Author Correction: Liver Transplantation for Hepatocellular Carcinoma: Malatya Experience and Proposals for Expanded Criteria

The original version of this article unfortunately contained a mistake in the author group section.

Comment on: Acute rejection after liver transplantation is less common, but predicts better prognosis in HBV-related hepatocellular carcinoma patients

• There is a strong correlation between acute rejection episodes in the postoperative first month and primary etiology that requires liver transplantation. • This difference substantially disappears after the postoperative first month which suggest the effcet of removal of the tumor. • The functional immune status of the patients determines the prognosis following liver transplantation.

Significance and outcome of living-donor liver transplantation in acute mushroom intoxication

Introduction

Mushroom intoxication (MT) can lead to acute liver injury which may result in Mushroom intoxication-related liver failure (M-ALF) requiring liver transplantation (LT). In the present study, we want to share the experience of our institute regarding living-donor LT (LDLT) due to mushroom poisoning.

Aim

The aim of this study is to identify the predictors of poor prognosis in patients with ALF secondary to mushroom intoxication requiring LDLT.

Materials and Methods

All patients with MT between 2008 and 2016 were evaluated. Demographics, symptoms, interval between symptoms and admission to our institute, laboratory data, model for end-stage liver disease (MELD)/pediatric end-stage liver disease (PELD) scores, clinical course, and outcomes of supportive therapy and LT were evaluated. There were two groups in the study: Group A = responsive to supportive therapy (n = 9) versus Group B = unresponsive to supportive therapy (n = 9).

Results

During the study, a total of 18 patients were admitted with M-ALF. Twelve (66.7%) of them were female, and the mean age was 39.9 ± 18.2 years. All of the nine patients in Group A fully recovered with supportive therapy. In Group B, one patient died during waiting period for LT and 8 patients received LDLT LDLT. Three of the eight patients who were transplanted died in the postoperative early period within postoperative 5 days. The patients in Group B had significantly higher MELD/PELD scores and encephalopathy rate than in Group A (P < 0.05). International normalized ratio (INR), bilirubin, ammonium levels, and platelet count were significantly different between groups (P < 0.05). The patients in Group B had significantly longer interval before admission to our institute (P < 0.05).

Conclusion

The presence of encephalopathy, higher MELD/PELD, INR, bilirubin, ammonium levels, and lower platelet count was related to poor prognosis in MT. LDLT provides a good therapeutic option in patients with M-ALF. The time is a crucial factor in successful treatment of MT. Early admission to a tertiary referral center with expertise in LT results in a better prognosis and increased survival following M-ALF.

Coexistence of Mirizzi syndrome with adenomyomatosis in the gallbladder: report of a case

BACKGROUND

Mirizzi syndrome is a rare complication of cholelithiasis. Adenomyomatosis is a common tumor-like lesion of the gallbladder.

METHODS

A 52-year-old man was admitted to our hospital complaining of right hypochondriac pain and jaundice. Ultrasonography and computed tomography revealed stones in the gallbladder and dilation of the intrahepatic bile ducts. Magnetic resonance cholangiopancreatography revealed narrowing of the common bile duct caused by compression of the gallbladder. Laparotomy revealed type II Mirizzi syndrome.

RESULTS

Partial cholecystectomy with a Roux-en-Y hepaticojejunostomy reconstruction was performed. Histologically, Rokitansky-Aschoff sinus proliferation, hypertrophy of smooth muscles, and fibrosis were seen in the gallbladder. A segmental type of adenomyomatosis of the gallbladder was diagnosed.

CONCLUSIONS

The pathogenic link between the two peculiar entities is unclear. A possible explanation is considered that the pathogenesis of Mirizzi syndrome is resulted from chronic inflammation due to adenomyomatosis.

Comprehensive Analysis of Long-term Splenic Volume Changes in Pediatric Liver Transplant Patients: Does It Correlate With Adverse Graft Outcomes?

OBJECTIVES

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.

Comment on the Correlation between Complete Blood Count Parameters and Appendix Diameter for the Diagnosis of Acute Appendicitis

We read the recent article published by Daldal and colleague with great interest [...].

Recommendations for the ethical guidelines for publication of scientific studies: The responsibilities of editors, reviewers and the authors

OBJECTIVE

We aimed to evaluate the role of anesthesiologist in the management of hydatid disease from the perspective of the editors, reviewers and the authors.

METHODS

We searched the PubMed/Medline database using the following keywords: (hydatid* OR echinococc*) AND (disease OR cyst) AND (anesthesiology). We have evaluated the authors, their institutions and department, and the aim of the studies. We also evaluated the studies published by anesthesiologists in terms of content.

RESULTS

The literature search showed 6344 articles published between February 2010 to 2021. Sixty-three had at least one anesthesiologist in the author list. Anesthesiologists were leading authors in 35 studies; and in 19 of them, all the authors were anesthesiologist. Sixteen (84.2%) of these articles defined the outcomes of surgical therapy and there was no information regarding anesthesia technique.

CONCLUSION

The results of our study emphasize an important controversy regarding jurisdiction of different departments in terms of scientific research ethics. We believe that different disciplines can work together to evaluate a scientific problem and can publish a study in collaboration. But collaboration is very important and violating the subject of another field without collaboration is a deontological problem.

Is There any Alteration in Erythrocyte Folate Status in Patients with Thyroid and Breast Cancers?

The aim of the study was to determine folate reserve in patients with thyroid and breast diseases. Erythrocyte folate concentrations of ninety-eight patients and thirty healthy subjects were determined by a modified microbiological assay. An increase in folate levels was observed in of both thyroid (n = 15) and breast (n = 22) cancer patients compared to controls, while a decrease was observed in benign breast disease patients (n = 24) compared to both control group and breast cancer patients. Patients with benign thyroid diseases (n = 37) had significantly lower folate concentrations as compared to both control and thyroid cancer groups. The results pointed out the elevated erythrocyte folate levels in the patients with malignant tumors.

Tryptophan Degradation and Antioxidant Status in Patients With Thyroid Disorders

BACKGROUND

The aim of this study was to evaluate the degradation of tryptophan (Trp), neopterin production and antioxidant capacity in patients with benign and malignant thyroid disease.

METHODS

For this reason, the levels of tryptophan, kynurenine (Kyn) and neopterin, and superoxide dismutase (SOD) and catalase (CAT) enzyme activities in 67 thyroid patients were evaluated in our study and the results were compared with 30 healthy controls.

RESULTS

Tryptophan and kynurenine levels in thyroid patients decreased compared to the control group. Patients with thyroid disease had lower CAT activity than the control group. The neopterin and tryptophan levels in malignant and benign patients were also significantly different.

CONCLUSION

The results of the present study suggest that thyroid disorders may lead to changes in tryptophan degradation, neopterin production and CAT enzyme activities.

Undetectable Brain Metastasis of Hepatocellular Carcinoma by PET-CT After Liver Transplantation: a Case Report

PURPOSE

Management of the unexplained AFP elevation after transplantation. F18 FDG PET/CT may not be helpful to detect post-transplant brain metastasis of hepatocellular carcinoma (HCC).

CASE REPORT

A-61-year old male patient with HBV related HCC have undergone living donor liver transplantation after successfully downstaging. AFP level started to increase on Post-transplant one year and there was no detectable metastases on PET/CT, abdominal thorax tomography. Patient admitted to hospital with confusion and seizure on post-transplant 16th month and diagnosed brain metastasis by brain tomography. Surgical resection was performed but the patientd died on post-transplant 20th month.

CONCLUSION

In the unexplained elevation of AFP after transplantation, it is beneficial to keep brain metastases in mind and perform cranial scanning with conventional imaging methods (CT, MRI) rather than FDG PET.