Changing trends in the etiology of liver transplantation in Turkiye: A multicenter study

Background and Aim: This study aimed to identify the indications for liver transplantation (LT) based on underlying etiology and to characterize the patients who underwent LT. Materials and Methods: We conducted a multicenter cross-sectional ob-servational study across 11 tertiary centers in Turkiye from 2010 to 2020. The study included 5,080 adult patients. Results: The mean age of patients was 50.3±15.2 years, with a predom-inance of female patients (70%). Chronic viral hepatitis (46%) was the leading etiological factor, with Hepatitis B virus infection at 35%, followed by cryptogenic cirrhosis (24%), Hepatitis C virus infection (8%), and al-cohol-related liver disease (ALD) (6%). Post-2015, there was a significant increase in both the number of liver transplants and the proportion of living donor liver transplants (p<0.001). A comparative analysis of patient characteristics before and after 2015 showed a significant decline in viral hepati-tis-related LT (p<0.001), whereas fatty liver disease-related LT significantly increased (p<0.001). Conclusion: Chronic viral hepatitis continues to be the primary indication for LT in Turkiye. However, the proportions of non-alcoholic fatty liver disease (NAFLD) and ALD-related LT have seen an upward trend over the years

SARS-CoV-2 vaccination and risk of severe COVID-19 outcomes in patients with autoimmune hepatitis

Background: Data regarding outcome of Coronavirus disease 2019 (COVID-19) in vaccinated patients with autoimmune hepatitis (AIH) are lacking. We evaluated the outcome of COVID-19 in AIH patients who received at least one dose of Pfizer- BioNTech (BNT162b2), Moderna (mRNA-1273) or AstraZeneca (ChAdOx1-S) vaccine. Patients and methods: We performed a retrospective study on AIH patients with COVID-19. The outcomes of AIH patients who had acute respiratory syndrome coronavirus 2 (SARS-CoV-2) breakthrough infection after at least one dose of COVID-19 vaccine were compared to unvaccinated patients with AIH. COVID-19 outcome was classified according to clinical state during the disease course as: (i) no hospitalization, (ii) hospitalization without oxygen supplementation, (iii) hospitalization with oxygen supplementation by nasal cannula or mask, (iv) intensive care unit (ICU) admission with non-invasive mechanical ventilation, (v) ICU admission with invasive mechanical ventilation or (vi) death, and data was analyzed using ordinal logistic regression. Results: We included 413 (258 unvaccinated and 155 vaccinated) patients (81%, female) with a median age of 52 (range: 17–85) years at COVID-19 diagnosis. The rates of hospitalization were (36.4% vs. 14.2%), need for any supplemental oxygen (29.5% vs. 9%) and mortality (7% vs. 0.6%) in unvaccinated and vaccinated AIH patients with COVID-19. Having received at least one dose of SARS-CoV-2 vaccine was associated with a significantly lower risk of worse COVID-19 severity, after adjusting for age, sex, comorbidities and presence of cirrhosis (adjusted odds ratio [aOR] 0.18, 95% confidence interval [CI], 0.10–0.31). Overall, vaccination against SARS-CoV-2 was associated with a significantly lower risk of mortality from COVID-19 (aOR 0.20, 95% CI 0.11–0.35). Conclusions: SARS-CoV-2 vaccination significantly reduced the risk of COVID-19 severity and mortality in patients with AIH.Fil: Efe, Cumali. Harran University Hospital; TurquíaFil: Taşçılar, Koray. Universitat Erlangen-Nuremberg; AlemaniaFil: Gerussi, Alessio. San Gerardo Hospital; Italia. Università degli Studi di Milano; ItaliaFil: Bolis, Francesca. Università degli Studi di Milano; ItaliaFil: Lammert, Craig. University School of Medicine; Estados UnidosFil: Ebik, Berat. Gazi Yaşargil Education and Research Hospital; TurquíaFil: Stättermayer, Albert Friedrich. Medizinische Universität Wien; AustriaFil: Cengiz, Mustafa. Gülhane Training and Research Hospital; TurquíaFil: Gökçe, Dilara Turan. Ankara City Hospital; TurquíaFil: Cristoferi, Laura. Università degli Studi di Milano; Italia. San Gerardo Hospital; ItaliaFil: Peralta, Mirta. Gobierno de la Ciudad de Buenos Aires. Hospital de Infecciosas "Dr. Francisco Javier Muñiz"; Argentina. Latin American Liver Research Educational And Awareness Network; ArgentinaFil: Massoumi, Hatef. Montefiore Medical Center; Estados UnidosFil: Montes, Pedro. Hospital Nacional Daniel Alcides Carrión; PerúFil: Cerda, Eira. Hospital Central Militar, Mexico City; MéxicoFil: Rigamonti, Cristina. Università del Piemonte Orientale UPO,; Italia. Azienda Ospedaliera Maggiore Della Carita Di Novara; ItaliaFil: Yapalı, Suna. Acıbadem University School of Medicine; TurquíaFil: Adali, Gupse. Umraniye Education and Research Hospital; TurquíaFil: Çalışkan, Ali Rıza. Adiyaman Üniversitesi; TurquíaFil: Balaban, Yasemin. Hacettepe Üniversitesi; TurquíaFil: Eren, Fatih. Uludag University; TurquíaFil: Eşkazan, Tuğçe. Cerrahpaşa School of Medicine; TurquíaFil: Barutçu, Sezgin. University of Gaziantep Medical Faculty; TurquíaFil: Lytvyak, Ellina. University of Alberta; CanadáFil: Zazueta, Godolfino Miranda. Instituto Nacional de la Nutrición Salvador Zubiran; MéxicoFil: Kayhan, Meral Akdogan. Gülhane Training and Research Hospital; TurquíaFil: Heurgue Berlot, Alexandra. Chu de Reims; FranciaFil: De Martin, Eleonora. Universite Paris-Saclay;Fil: Yavuz, Ahmet. Necmettin Erbakan University; TurquíaFil: Bıyık, Murat. Necmettin Erbakan University; TurquíaFil: Ridruejo, Ezequiel. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. CEMIC-CONICET. Centro de Educaciones Médicas e Investigaciones Clínicas "Norberto Quirno". CEMIC-CONICET; Argentina. Universidad Austral; Argentina. Latin American Liver Research Educational and Awareness Network; Argentin

The efficacy and tolerability of glecaprevir/pibrentasvir treatment in a real-world chronic hepatitis C patients cohort

Background and Aim: The aims of the present study were to evaluate the real-life efficacy and tolerability of glecaprevir (GLE)/pibrentasvir (PIB) in the treatment of patients with chronic hepatitis C (CHC). Materials and Methods: Between May 2019 and May 2022, 686 patients with CHC, treated with GLE/PIB combination from 21 participating centers in Turkiye, were enrolled in the study. Results: All patients were Caucasian, and their median age was 56 years. At the start of GLE/PIB treatment, the median serum Hepatitis C virus RNA and serum alanine amino transaminase (ALT) levels were 6.74 log10 IU/mL and 47 U/L, respectively. Fifty-three percent of the patients were infected with genotype 1b, followed by genotype 3 (17%). Diabetes was the more common concomitant disease. The sustained virological response (SVR12) was 91.4% with intent-to-treat analysis and 98.5% with per protocol analysis. The SVR12 rates were statistically significant differences between the patients who were i.v. drug users and non-user (88.0% vs. 98.8%, p=0.025). From the baseline to SVR12, the serum ALT levels and Model for End-Stage Liver Disease score were significantly improved (p<0.001 and p=0.014, respectively). No severe adverse effect was observed. Conclusion: GLE/PIB is an effective and tolerable treatment in patients with CHC

SARS-CoV-2 vaccination and risk of severe COVID-19 outcomes in patients with autoimmune hepatitis

Data regarding outcome of Coronavirus disease 2019 (COVID-19) in vaccinated patients with autoimmune hepatitis (AIH) are lacking. We evaluated the outcome of COVID-19 in AIH patients who received at least one dose of Pfizer- BioNTech (BNT162b2), Moderna (mRNA-1273) or AstraZeneca (ChAdOx1-S) vaccine