The Model for End-stage Liver Disease Sodium (MELD-Na) score predicts mortality in liver transplant candidates. MELD 3.0 has been proposed as an improved model for estimating mortality risk. This study evaluated MELD 3.0’s predictive accuracy for short-term mortality among Turkish liver transplant candidates and compared its performance with MELD and MELD-Na scores. Patients listed both for deceased donor transplants and living donor transplants were analyzed in the study. The discriminative abilities of MELD, MELD-Na, and MELD 3.0 scores were assessed using the area under the receiver operating characteristic curve (AUROC). Comparisons between AUROC values used the DeLong test. The most predictive cutoff for MELD 3.0 was determined using the Youden index. Transplant-free survival was analyzed using the Kaplan–Meier method, with survival curves compared using the log-rank test. A total of 1689 patients were included in this nationwide, multicenter study. Hepatitis B was the leading cause of cirrhosis (29%, n=491), followed by metabolic dysfunction–associated steatohepatitis (20%, n=335). For 3-month mortality, MELD 3.0 had the highest AUROC (0.753), followed by MELD-Na (0.747) and MELD (0.725). The most predictive cutoff values were 18 for MELD and 21 for MELD-Na and MELD 3.0. Both MELD-Na and MELD 3.0 outperformed MELD ( p <0.001), but showed no significant difference between them ( p =0.17). MELD 3.0 and MELD-Na demonstrated superior performance to MELD in predicting 3-month mortality among Turkish liver transplant candidates, though their predictive accuracy was comparable. Further refinements are needed to enhance MELD 3.0’s clinical utility.

Methotrexate (MTX) is an effective drug used to treat various diseases, especially rheumatological diseases. However, myelosuppression is a severe side effect, the frequency of which increases in patients with renal insufficiency. Here, we presented a chronic hemodialysis patient who developed pancytopenia and mucositis after using low-dose MTX to treat psoriasis.

Background/Aims: Despite the widespread use of direct-acting antivirals (DAAs), real-world data on treatment outcomes and predictors of response in hepatitis C virus (HCV) genotypes 2 and 3 remain limited, particularly in countries with heterogeneous patient populations such as Türkiye. This study evaluates the efficacy and safety of direct-acting antivirals (DAAs) in treating hepatitis C virus (HCV) genotype 2 (GT-2) and genotype 3 (GT-3) in Türkiye. Materials and Methods: This cohort is a multicenter, retrospective, and observational study. Data from 267 GT-2 or GT-3 patients treated with a DAA were analyzed. Treatment efficacy was assessed by sustained virological response at 12 weeks after the end of treatment (SVR), and baseline demographic, clinical, and laboratory parameters were evaluated to identify factors associated with treatment response. Results: An overall sustained virological response (SVR) rate of 95.9%, with no significant difference between GTs. The SVR rates were relatively lower in patients with cirrhosis. Prior pegylated interferon and ribavirin reduced SVR rates, particularly in males and patients with cirrhosis. The most common treatments were sofosbuvir-based regimens, which demonstrated comparable efficacy. No significant drug interactions were observed. The most commonly reported adverse events were fatigue and mild anemia, particularly in cirrhotic patients; however, these did not lead to treatment discontinuation. Conclusion: This study supports the efficacy and tolerability of DAA regimens for these HCV GTs, thereby reinforcing their role in HCV eradication. Cite this article as: Eren F, Goktug MR, Ari D, et al. Fibrosis-4 score and postoperative outcomes in metabolic dysfunction associated steatotic liver disease. Turk J Gastroenterol. 2026;37(1):127-135.

Aims: This research aims to determine the impact of maximum tumor diameter and FDG PET CT status at the time of diagnosis on survival outcomes and to identify prognostic factors that influence treatment response and survival. Methods: 239 patients with a diagnosis of Hodgkin lymphoma participated in the study. Clinical characteristics, treatment responses, and prognostic factors influencing survival were retrospectively analyzed from patient medical records. Results: There were 136 (56.9%) male patients and 103 (43.1%) female patients, who participated in the study. Of these patients, 202 (84.5%) survived, while 37 (15.5%) died during the study period. When surviving patients and non-survivor patients were compared, the deceased patients had a higher mean age (p = 0.003), a higher prevalence of spleen involvement and B symptoms (p = 0.011 and p = 0.001, respectively), lower albumin levels (p = 0.008), higher beta-2 microglobulin levels (p = 0.001), and more bone marrow involvement (p = 0.006). A fourfold increase in mortality was seen in patients with beta-2 microglobulin levels > 2920 mg/L, and a 3.188-fold increase in mortality was seen in patients with spleen involvement. Conclusion: In conclusion, beta-2 microglobulin > 2920 mg/L, the presence of spleen involvement, the presence of relapse, and the presence of progressive or refractory disease in FDG PET CT were significant prognostic factors for 1st, 3rd, and 5th-year survival rates in patients with Hodgkin lymphoma. In addition, there was no correlation between survival rate and maximum tumor diameter as measured by FDG-PET or CT.

Ustekinumab is an effective biological agent for the treatment of ulcerative colitis (UC); however, real-world data on treatment persistence and factors affecting drug survival in biologic-experienced patients remain limited. This retrospective cohort study aimed to evaluate ustekinumab treatment persistence and identify factors associated with treatment discontinuation in UC patients treated between January 2021 and December 2025. Treatment persistence was defined as the time from treatment initiation to discontinuation and was analyzed using the Kaplan–Meier method. A total of 42 biologic-experienced UC patients were included. The 12-month and 24-month treatment persistence rates were 90.5% and 85.7%, respectively, and 14.3% of patients discontinued treatment during follow-up. Surgical history was significantly associated with higher treatment discontinuation rates (p=0.026), and patients with prior surgery had significantly lower treatment persistence (log-rank p<0.001). Female sex was also associated with lower treatment persistence (log-rank p=0.045). Other clinical variables, including smoking status, disease extent, prior biologic exposure, and extraintestinal manifestations, were not significantly associated with treatment persistence. In conclusion, ustekinumab demonstrates high treatment persistence in biologic-experienced UC patients in real-world practice, and surgical history and female sex may be associated with lower treatment persistence. Larger prospective studies are needed to confirm these findings.

Background and Objectives: Anti-hepatitis B core antibody (anti-HBc) is generally regarded as a lifelong serological marker of previous hepatitis B virus (HBV) infection. However, anti-HBc seroclearance has been increasingly reported in patients receiving anti-CD20 therapy, while its incidence, longitudinal serological dynamics, and clinical significance remain insufficiently characterized. In this study, we aimed to evaluate the incidence, timing, and predictors of anti-HBc seroclearance and investigate longitudinal changes in HBV serology in HBsAg-negative/anti-HBc-positive patients undergoing anti-CD20 therapy. Materials and Methods: This retrospective single-center cohort study included 230 HBsAg-negative/anti-HBc-positive adults who received anti-CD20 therapy between 2011 and 2025. Anti-HBc seroclearance was evaluated using Kaplan–Meier analysis and Cox proportional hazards regression. Longitudinal changes in anti-HBc and anti-HBs titers were assessed using linear mixed-effects models. Results: Confirmed anti-HBc seroclearance occurred in 38 of 230 patients (16.5%). Younger age (adjusted hazard ratio (aHR) 0.96, 95% confidence interval (CI) 0.93–0.98; p = 0.001), fewer anti-CD20 treatment cycles (aHR 0.90, 95% CI 0.83–0.99; p = 0.025), and mycophenolate mofetil therapy (aHR 2.52, 95% CI 1.14–5.56; p = 0.022) were independently associated with anti-HBc seroclearance. Anti-HBc titers progressively declined during follow-up, with a significantly steeper decline among patients receiving mycophenolate mofetil. HBV reactivation occurred in five of 230 patients (2.2%), including two who had developed anti-HBc seroclearance. HBsAg seroreversion occurred in all five patients. Conclusions: Anti-HBc seroclearance is a relatively frequent serological finding in HBsAg-negative/anti-HBc-positive patients receiving anti-CD20 therapy and is accompanied by progressive declines in anti-HBc titers. Despite seroclearance, HBV reactivation may still occur, indicating that anti-HBc loss should not be considered evidence of elimination of HBV-related immunological risk. These findings improve our understanding of HBV serological dynamics during anti-CD20 therapy and support maintaining current antiviral prophylaxis and virological monitoring strategies regardless of anti-HBc seroclearance.