatory markers and early postoperative AKI development in pediatric liver transplantation (LT) patients. Methods: Data from 190 pediatric patients were retrospectively analyzed. The preoperative neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), and pan-immune-inflammation value (PIV) levels were calculated. AKI was classified according to the Kidney Disease: Improving Global Outcomes staging. Patients who did not develop AKI in the early postoperative period were classified as group 0, patients with stage 1 AKI were classified as group 1, and patients with stage 2-3 AKI were classified as group 2. The relationship between the inflammatory parameters and AKI was evaluated. Results: AKI developed in 20% of patients, and 16.31% of these patients had severe AKI. The NLR, SII, and PIV values were significantly higher in patients with severe AKI (p<0.001). Preoperative high PIV values were found to be an independent predictor of AKI development. Conclusion: High preoperative PIV values may be used as a predictive factor for the development of early AKI in patients undergoing pediatric LT.Öğe Co-existence of idiopathic cecal ulcer and incidental appendix carcinoid tumor(Aves, 2016) Ince, Volkan; Barut, Bora; Karakas, SerdarIdiopathic cecal ulcer or solitary cecal ulcer is a rare entity that can only be diagnosed by histopathological evaluation. Generally, it is diagnosed by histolopathological evaluation of biopsy specimens obtained by colonoscopy that is performed for lower gastrointestinal bleeding. It can also be diagnosed after surgical resection performed for acute abdomen or cecal mass mimicking malignancy. Cecal carcinoid tumor is a rare cause of this condition; however, coexistence of cecal ulcer and appendix carcinoid tumor has not been previously reported. In this case, we present a 73-year-old woman who clinically presented as acute appendicitis with cecal wall thickening, underwent right hemicolectomy and was subsequently diagnosed with cecal ulcer, serosal abscess and coexisting appendix carcinoid tumor.Öğe Comment on the high-end range of biliary reconstruction in living donor liver transplant(Lippincott Williams & Wilkins, 2020) Yilmaz, Sezai; Akbulut, Sami; Koc, Cemalettin; Usta, Sertac; Baskiran, Adil; Karakas, Serdar; Sahin, Tevfik Tolga[Abstract Not Available]Öğe Comparison of liver resection and living donor liver transplantation in patients with hepatocellular carcinoma within Milan criteria and well-preserved liver function(Kare Publ, 2023) Karakas, Serdar; Yilmaz, Sezai; Ince, Volkan; Akbulut, Sami; Dalda, Yasin; Akatli, Ayse Nur; Kahraman, Aysegul SagirBackground and Aim: Liver resection (LR) and liver transplantation (LT) are curative treatments for hepatocellular carcinoma (HCC). The main pur-pose of this study was to compare the survival of LR and LDLT in patients with HCC within the Milan criteria. Materials and Methods: The results of the LR (n=67) and LDLT (n=391) groups were compared for overall survival (OS) and disease-free survival (DFS). Twenty-six of the HCCs in the LRs met the Milan and Child A cri-teria. Also, 200 of the HCC patients in the LDLTs met the Milan criteria, of which 70 also met the Child A criteria. Results: Early mortality was higher in the LDLT group (13.9% vs 1.47%; p=0.003). The 5-year OS was higher in the LDLTs than the LRs, but not statistically significant (84.6% vs 74.2%; p=0.287). However, 5-year DFS was better in the LDLT group (96.8% vs 64.3%; p<0.001). When the LRs (n=26) and the LDLTs (n=70) that met both Milan and Child A criteria were compared, 5-year OS was similar (81.4% vs 74.2%; p=0.512), but DFS was better in the LDLTs (98.6% vs 64.3%; p<0.001). Conclusion: LR can be justified as the first-line treatment for HCC patients who meet Milan and Child A criteria in terms of and OS.Öğe Comprehensive Analysis of Long-term Splenic Volume Changes in Pediatric Liver Transplant Patients: Does It Correlate With Adverse Graft Outcomes?(Elsevier Science Inc, 2021) Dogan, Gulec Mert; Dogan, Sait Murat; Okut, Gokalp; Karakas, Serdar; Kutluturk, Koray; Ulubaba, Hilal Er; Sahin, Tevfik TolgaObjectives. Splenomegaly and hypersplenism caused by liver failure increase the mortality and morbidity of patients even after liver transplantation if they do not regress. We evaluated the relation of splenic volume change and transplanted liver function. Material and Methods. A total of 59 of 207 pediatric patients who had liver transplantation between 2013 and 2018 in our institute were evaluated. The relation of spleen volume changes (splenic volume to standard splenic volume ratio [SV/SSV]) were measured at 0, 1, 6, 12, 24, and 36 months of follow-up by constructing electronic three-dimensional structure of the spleen at dynamic computed tomography (CT), and the course of liver functions were evaluated. Results. The SV/SSV ratio decreases in the first postoperative 6 months. After 6 months, SV increases and SV/SSV increases gradually. In a normal functioning graft, SV/SSV significantly decreased in all time points (P < .001). In patients with adverse events, SV/SSV started to increase after 6 months. In patients with fulminant hepatic failure, SV/SSV started to increase after postoperative 6 months. Adverse events in patients with fulminant hepatic failure were more than the patients with chronic liver disease (58% vs 28%). There was an inverse correlation between SV/SSV and thrombocyte levels (P < .001). Conclusions. SV/SSV seems to be correlated to the adverse events (ie, rejection). Together with thrombocyte levels, it can be used as a noninvasive test for follow-up of transplant patients in terms of adverse events in graft function.Öğe Comprehensive analysis of the efficacy of liver transplantation in pediatric patients with Wilson’s disease(2023) Sarıcı, Barış; Şahin, Tevfik Tolga; Ara, Cengiz; Aydın, Cemalettin; Karakas, Serdar; İnce, Volkan; Varol, FatmaAim: The aim of the present study is to evaluate the results of liver transplantation (LT) in pediatric Wilson disease (WD) with a specific sub-analysis in patients with neuropsychiatric symptoms. Materials and Methods: Demographic, operative, laboratory and neurologic findings of 23 pediatric patients with WD that underwent LT were analyzed by examining the patient charts. Results: Median age of the patients was 13 ( 7 to 17) years. Median Wilson’s Index scores of the patients were 7 (5-13). Median Child-Pugh Score, MELD-Na and PELD scores of the patients were 10 (5-12), 19 (8-34) and 25.4 (8.4-30.7); respectively. Eight patients (34.8%) had Kayser-Fleischer rings on examination. Five patients (21.7%%) presented with acute decompensated Wilson’s disease. Fifteen patients (65.2%) received living donor liver transplantation. Totally, 10 patients (43,4%) had nervous system involvement in the preoperative period. Two patients fully recovered; 2 patients showed partial recovery. On the other hand, 4 patients showed no improvement and 2 patients had progression of their disease in the postoperative period. Conclusions: The results of the present study show that LT is an effective and safe alternative in end-stage liver failure in WD. However, in these patients, nervous system involvement may not improve despite successful LT.Öğe Conservative treatment and follow-up for acute appandicitis: Is emergent surgery necessary?(2023) Karakas, SerdarAim: Emergent operation is the accepted standart therapy of acute appendicitis. But medical therapy is an emerging solution for acute appendicitis. We aimed to publish the conservative treatment experience of Inonu University Medical School, Department of General Surgery. Materials and Methods: Between January 2020 and January 2022, patients with sus- picious acute appendicitis were scanned by the hospital medical record system. Patients that had an emergent operation were excluded. Remaining patients were reviewed. All pa- tients were followed up both by the Inonu University and Turkish Health Ministry medical record system. Patient demographics and clinical data were analyzed retrospectively. Results: Fifteen patients were detected within the 2 years period that received medical therapy for acute appendicitis. Median age was 32.0 (min:19 - max:70), median appendix diameter was 7.2 mm (min:5.5 - max:11.0). One patient was died due to Non-Hodgkin Lymphoma after 16 days of diagnosis of acute appendicitis. None of the patients required an operation during surveillance. Most frequent reasons for conservative treatment were probability of pelvic inflammatory disease, inflammatory intestinal disease and urinary tract infections. Conclusion: While some comorbidities may accompany with acute appendicitis such as cardiac and systemic haematologic diseases, some of them mimic acute appendicitis such as pelvic inflamatory disease or inflamatory bowel diseases. Elder patients, who have a suspicious case, may benefit from antibiotherapy. Low crp and neutrophilia counts are the predictors of uncomplicated appendicitis and medical treatment. More patients with an appendectomy history need to be evaluated on this aspect.Öğe Diaphragmatic hernias after pediatric liver transplantation: Experience of a high-volume transplant center(Wiley, 2020) Karakas, Serdar; Sahin, Tevfik Tolga; Kutluturk, Koray; Otan, Emrah; Baskiran, Adil; Sarici, Kemal Baris; Varol, IlknurDiaphragmatic hernias (DHs) are rare complications after pediatric liver transplantation (PLT). It is now widely accepted that DHs after liver transplantation (LT) is a pediatric related condition. PLTs (under of age 18) performed between January 2013 and June 2019 at Malatya Inonu University Institute of Liver Transplantation were retrospectively scanned. Study group consisting DHs and a control group were compared. Among 280 PLTs, 8 of them were complicated with DHs (%2.9). Median age of the patients with DH was 3.0 (0.8-9.5) years. Median graft recipient weight ratio was 2.5 (0.9-4.4). Five patients were below 5th percentiles in terms of pediatric weight growth chart at the time of LT. Also, 6 patients were below 5th percentiles in terms of pediatric height growth chart. There was no statistical difference between study and control groups. There are many risk factors mentioned in literature that may be primarily responsible for DHs after PLT. These factors are left lobe and large-for-size grafts, malnutrition, trauma or diathermy of diaphragmatic nerve and vessels and immunosuppressants. In our study, we could not specify any reason that differs in DHs. In our aspect, narrow diaphragma and thorax are exposed to high intra-abdominal pressure from abdomen. Large-for-size grafts, which are specific to children, also may contribute to this affect. Excessive diathermy and trauma to diaphragmatic collaterals may aggravate the risk of DH. More patients are needed to make an exact conclusion, in order to evaluate with comparable study on this aspect.Öğe Does Preoperative Transarterial Chemoembolization for Hepatocellular Carcinoma Increase the Incidence of Hepatic Artery Thrombosis After Living-Donor Liver Transplant?(Baskent Univ, 2017) Ince, Volkan; Ersan, Veysel; Karakas, Serdar; Kutluturk, Koray; Karadag, Nese; Kutlu, Ramazan; Yilmaz, SezaiObjectives: Transarterial chemoembolization is a potential risk factor for hepatic artery damage, which may lead to severe consequences. We aimed to investigate this controversial issue in our population of liver transplant patients with hepatocellular carcinoma. Materials and Methods: Between March 2006 and December 2016, a total of 262 patients with hepa-tocellular carcinoma underwent liver transplant at our institution. Of these, 22 (8.4%) had preoperative transarterial chemoembolization. We retrospectively reviewed the data of all patients, comparing those who did and did not undergo transarterial chemo embolization. Results: The groups were similar in terms of patient sex, mean age, mean alpha-fetoprotein levels, and Milan criteria. The nontransarterial chemoembolization group had a significantly higher mean Model for End-Stage Liver Disease score. Hepatic artery thrombosis after liver transplantation was diagnosed in 6 of 22 patients (27%) in the transarterial chemoembolization group and in 12 of 240 patients (5%) in the non transarterial chemoembolization group (P = .002). Retransplant was performed in 5 of the 6 patients with hepatic artery thrombosis in the transarterial chemo embolization group and 3 of the 12 patients in the nontransarterial chemoembolization group (P = .04). Conclusions: In patients who undergo transarterial chemoembolization before liver transplantation, the incidence of hepatic artery thrombosis and retrans plantation is significantly higher than in those who do not undergo this intervention. The tissues should be carefully handled at the time of transplantation to prevent trauma that may cause intimal dissection in the fragile vessels.Öğe Early portal vein thrombosis after pediatric liver transplantation: Assesment of risk factors(2023) Karakas, Serdar; Şahin, Tevfik Tolga; Sarıcı, Barış; Usta, Sertaç; Kutlutürk, Koray; Varol, Fatma İlknur; Sağlam, KutayAim: Despite advancements in surgical techniques, early portal vein thrombosis (ePVT) continues to be one of the major complications of liver transplantation (LT) in pediatric age group. Possible risk factors are portal vein diameter < 5 mm, infancy, patient body weight < 10 kg and high graft recipient weight ratios (GRWR > 4.0). We retrospectively evaluated our records of pediatric LTs’ in terms of ePVT and possible risk factors determining development of this dreaded complication. Materials and Methods: Between January 2018 and January 2022, 228 LTs were performed for pediatric age (under the age of 18) group at Inonu University, Liver Trans- plantation Institute. Among these patients, 212 were eligible for the study. Patients with ePVT were defined as Portal Vein Thrombüs Group (PVTG) and patients with no Portal Vein thrombosis were defined in control group (CG). ePVT was described as detection of impeded portal venous outflow with imaging studies either perioperatively or within postoperative 3 days . Demographic, clinical and operative variables were retrospectively evaluated. Results: Among 212 LTs, 24 cases were complicated with ePVTs (11.3 %). Preoperative platelet counts, etiology of Budd-Chiari, postoperative hepatic artery thrombosis (HAT) and lower age were significantly higher for early PVT. In multivariate analysis, preop- erative platelet levels, etiology of Budd-Chiari and postoperative HAT were significantly higher for PVT. One and 5 years overall survivals (OS) for PVTG and CG were 50.0 % - 50.0 % and 69 % - 63 % respectively. No significant OS difference was observed despite much more patients were died in PVTG. Conclusion: High preoperative platelet counts, Budd-Chiari syndrome and postoperative HAT are predictive factors for ePVT. Anti-thrombotic prophylaxes can be considered in high-risk patients. Venous jump grafts seem to have no effect on ePVT. Despite PVT increases the mortality rates, it can be resolved easily with immediate reoperation.Öğe Effect of HBV-HDV co-infection on HBV-HCC co-recurrence in patients undergoing living donor liver transplantation(Springer, 2020) Baskiran, Adil; Akbulut, Sami; Sahin, Tevfik Tolga; Koc, Cemalettin; Karakas, Serdar; Ince, Volkan; Yurdaydin, CihanPurpose To evaluate the effect of hepatitis D virus (HDV) on hepatitis B virus-hepatocellular carcinoma (HBV-HCC) co-recurrence in patients undergoing living donor liver transplantation (LDLT) for HBV alone or HBV-HDV coinfection. Methods Between 2002 and 2019, 254 HBV-HCC patients underwent LDLT. The patients were divided into two groups after the application of the exclusion criteria: HBV-HCC (Group B;n = 163) and HBV-HDV-HCC (Group D;n = 31). First, the B and D groups were compared in terms of demographic and clinical parameters. Second, patients with (n = 16) and without (n = 178) post-transplant HBV-HCC co-recurrences were grouped and compared in terms of the same parameters. Results Although the risk of HBV-HCC co-recurrence in group D was 4.99-fold higher than in group B, the risk of HBV recurrence alone in group D was 12.5-fold lower than in group B. The AFP (OR = 4.4), Milan criteria (beyond; OR = 18.8), and HDV (OR = 8.1) were identified as the independent risk factors affecting post-transplant HBV-HCC co-recurrence. The Milan criteria (OR = 2.1) and HBV-HCC co-recurrence (OR = 10.9) were identified as the risk factors affecting post-transplant mortality. HBV-HCC co-recurrence developed in 26.5% of patients in Group B and 100% in Group D (OR = 40;p = 0.001). HCC recurrence alone developed in 10% of patients without HBV recurrence in group B and 0% of patients without HBV recurrence in group D (OR = 5.7). Conclusion This study showed that the risk of HBV recurrence alone was reduced by 12.5-fold in the presence of HDV; however, the HCC recurrence occurred in all patients with HDV when HBV recurrence developed.Öğe Effects of Body Mass Index of Living Donors On Postoperative Course of Liver Function Tests(Lippincott Williams & Wilkins, 2015) Akbulut, Sami; Karakas, Serdar; Aydin, Cemalettin; Sumer, Fatih; Kayaalp, Cuneyt; Isik, Burak; Colak, Cemil[Abstract Not Available]Öğe Evaluation of Cytomegalovirus Infections in Liver Transplant Recipients Under Universal Prophylaxis: A Single Centre Experience(Kowsar Publ, 2021) Toplu, Sibel Altunisik; Kose, Adem; Karakas, Serdar; Bayindir, Yasar; Otlu, Baris; Yilmaz, SezaiBackground: Cytomegalovirus (CMV) is one of the leading viral agents that can pave the way for serious complications and organ damage in solid organ transplant (SOT) recipients after transplantation. Strategies have been developed to protect at-risk patients from CMV infection following transplantation. Since more than 90% of adults in Turkey were positive for CMV IgG, universal CMV prophylaxis was applied, and the results were evaluated. Objectives: This study aimed to evaluate the results of universal CMV prophylaxis after liver transplantation in the long term. Methods: A total of 1,090 liver transplant patients were evaluated in terms of CMV infection in the Organ Transplantation Institute of Inonu University, Malatya, Turkey, from October 2014 to December 2019. In order to identify the CMV infections, quantitative nucleic acid amplification (QNAT) was used to detect potential CMV DNA. The cut-off value of CMV DNA was determined to be 1000 copies/mL after transplantation. Results: According to the clinical and laboratory assessments, 33 (3%) patients were diagnosed with CMV infection, and 25 (2.3%) patients were evaluated as possibly having CMV syndrome. Also, eight of the 33 patients were assessed as having end-organ CMV disease and 25 as probable CMV syndrome. In the late period following prophylaxis, CMV infection was observed in 10 (0.9%) cases. The infection rate after prophylaxis (0.9%) was lower than the infection rate (2.1%) seen during prophylaxis. Conclusions: Close clinical follow-up with CMV prophylaxis and strict monitoring of CMV DNA by determining a specific cut-off point are important in the follow-up of liver transplant patients.Öğe Evaluation of Liver Function Tests for Living Liver Donors in Postoperative Course(Lippincott Williams & Wilkins, 2015) Aydin, Cemalettin; Akbulut, Sami; Otan, Emrah; Karakas, Serdar; Dirican, Abuzer; Kayaalp, Cuneyt; Colak, Cemil[Abstract Not Available]Öğe Evaluation of Serum Thiamine and Pyridoxine Levels in Patients Undergoing Liver Transplant: A Prospective Study(Baskent Univ, 2021) Akbulut, Sami; Abbasov, Parviz; Karakas, Serdar; Karabulut, Aysun Bay; Yilmaz, SezaiObjectives: This prospective study aimed to compare changes in serum thiamine and pyridoxine levels of patients who underwent liver transplant or living donor hepatectomy. Materials and Methods: Between January 2013 and November 2013, 35 patients with chronic liver disease who underwent liver transplant (the recipient group) and 30 healthy individuals who underwent living donor hepatectomy (the control group) during the same period were prospectively compared in terms of both preoperative and postoperative serum thiamine and pyridoxine levels. The groups were also subjected to intragroup analysis of preoperative and postoperative changes in serum vitamin levels to determine how a major surgical procedure affected serum vitamin levels. Mann-Whitney U test and Wilcoxon signed-rank test were used for intergroup comparisons and intragroup repeated measurements, respectively. Results: The intergroup comparisons revealed significant differences in favor of the control group with respect to preoperative thiamine (P < .026) and postoperative thiamine (P < .017) levels, whereas there were statistically significant differences in favor of the recipient group with respect to the preoperative pyridoxine (P < .006) and postoperative pyridoxine (P < .001) levels. The intragroup comparisons showed significant increases in serum thiamine (P < .001) and pyridoxine (P < .031) levels compared with the preoperative serum levels of both vitamins at postoperative day 5 in the recipient group. In the control group, serum thiamine level (P < .001) at postoperative day 5 was significantly different from the preoperative level. On the other hand, a drop in serum pyridoxine level was detected at postoperative day 5, although this was not statistically significant (P < .21). Conclusions: This study showed a lower serum thiamine level but a higher serum pyridoxine level in patients with chronic liver disease versus healthy controls. This difference persisted into the early postoperative period. This study also showed significant increases in thiamine and pyridoxine levels after transplant surgery.Öğe HBsAg relapse after living donor liver transplantation in hepatocelluler carcinoma patients with hepatitis D virus infection may result in hepatocellular carcinoma relapse(Elsevier, 2020) Baskiran, Adil; Sahin, Tevfik Tolga; Ince, Volkan; Karakas, Serdar; Ozdemir, Fatih; Cicek, Ipek Balikci; Yalcin, Kendal[Abstract Not Available]Öğe Incidence and Risk Factors of Acute Kidney Injury in Pediatric Liver Transplant Patients: A Retrospective Study(Jaypee Brothers Medical Publishers Pvt Ltd, 2024) Demiroz, Duygu; Colak, Yusuf Ziya; Ozdes, Oya Olcay; Ucar, Muharrem; Erdogan, Mehmet Ali; Toprak, Huseyin Ilksen; Karakas, SerdarBackground:Acute kidney injury (AKI) significantly contributes to the mortality and morbidity rates among pediatric liver transplant (LT) recipients. Objective: Our study aimed to assess the potential factors contributing to AKI in pediatric LT patients and to analyze the impact of AKI on postoperative mortality and hospitalization duration. Materials and methods: About 235 pediatric LT patients under the age of 18 between the years 2015 and 2021 were evaluated retrospectively. The relationship between preoperative and intraoperative variables of the patients and AKI developed when the early postoperative period was assessed. Results: A correlation was found between the patients' preoperative age, albumin levels, and AKI. AKI was found to be associated with the duration of surgery and intraoperative blood transfusion. Conclusion: Our findings revealed that the severity of AKI in pediatric LT patients is linked to extended surgical durations and increased blood transfusions resulting from hemodynamically compromised blood loss. Furthermore, independent risk factors for AKI were identified as prolonged warm ischemia and the overall duration of the operation.Öğe Liver Transplantation After Bone Marrow Transplantation: Consecutive Two Cases(Lippincott Williams & Wilkins, 2015) Ersan, Veysel; Ozdemir, Fatih; Karakas, Serdar; Baskiran, Adil; Ince, Volkan; Yilmaz, Sezai[Abstract Not Available]Öğe Liver Transplantation for Hepatocellular Carcinoma at Inonu University(Springer, 2017) Kayaalp, Cuneyt; Ince, Volkan; Ersan, Veysel; Karakas, Serdar; Kahraman, Aysegul Sagir; Yilmaz, SezaiThere is a great effort in the world to find a new drug in hepatocellular carcinoma (HCC) treatment. Turkey has a limited number of basic science studies to discover a new therapeutic drug for HCC. It seems that Turkey is distanced from the global drug discovery race and competition, however, Turkey has the advantage of a wide experience in living donor liver transplantation, like South Korea and Japan. Turkey can plan new studies on HCC, particularly with living donor liver transplantation. Neoadjuvant treatment methods before living donor liver transplantation for advanced tumors would be a good idea for study in Turkey. Because Inonu University has the busiest liver transplantation program in Turkey, the contribution of Inonu University to trials like this can improve the depth of the studies. To conclude, the Inonu University Liver Transplantation Institute has the busiest program in Turkey with 1,600 transplantations in eight years. The program is based on living donor liver transplantations (80%). Living donor liver transplantation for advanced HCC patients is our favorite topic to study.
