Serdar ASLAN, Şerafettin YAZAR, Ahmet KARGI, Eray KURNAZ, Dilek ŞAHİN, Kemal PEKER, Ibrahim ASTARCİOGLU, Kamil POLAT

Hepatosellüler kanser nedeniyle tek merkezde yapılan karaciğer nakli sonuçları

Amaç: Hepatosellüler kanser (HSK), hepatobiliyer sistemin en sık görülen malignitesidir. HSK'nin küresel yayılımında önemli farklılıklar vardır. Sirozlu hastalarda en önemli ölüm nedenidir. Moleküler patogenezi oldukça karmaşık ve heterojendir. HSK gelişimi için başlıca risk faktörleri kronik hepatit B virüsü (HBV) enfeksiyonu, kronik hepatit C virüsü (HCV) enfeksiyonu ve alkole bağlı karaciğer sirozudur. HSK, HBV enfeksiyonunun hiperendemik olduğu bölgeler dışında, genellikle hayatın ilk dört dekadı içerisinde görülmez. Metod: Çalışma, 21.09.2014-13.04.2019 tarihleri arasında organ nakli merkezine başvuran HSK tanılı 204 hastanın dosyaları geriye dönük olarak taranarak gerçekleştirildi. Hastalara Milan kriterlerine, San Francisco [University of California San Francisco (UCSF)] kriterlerine ve Barcelona Clinic Liver Cancer (BCLC) kriterlerine göre sınıflandırılarak karaciğer nakli yapıldı. Bulgular: Hastaların medyan yaşı 58.03 (31-72 aralığında) idi. Hastaların 170'i erkek, 34'ü kadındı. Kadavra vericisinden 31 hastaya, canlı vericiden ise 173 hastaya karaciğer nakli yapıldı. Hastaların yaşam süreleri ile cinsiyetleri arasında anlamlı bir ilişki olduğu görüldü. Kadın hastaların yaşam beklentisi daha uzundur [t (202) = 2.963, p =0.003]. Yaşam beklentisi ile cerrahi sınıflandırma arasında anlamlı bir ilişki bulundu [F (3) = 3.008, (p =0.031)]. Sonuç: HSK tanılı olup karaciğer nakli yapılan hastalarda; cinsiyetin kadın olması ve nakil öncesi yapılan sınıflandırma yöntemi, yaşam beklentisini etkilemektedir.

Anahtar Kelimeler:

Transplantasyon, Karaciğer, Hepatosellüler kanser

The results of liver transplantation performed in a single center due to hepatocellular carcinoma

Objective: Hepatocellular cancer (HCC) is the most common malignancy of the hepatobiliary system. There are significant differences in the global spread of HCC. It is the major cause of death in patients with cirrhosis. Its molecular pathogenesis is highly complex and heterogeneous. Major risk factors for the development of HCC are chronic hepatitis B virus (HBV) infection, chronic hepatitis C virus (HCV) infection and alcohol-related liver cirrhosis. Hepatocellular cancer is rarely seen in the first 4 decades of life, except in communities where HBV infection is hyperendemic. Method: The study was conducted by retrospectively scanning the files of 204 patients diagnosed with HCC who applied to Organ Transplantation Center between 21.09.2014 and 13.04.2019. Patients were transplanted liver by being classified according to Milan criteria, San Francisco [University of California San Francisco (UCSF)] criteria, and Barcelona Clinic Liver Cancer (BCLC) criteria. Result: The median age of the patients was 58.03 (range 31 to 72). 170 of the patients were men and 34 of them were female. Liver transplantation was performed from cadaveric donors to 31 patients and from living donors to 173 patients. There is a significant relationship between the life span of the patients and their gender. Female patients have a longer life expectancy [t (202) = 2,963, p =, 003]. A significant relationship was found between life expectancy and surgical classification [F (3) = 3,008, (p =, 031)]. Conclusion: In patients diagnosed with HCC and undergoing liver transplantation; the gender being female and the classification method before transplantation affect life expectancy.

Keywords:

Transplantation, Liver, Hepatocellular carcinoma,

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ISSN: 1309-3878
Yayın Aralığı: Yılda 3 Sayı
Başlangıç: 2009
Yayıncı: Düzce Üniversitesi Tıp Fakültesi Aile Hekimliği AD adına Yrd.Doç.Dr.Cemil Işık Sönmez