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    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, Cihan
    Purpose 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.
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    Long-Term Post-transplant Outcomes in Patients with Hepatitis D Virus Infection at a High-Volume Liver Transplant Center
    (Springer, 2026) Keser, Muhammed Furkan; Keser, Zeynep Busra; Yurdaydin, Cihan; Yilmaz, Sezai; Harputluoglu, Murat
    Background and Aims Hepatitis D virus (HDV) infection remains a major cause of liver failure in T & uuml;rkiye, yet post-transplant outcomes and recurrence predictors are not well defined. This study aimed to evaluate long-term outcomes and risk factors for HDV recurrence following liver transplantation in a high-volume transplant center. Methods We retrospectively analyzed 182 patients who underwent liver transplantation for HDV-related liver disease between 2010 and 2024. Clinical, virological, and survival data were compared between patients with and without HDV recurrence. Kaplan-Meier survival and Cox regression analyses were performed to identify independent predictors of recurrence. Results HDV recurrence occurred in 12 patients (6.6%) during a median follow-up of 80 months. HBIG administration significantly reduced recurrence risk (HR = 0.001, p < 0.001), while post-transplant HBV recurrence was strongly associated with HDV relapse (p < 0.001). Pre-transplant hepatocellular carcinoma (HCC) showed no significant association with HDV recurrence. Overall survival did not differ significantly between recurrence and non-recurrence groups (p = 0.068). Conclusions Our results showed that HDV recurrence was infrequent and was not associated with a statistically significant difference in post-transplant survival. Post-transplant HBV recurrence and HBIG therapy were identified as the main factors influencing HDV recurrence. Another important finding was that pre-transplant hepatocellular carcinoma (HCC) was not significantly associated with HDV recurrence. These results provide valuable long-term evidence from an HDV-endemic region and may guide post-transplant management strategies.