Seyed Ali Malek-Hosseini

Shiraz University of Medical Sciences | SUMS · Department of Surgery

Objectives: Thiopurine prodrugs are commonly used in kidney transplant recipients. Inosine triphosphate pyrophosphatase is an enzyme encoded by the ITPA gene. Alteration of ITPA gene is one of the pharmacogenetic sequence variants possibly involved in thiopurine metabolism. The ITPA 94C>A sequence variant (C-to-A substitution at nucleotide 94) is...

Aim of the study: Precore/core variations and liver disease progression have been suggested. In this study, we aimed to determine the frequency of precore/core mutations in hepatitis B virus (HBV)-infected patients at various clinical stages. Material and methods: In total, 73 HBV-infected patients including 26 inactive carriers (IC), 20 chronic...

Background: Biliary complications are the leading cause of morbidity and mortality in patients undergo¬ing Liver Transplantation (LT). Post-biliary transplantation strictures (BSs) are a severe problem with a high risk of graft failure. However, management of these BSs has remained controversial, and consid¬erable variability has been reported in...

Background Genetic abnormalities might have important role in pathogenesis of hepatic steatosis after liver transplantation. We aimed to investigate association between genetic variations in transmembrane 6 superfamily member 2 (TM6SF2) rs58542926, proprotein convertase subtilisin/kexin type 9 (PCSK9) rs505151 and proprotein convertase subtilisin/k...

Background: Progressive familial intrahepatic cholestasis is a disease presenting with severe cholestasis and progressing to the end-stage liver disease later. Liver transplantation is a treatment modality available for progressive familial intrahepatic cholestasis, especially in patients with end-stage liver disease or those who are unsuitable for...

Knowledge of living donor liver transplantation (LDLT) for autoimmune liver diseases (AILDs) is scarce. This study analyzed survival in LDLT recipients registered in the European Liver Transplant Registry with autoimmune hepatitis, primary biliary cholangitis, primary sclerosing cholangitis (PSC) and the non-autoimmune disorder alcohol-related cirr...

Objectives: Estimation of liver fat among living donor candidates is necessary before living donor liver transplant. This study aimed to investigate the usefulness of the controlled attenuation parameter compared with liver biopsy for pretransplant estimation of hepatic steatosis in living liver donors. Materials and methods: In this retrospecti...

Background The management of COVID-19 in organ transplant recipients is among the most imperative, yet less discussed, issues based on their immunocompromised status along with their vast post-transplant medication regimens. No conclusive study has been published to evaluate proper anti-viral and immunomodulator medications effect in treating COVID...

Background With the ongoing coronavirus (COVID-19) pandemic, evaluating the incidence of infection in major health centers and assessing the employed protocols is necessary for the management of the disease. Aim Since Shiraz Transplant Center is one of the major transplant centers in Iran and the Middle East, this study was conducted to evaluate o...

Objectives: Vascular endothelial growth factor is an endothelial-specific growth factor that promotes endothelial cell proliferation, differentiation, and survival; mediates endothelium-dependent vasodilatation; induces microvascular hyperpermeability; and participates in interstitial matrix remodeling. The aim of the present study was to investig...

Background: The lack of consent to donate body organs leads to an increase in the death rate of patients on the waiting list for transplantation. Unwillingness of families is known as the main obstacle to organ donation, and the media has an essential role in motivating organ donation. Objectives: This study aimed to explore obstacles to obtaining...

Background/PurposeBudd-Chiari syndrome (BCS) is a rare, life-threatening disease characterized by hepatic venous outflow obstruction. Liver transplantation (LT) is widely accepted as an effective therapeutic measure for irreversible liver failure due to BCS. There is debate on differences in the post LT course and complications in patients with BCS...

Background: Tuberculosis is an important cause of mortality and morbidity in liver transplant patients, so it is valuable to diagnose latent tuberculosis in liver transplant candidates by an accurate screening test prior to transplantation. Tuberculin skin test (TST) is the standard test for the diagnosis of latent tuberculosis. Currently interfer...

Background: Chronic hepatitis E infection has been reported in solid organ transplant recipients following acute hepatitis due to the compromised immune status. Almost all reports are from areas where hepatitis E virus (HEV) genotypes 3 and 4 are the dominant genotypes. This study was conducted to investigate the role of hepatitis E infection as a...

Background: MicroRNAs (miRNAs) are endogenous, 18-22 nucleotide non-coding RNA molecules. Human cytomegalovirus (HCMV) is a ubiquitous and particular herpes virus that encodes miRNAs, which increases gradually in the presence of infection. One of the important viral miRNAs is HCMV-miRUL-148D, which plays a role in establishing and maintaining vira...

Background: In hepatitis B virus (HBV) infection, an association between Precore/Core variations and liver disease progression has been suggested. In this study, we aimed to determine the frequency of Precore/Core mutations in HBV-infected patients at various clinical stages. Methods: Totally, 73 HBV-infected patients including 26 inactive carriers...

Background: End-Stage Liver Disease (ESLD) causes several clinical and psychological comorbidities. Some accompanying psychiatric disturbances have significant effects on the patients’ quality of life. Objectives: Thus, we aimed to evaluate some psychological characteristics of ESLD patients. Methods: A cross-sectional study was conducted on 91 ESL...

Coronavirus 2019 (COVID-19) is caused by a novel coronavirus. Although liver injury is common in patients with COVID-19, little is known about its clinical presentation and management in liver transplantation. This is the first report from Iran that presented two cases of liver transplantation with COVID-19, neither of which had pulmonary signs and...

Our data about pathogenesis of hepatic steatosis after liver transplantation is scarce. This study aimed to investigate the association between serum adipokines and insulin resistance with hepatic steatosis in liver transplant recipients. We investigated the association between insulin resistance, serum adiponectin, insulin, and leptin with hepatic...

Background: Primary hyperoxaluria (PH) is an autosomal genetic disorder characterized by abnormal glycosylate metabolism. Objectives: The aim of the present study was to assess post-transplant complications and survival of patients with PH who underwent either liver transplantation (LT) or simultaneous liver-kidney transplantation. Methods: 18 pati...

Liver transplantation is a potentially curative treatment for terminal stage hepatic diseases. Bacterial infections are the main causes of mortality and morbidity in the early period post liver transplantation. Identifying the risk factors could help in minimizing their development. We prospectively investigated the incidence, characteristics, and...

Background and aims: The aim of this study was to analyse long-term patient and graft survival after liver transplantation for autoimmune hepatitis (AIH-LT) from the prospective multicentre European Liver Transplant Registry. Methods: Patient and liver transplant survival between 1998 and 2017 were analysed. Patients after AIH-LT (n=2,515) were...

Background: Probable effects of living donor liver transplantation on the wellbeing of the donor and psychological difficulties are necessary to be understood. Objective: To assess the quality of life of living donors after liver donation. Methods: 140 living donors who underwent hepatectomy between 2012 and July 2015 were enrolled in this stu...

Background: Hepatocyte transplantation using isolated human hepatocytes is an alternative source that can be used for the treatment of metabolic diseases and acute liver failure as a time bridge to liver transplantation. These cells can also be used for bioartificial liver systems and in vitro study of drug toxicity. Objective: To determine whic...

Background: Cytokines have regulatory crosstalk with CMV infection leading to manage of post-liver transplantation virus-related outcomes. Objective: To investigate the link between IL-21, IL-23 and IL-27 mRNA and protein level with active CMV infection, which was evaluated in reactivated and non-reactivated liver transplant recipients. Methods...

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Objectives: Primary hyperoxaluria type 1 is an autosomal recessive disorder that causes overproduction and urinary excretion of oxalate. Liver transplant has been suggested as a treatment for primary hyperoxaluria type 1 since the defective enzyme is expressed in the liver. This study aimed to investigate results of combined liver and kidney, sequ...

Objectives: Nonalcoholic fatty liver disease is a rapidly growing disease and is hypothesized to become the most common cause of liver cirrhosis in the near future. This study aimed to investigate trends of nonalcoholic steatohepatitis as an indication for liver transplant in Iranian patients. Materials and methods: Liver transplant data from al...

Background Non-alcoholic fatty liver disease (NAFLD) is frequently seen among non-obese overweight individuals and lean subjects (those with normal body mass index). This study aimed to investigate prevalence and risk factors of biopsy proven NAFLD in a cluster of healthy non-obese and lean individuals. Methods and Materials In a retrospective stu...

Purpose Cystic lymphangioma of the pancreas was first recognized in 1913 as a form of benign cyst. It is extremely rare, accounting for less than 1% of the lymphangiomas. Case report Herein, we report a case of cystic pancreatic lymphangioma diagnosed in a 51-year-old female patient who was hospitalized for a colicky upper abdominal pain for a mon...

Background Nonalcoholic fatty liver disease (NAFLD) may occur in liver transplant recipients. This study aimed to investigate the prevalence and risk factors of NAFLD after liver transplantation in patients with NASH and cryptogenic cirrhosis, focusing on the impact of graft steatosis. Methods Patients with NASH and cryptogenic cirrhosis who had u...

Introduction: Concerning that the leading cause of short bowel syndrome in Asian countries is vascular events, unlike western countries which Chron’s disease lies at the top of the list, and also considering that most of these patients would die without proper management and planning, we had decided to design an algorithmic approach for managing th...

Introduction: Intestinal failure (IF) - a life-threatening medical status- is a rare disease still remains orphan in most countries. However, the management of this condition is still unclear in the middle-income countries (MIC) not benefiting from HPN. The current study aimed at investigating the current management of IF utilized in our center. Me...

Background & aims: Little is known about outcomes of liver transplantation for patients with non-alcoholic steatohepatitis (NASH). We aimed to determine the frequency and outcomes of liver transplantation for patients with NASH in Europe and identify prognostic factors. Methods: We analyzed data from patients transplanted for end-stage liver dis...

Introduction and objectives: The hepatitis B virus (HBV) surface antigen (HBsAg) variations suggested having some effects on infection outcome. Due to some controversial issues, the aim of this study was to compare the pattern of HBsAg variation between asymptomatic carriers and HCC/cirrhosis patients. Materials and methods: In this cross-sectio...

Background: Liver transplant recipients are treated with various drugs, the metabolism of which is dependent on the cytochrome P450 polymorphic genotype. Objective: To identify the polymorphic variety of CYP2C19 genotype in liver allograft before and after transplantation. Methods: The study was conducted on 88 liver recipients. The CYP2C19 ge...

Candida infections are common diseases in immunocompromised patients. A 19-year-old boy with liver transplantation, necrotic skin lesion, jaundice, dyspnea, and ascites was admitted to Namazi Hospital, Shiraz, southern Iran. The mycological examination for the skin lesion was requested. The skin sample was cultured on Sabouraud dextrose agar and ev...

Background: Liver transplantation is the only treatment for end-stage and genetic liver diseases. The main burden of this treatment is the shortage of both living and cadaveric liver donors. An alternative treatment is using liver cell transplantation, which can be obtained from unused livers for transplantation. These hepatocytes should be kept r...

Aim Portal vein thrombosis (PVT) is a common complication amongst patients with liver cirrhosis. The PVT risk factors and its impact on post‐liver transplant outcome has not been well defined, yet. This study aimed to investigate PVT prevalence, its risk factors and influence on early and long‐term outcomes after liver transplantation. Methods Adu...

Objectives: Investigations into the viral causes of end-stage liver disease in liver transplant patients with cryptogenic underlying disease remain of interest. Hepatitis C virus infection, especially in its silent (occult) form, may play a key role in the introduction and development of cryptogenic cirrhosis. We aimed to determine the prevalence...

Cytokines have prominent roles in activating of different T cells and shifting the immune response, in this study the role of three cytokines (IL-21, IL-23 and IL-27) is investigated in the liver transplant rejection. Three EDTA-treated blood samples were collected from each liver transplanted patient in 1st, 4th and 7th day of post-transplantation...

Background Histopathologic changes of post-reperfusion liver needle biopsies in patients with liver transplantation have rarely been reported and most of the previous reports have been in less than 200 cases. Objective In this study, we evaluated 408 post-perfusion liver needle biopsies for the histopathologic changes attributable to reperfusion i...

Background Bacterial infection in early period after liver transplant (LT) is the main cause of morbidity and mortality; however, data on children is limited. Methods To investigate the frequency, characteristics, and the associated factors of bacterial infection during hospitalization after LT, we prospectively enrolled all consecutive children w...

We read with interest the article by Saidi and colleagues on current challenges of liver transplantation (LT) in Iran.1 The authors have truly pointed out the increasing need for LT in Iran, but some of the issues they raised as challenges need to be looked more carefully.

Background: Iran's experience with liver transplantation (LT) began more than two decades ago. The purpose of this article is to present the status of LT in Iran, review specific characteristics of the programs, their outcomes, and their growth to become one of the largest LT programs in the world. Methods: A questionnaire, asking for data on th...

Background Liver function indices and anti-viral immune regulatory markers can both improve graft outcomes, which lead to better post-transplantation management and increase the possibility of surveillance in liver transplant recipients with chronic hepatitis B virus (HBV) infection. Objective To determine the association between the interferon re...

Background Patients with hepatic diseases are treated with numerous drugs metabolized by cytochrome P450. Objective To evaluate the frequencies of CYP2C19 variant alleles (*2, *3, and *17), genotypes, and phenotypes, and the relationship between the frequency of these alleles and the underlying hepatic diseases among patients with advanced liver d...

Objectives: Patients with end-stage liver disease face various psychologic challenges. We aimed to compare levels of depression, anxiety, fatigue, sleepiness, and memory in patients before and after liver transplant. Materials and methods: Forty patients (24 male, 16 female) were recruited from the liver transplant clinic affiliated with Shiraz...

Background: Liver transplantation (LT) is the only approved treatment for patients with end stage liver disease (ESLD). Shiraz organ transplantation center (SOTC) was the first center in Iran to provide LT. This report is on the evolution of LT program in this center. Methods: We report the clinical features and outcomes of all those who received L...

Background: The pathogenesis of non-alcoholic fatty liver disease (NAFLD) has not been well recognized yet. Objective: This study aimed to investigate the association between serum magnesium concentration and NAFLD. Methods: Study participants were healthy individuals who had undergone liver biopsies between January 2012 and August 2015 as a r...

AIM To investigate incidence and survival of post-transplant lymphoproliferative disorder (PTLD) patients after liver transplantation. METHODS A cross-sectional survey was conducted among patients who underwent liver transplantation at Shiraz Transplant Center (Shiraz, Iran) between August 2004 and March 2015. Clinical and laboratory data of patie...

Objectives: Budd-Chiari syndrome can lead to fulminant hepatic failure and cirrhosis. The treatment depends on the severity of disease. Liver transplant is a successful treatment option for those with advanced-stage disease. Materials and methods: In this retrospective study, we analyzed all liver transplants conducted for Budd-Chiari syndrome a...

Objectives: In some cases of liver transplant, standard hepatic artery reconstruction may be difficult or impossible due to inadequate flow of the recipient's hepatic artery, as a result of stenosis, intimal dissection, or anomalies of the hepatic artery. We compared splenic artery transposition with extra-anatomic jump graft as 2 alternative meth...

Objectives: Urinary tract infections are among the most common infections after liver transplant, especially soon after surgery. This study analyzed urinary tract infections or bacteriuria, their causative agents, and related risk factors in the early period after liver transplant in hospitalized adult transplant recipients in the main liver trans...

A successful liver transplantation team consists of several specialists to work closely together. The histopathologist (anatomical pathologist) is one of the key players in this multidisciplinary team. This role starts with the pre-transplantation evaluation of the recipient's liver by diagnosis or confirming the underlying liver disease and contin...

Background: Patients with end-stage liver disease frequently acquired complex disorders in hemostasis secondary to liver dysfunction. Objectives: This study aims to determine the incidence of vascular complications associated with central venous catheterization (CVC) in patients with coagulopathy and liver disease. Methods and Subjects: This multic...

Background and Aim Liver transplantation is a potential cure for liver damage from Wilson’s disease but the course of neuropsychiatric manifestations after transplantation remains undetermined. Material and methods In this study, data on all patients who’d received a liver transplant for Wilson’s disease at the Shiraz Organ Transplantation Center...

Patients' characteristics. (XLSX)

Background The current organ shortage has prompted the use of marginal organs. We conducted this retrospective study to present our experience with transplanting deceased donor livers with elevated levels of serum transaminases and to explain whether elevated levels of serum transaminases in donors affect allograft function and survival of the reci...

Background: The most common cause of liver transplantation in Iran is hepatitis B positive cirrhosis, and it also one of the major and important causes of hepatocellular carcinoma (HCC). Most cases with HCC follow a multistep sequence. Morphologic lesions during hepatocarcinogenesis include dysplastic lesions and small cancerous lesions (2 cm in d...

Background: Metabolic syndrome (MetSx) is common among liver transplant recipients. It contributes to morbidity and mortality. Objective: To determine the prevalence of MetSx in patients undergoing liver transplantation (LTx) in Iran. Methods: 202 liver transplant recipients of both sexes completed this study. Relevant information including ag...

Background: Myocardial performance index (MPI) or Tei index is a Doppler-derived index of combined systolic and diastolic myocardial function, calculated as the sum of isovolumetric relaxation time (IRT) and isovolumetric contraction time (ICT) divided by the ejection time (ET). Objective: To evaluate the right and left ventricular systolic and di...

Abstract Background: Portal vein thrombosis is a fairly common and potentially life-threatening complication in patients with liver cirrhosis. The risk factors for portal vein thrombosis in these patients are still not fully understood. Objectives: This study aimed to investigate the associations between various risk factors in cirrhotic patients a...