Kronik karaciğer hastalığı ve/veya hepatosellüler karsinom nedeniyle karaciğer nakli olan hastalarda Helicobacter pylori varlığının araştırılması

Objective: Chronic liver diseases are one of the leading causes of morbidity and mortality worldwide and are an important public health problem. Chronic liver diseases can lead to liver fibrosis due to transient or persistent intrahepatic inflammation, and some may progress to liver cirrhosis and hepatocellular carcinoma (HCC). While liver cirrhosis is a disease that develops due to long-term hepatocyte damage and fibrosis, hepatocellular carcinoma is a complex process associated with various etiological factors that cause the imbalance between different cellular and molecular pathways and abnormal activation and inactivation of protooncogenes and tumor suppressor genes. In addition, with the demonstration of Helicobacter species in the biliary tract and liver tissues, it has attracted the attention of researchers to explore the possible influence of these bacteria in the pathogenesis of hepatobiliary diseases and malignancies. In studies conducted in recent years; it has been shown that together with Helicobacter pylori, other Helicobacter species (such as H. pullorum, H. bilis, H. flexispira) can be found in the liver tissue of patients with primary liver cancer, primary sclerosing cholangitis and primary biliary cirrhosis. In our study, it was aimed to investigate the presence of Helicobacter species in bile samples and liver tissue of patients who were transplanted due to chronic liver disease and/or hepatocellular carcinoma in our hospital, and possible relationships with the diagnosis of the disease. Materials and Methods: Adult patients aged 18 and over, who were diagnosed with chronic liver disease or HCC, who were underwent liver transplantation in İnönü University Liver Transplant Institute Hospital, between 19 April 2017 and 19 May 2018 were included in the study. Helicobacter species in liver and bile were investigated by polymerase chain reaction (PCR) test in donor and recipient groups. Results: Of the 195 subjects included in the study, 121 (62.1%) were male, 74 (37.9%) were female, and the median age was 36 (Min: 18, Max: 72). Of these, 109 (55.9%) were recipients and 86 (44.1%) were donors. Donors were considered as the control group. While eight (9.3%) of the bile samples in donors were positive for H. pylori PCR, two (2.3%) for Helicobacter 8 bilis, two (2.3%) for H. pylori+H. bilis, and H. pylori PCR positivity was detected in only one (1.2%) of the liver tissues. In the bile samples of liver transplant recipients, 18 (16.5%) H. pylori, five (4.6%) H. bilis, two (1.8%) H. pylori+H. bilis PCR positivity were detected. In the liver tissues of the recipients, two (1.8%) samples were positive for H. pylori PCR, and H. bilis PCR was negative in all of them. There was no statistical difference between the recipients and donors in terms of the presence of H. pylori in both bile and liver tissue. Conclusions: According to our knowledge, our study is the first in the English literature evaluating the presence of Helicobacter in liver transplant donors and recipients, simultaneously. Further studies are needed to investigate the effect of Helicobacter species on the disease process in patients with chronic liver disease and HCC who are candidates for liver transplantation in countries where Helicobacter infection is endemic, such as our country. Keywords: Helicobacter pylori, Helicobacter bilis, chronic liver disease, hepatocellular carcinoma, liver transplantation