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Genco Gencdal

Koç University, Gastroenterology, Faculty Member

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Genco Gençdal graduated at Ankara University School of Medicine in 2001. He specialized in internal medicine at the Okmeydanı Training and Research Hospital and in 2008.Then He specialized in Gastroenterohepatology at Ege University School of Medicine in 2012. He has worked as clinician and teaching staff in the department of Gastroenterology at Yeni Yuzyil University and at Uskudar University in Istanbul. He is working as clinician and teaching staff in the department of Gastroenterology at Istanbul Koc University since October 2020. He has published several national and international articles. He was an Editorial Board member of the World Journal of Hepatology from 2015 to 2023. Research interests Liver transplantation, Hepatic encephalopathy,Sleep disorders in Liver cirrhosis, Hepatitis c, Hepatitis B, Autoimmune hepatititis.

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Papers by Genco Gencdal

Adult living donor liver transplantation from donors with Gilbert’s syndrome: Is it safe?

Clinical Transplantation

BackgroundsWe evaluate whether it is safe to accept donors with Gilbert's syndrome (GS) for a... more BackgroundsWe evaluate whether it is safe to accept donors with Gilbert's syndrome (GS) for a living donor liver transplantation (LDLT) or not. This study is the first controlled study to be conducted.MethodsBetween January 2004 and May 2014, 600 LDLTs which used right lobe liver grafts were performed in our center. Forty‐five of the 600 donors had a GS diagnosis. For a control group, 99 donors without GS who had completed 1 year or more of follow‐up were selected retrospectively and consecutively. The clinical results of the donors and recipients were then analyzed.ResultsA total of 45 donors with GS and 99 donors without GS were included. There were no significant differences in patient demographics, actual graft weight, remnant ratio, portal and ductal variations, pre‐peri‐post–operative liver enzymes. The donors with GS had significantly higher bilirubin levels compared with the control group at first reading, at maximal peak, and post‐operative 1‐7 days, 1st and 6th months ...

Association of LCT-13910 C/T Polymorphism and Colorectal Cancer

Annals of coloproctology, Oct 31, 2017

The activity of epithelial lactase (LCT) is associated with a polymorphism 13910 bp upstream in t... more The activity of epithelial lactase (LCT) is associated with a polymorphism 13910 bp upstream in the lactase encoding gene. Because the association between the LCT-13910 polymorphism and the risk for colorectal cancer is not clear, we investigated the role of the LCT-13910 polymorphism as a potential risk factor for colorectal cancer and colorectal polyps in the Turkish population. Methods: One hundred sixty-six subjects (74 with polyps, 44 with colorectal cancer, 48 controls), who had undergone a total colonoscopy between January 2012 and November 2012 in our endoscopy unit were genotyped for the LCT-13910 polymorphism by using the polymerase chain reaction and minisequencing. Results: The CC genotype in the lactose gene 13910 locus, which is accepted as the genetic indicator of lactase deficiency, was determined as 83.7%. The CC genotype rate was determined as 89.1% in patients who had a history of lactose intolerance and 81.5% in those without a history of lactose intolerance (P = 0.236). No difference was detected between the patients who had colorectal polyp(s) and/or cancer and the controls with regard to the LCT-13910 polymorphism. No differences were determined between groups when they were compared with regard to the C or the T allele. Conclusion: No differences were detected between the patients who had colorectal polyp(s) and/or cancer and those with normal colonoscopy findings with regard to lactase gene polymorphisms. No differences were determined between the groups when they were compared with regard to the C or the T allele.

Hepatitis delta virus infection in Turkey: A meta analysis of prevalence

Journal of Hepatology

Identification of risk factors for alcohol relapse in liver transplant patients with alcohol-related liver disease

Journal of Hepatology

Non‐invasive fibrosis markers for assessment of liver fibrosis in chronic hepatitis delta

Journal of Viral Hepatitis

Assessment of liver fibrosis by non‐invasive means is clinically important. Studies in chronic he... more Assessment of liver fibrosis by non‐invasive means is clinically important. Studies in chronic hepatitis delta (CHD) are scarce. We evaluated the performance of eight serum fibrosis markers [fibrosis‐4 score (FIB‐4), aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio (AAR), age‐platelet index (API), AST‐to platelet‐ratio‐index (APRI), Goteborg University Cirrhosis Index (GUCI), Lok index, cirrhosis discriminant score (CDS) and Hui score] in CHD and chronic hepatitis B (CHB). Liver stiffness was assessed by transient elastography (TE) in CHD. The ability of fibrosis markers to detect significant fibrosis and cirrhosis were evaluated in 202 CHB and 108 CHD patients using published and new cut‐offs through receiver operating characteristics (ROC) analysis. The latter was also applied to obtain cut‐offs for TE. APRI, Fib‐4, API and Hui score were assessed for significant fibrosis, and APRI, GUCI, Lok index, CDS and AAR for cirrhosis determination. Fibrosis markers ...

Chronic hepatitis delta with normal ALT and hepatitis D viremia

Journal of Hepatology

The course of COVID-19 infection in patients with chronic hepatitis B and Delta

Journal of Hepatology

Trends and causes of etiology in adult liver transplant patients: multicenter study

Journal of Hepatology

The effect of clinicopathologic findings of hepatocellular carcinoma on posttransplant survival: a multcenter cohort from TASL liver transplantation special interest group

Journal of Hepatology

Long Term Results of Entecavir versus Tenofovir in Treatment-naive Patients with Chronic Hepatitis B. A Single Center, Daily Practice Data

64th Annual Meeting and Postgraduate Course of the American-Association-for-the-Study-of-Liver-Di... more

Circadian changes in Critical Flicker Frequency in Cirrhotics and its relation with Sleep Disturbances

63rd Annual Meeting of the American-Association-for-the-Study-of-Liver-Diseases (AASLD) -- NOV 09... more

Etiology of Cirrhosis in Turkey: A National Cohort Study

Covid-19 in Liver Transplant Recipients: A National Cohort

Journal of Hepatology, 2021

Determination of Turkish Norms of Psychometric Tests For Diagnosing Minimal Hepatic Encephalopathy and Proposal of a Simplified Paper Pencil Test Battery

Background: Psychometric hepatic encephalopathy score (PHES) needs standardization for countries ... more Background: Psychometric hepatic encephalopathy score (PHES) needs standardization for countries and is used for minimal hepatic encephalopathy (mHE) diagnosis. Assessing it is cumbersome.Aims: To standardize PHES for Turkish patients and compare it with German norms; to determine mHE prevalence with two different methods and to assess whether the PHES test can be simplified.Methods: Healthy volunteers (n=816; 400 male) and cirrhotics (n=124; 58 male) were included. PHES score threshold was set at ≤-5 points and that of critical flicker frequency (CFF) at <39 Hz for mHE diagnosis. For comparing German and Turkish norms, datasets were combined. Multiple backward procedure was applied. Receiver operating characteristic (ROC) curves were created for assessing diagnostic capabilities of single subtests of the PHES test. Results: Turkish norms displayed non-linear dependence on age and education. Rate of mHE in compensated cirrhotics was 29.8% and 27.4% with PHES and CFF tests, respec...

Kemik İliği Nakli Alıcılarında Gastrointestinal Komplikasyonlar

Recommendations for Hepatitis B Immunoglobulin and Antiviral Prophylaxis Against Hepatitis B Recurrence After Liver Transplantation

The Turkish Journal of Gastroenterology, 2021

The combination of hepatitis B immunoglobulin and potent nucleos(t)ide analogs after liver transp... more The combination of hepatitis B immunoglobulin and potent nucleos(t)ide analogs after liver transplantation is considered as the standard of care for prophylaxis against hepatitis B virus recurrence. However, the recommended doses, route of administration, and duration of HBIG administration remain unclear. Moreover, hepatitis B immunoglobulin-free prophylaxis with potent nucleos(t)ide analogs has shown promising disease outcomes in preventing hepatitis B virus recurrence. The current recommendations, produced by the Turkish Association for the Study of the Liver, Acute Liver Failure and Liver Transplantation Special Interest Group, suggest a reduced need for hepatitis B immunoglobulin administration with effective long-term suppression of hepatitis B virus replication using potent nucleos(t) ide analogs after liver transplantation.

Outcomes following deceased and live donor liver transplantation for the indication of acute liver failure: a multicenter experience

Journal of Hepatology, 2020

(H&E) staining and immunohistochemistry were used to examine liver injury and regeneration. Resul... more (H&E) staining and immunohistochemistry were used to examine liver injury and regeneration. Results: iHepLPCs exhibited efficient expansion without growth arrest. Overexpression of FOXA3 significantly improved the synthesis, secretion and detoxification functions of iHepLPCs. When cultured on macroporous carriers in Ali-BAL, not only sufficient cell yield was obtained, but the cells formed 3-D constructs, leading to further enhanced liver functions. After Ali-BAL treatment, ALF porcine had markedly improved survival (83%, n = 6) compared to ALF control (17%, n = 6, p = 0.02) and No-cell device therapy (0%, n = 6, p = 0.003). The blood ammonia levels, as well as biochemical and coagulation indices were significantly reduced in Ali-BAL-treated pigs. Ali-BAL treatment attenuated liver damage, ameliorated inflammation and enhanced liver regeneration. Conclusion: Novel air-liquid interactive bioartificial liver embedded with 3D-layered iHepLPCs can improve ALF porcine survival. The Ali-BAL might be considered as a new therapeutic device for ALF treatment.

Comparing computerized tomography indices and liver biopsy in liver transplantation donors for hepatosteatosis

Journal of Clinical Medicine of Kazakhstan, 2020

Background: Selecting the right donor to achieve a successful liver transplantation is very impor... more Background: Selecting the right donor to achieve a successful liver transplantation is very important; thus computerized tomography and liver biopsy are frequently applied in the diagnosis of steatosis in donors. Purpose: We sought to investigate the efficacy of computerized tomography in the evaluation of hepatosteatosis in living donor liver transplantation donors. Material and methods: The living donor liver transplantation cases between January 2015 and December 2017 were screened retrospectively. The study participants were divided into three groups according to the degree of steatosis determined during LB as follows: grade 0: less than 5%, grade 1: 6% to 20%, and grade 2: greater than 20%. Using computerized tomography scans, hepatic attenuation value (CTL), hepatic attenuation value and spleen attenuation value ratio (CTL/S), and the difference between hepatic attenuation value and splenic attenuation values (CTL−S) were determined and the correlations of these indices and the findings of LB were compared. Results: Of the 60 patients (42 males, mean age: 32.4±7.7 years), 43 had grade 0, 15 had grade 1, and two had grade 2 hepatosteatosis, respectively. The CTL, CTL/S, and CTL−S cutoff values were 48.3, 1.06, and 3.2, respectively, while the sensitivity and specificity results of these cutoff values were 64.7% and 88.3%, 64.7% and 86%, and 64.7% and 86% and the area under the curve values were determined to be 0.81, 0.79, and 0.80 (p< 0.001). Conclusion: The use of these noninvasive indices can reduce the need for liver biopsy, which is an invasive procedure, as well as lessen the associated complication and cost rates. Future prospective studies are needed on this subject.

Association of LCT-13910 C/T Polymorphism and Colorectal Cancer

Annals of Coloproctology, 2017

The activity of epithelial lactase (LCT) is associated with a polymorphism 13910 bp upstream in t... more The activity of epithelial lactase (LCT) is associated with a polymorphism 13910 bp upstream in the lactase encoding gene. Because the association between the LCT-13910 polymorphism and the risk for colorectal cancer is not clear, we investigated the role of the LCT-13910 polymorphism as a potential risk factor for colorectal cancer and colorectal polyps in the Turkish population. Methods: One hundred sixty-six subjects (74 with polyps, 44 with colorectal cancer, 48 controls), who had undergone a total colonoscopy between January 2012 and November 2012 in our endoscopy unit were genotyped for the LCT-13910 polymorphism by using the polymerase chain reaction and minisequencing. Results: The CC genotype in the lactose gene 13910 locus, which is accepted as the genetic indicator of lactase deficiency, was determined as 83.7%. The CC genotype rate was determined as 89.1% in patients who had a history of lactose intolerance and 81.5% in those without a history of lactose intolerance (P = 0.236). No difference was detected between the patients who had colorectal polyp(s) and/or cancer and the controls with regard to the LCT-13910 polymorphism. No differences were determined between groups when they were compared with regard to the C or the T allele. Conclusion: No differences were detected between the patients who had colorectal polyp(s) and/or cancer and those with normal colonoscopy findings with regard to lactase gene polymorphisms. No differences were determined between the groups when they were compared with regard to the C or the T allele.

Assessment of sleep pattern and quality before and after liver transplantation using different methods

The Turkish Journal of Gastroenterology, 2019

Anti-colon cancer activity of Bifidobacterium metabolites on colon cancer cell line SW742

Adult living donor liver transplantation from donors with Gilbert’s syndrome: Is it safe?

Clinical Transplantation

BackgroundsWe evaluate whether it is safe to accept donors with Gilbert's syndrome (GS) for a... more BackgroundsWe evaluate whether it is safe to accept donors with Gilbert's syndrome (GS) for a living donor liver transplantation (LDLT) or not. This study is the first controlled study to be conducted.MethodsBetween January 2004 and May 2014, 600 LDLTs which used right lobe liver grafts were performed in our center. Forty‐five of the 600 donors had a GS diagnosis. For a control group, 99 donors without GS who had completed 1 year or more of follow‐up were selected retrospectively and consecutively. The clinical results of the donors and recipients were then analyzed.ResultsA total of 45 donors with GS and 99 donors without GS were included. There were no significant differences in patient demographics, actual graft weight, remnant ratio, portal and ductal variations, pre‐peri‐post–operative liver enzymes. The donors with GS had significantly higher bilirubin levels compared with the control group at first reading, at maximal peak, and post‐operative 1‐7 days, 1st and 6th months ...

Association of LCT-13910 C/T Polymorphism and Colorectal Cancer

Annals of coloproctology, Oct 31, 2017

The activity of epithelial lactase (LCT) is associated with a polymorphism 13910 bp upstream in t... more The activity of epithelial lactase (LCT) is associated with a polymorphism 13910 bp upstream in the lactase encoding gene. Because the association between the LCT-13910 polymorphism and the risk for colorectal cancer is not clear, we investigated the role of the LCT-13910 polymorphism as a potential risk factor for colorectal cancer and colorectal polyps in the Turkish population. Methods: One hundred sixty-six subjects (74 with polyps, 44 with colorectal cancer, 48 controls), who had undergone a total colonoscopy between January 2012 and November 2012 in our endoscopy unit were genotyped for the LCT-13910 polymorphism by using the polymerase chain reaction and minisequencing. Results: The CC genotype in the lactose gene 13910 locus, which is accepted as the genetic indicator of lactase deficiency, was determined as 83.7%. The CC genotype rate was determined as 89.1% in patients who had a history of lactose intolerance and 81.5% in those without a history of lactose intolerance (P = 0.236). No difference was detected between the patients who had colorectal polyp(s) and/or cancer and the controls with regard to the LCT-13910 polymorphism. No differences were determined between groups when they were compared with regard to the C or the T allele. Conclusion: No differences were detected between the patients who had colorectal polyp(s) and/or cancer and those with normal colonoscopy findings with regard to lactase gene polymorphisms. No differences were determined between the groups when they were compared with regard to the C or the T allele.

Hepatitis delta virus infection in Turkey: A meta analysis of prevalence

Journal of Hepatology

Identification of risk factors for alcohol relapse in liver transplant patients with alcohol-related liver disease

Journal of Hepatology

Non‐invasive fibrosis markers for assessment of liver fibrosis in chronic hepatitis delta

Journal of Viral Hepatitis

Assessment of liver fibrosis by non‐invasive means is clinically important. Studies in chronic he... more Assessment of liver fibrosis by non‐invasive means is clinically important. Studies in chronic hepatitis delta (CHD) are scarce. We evaluated the performance of eight serum fibrosis markers [fibrosis‐4 score (FIB‐4), aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio (AAR), age‐platelet index (API), AST‐to platelet‐ratio‐index (APRI), Goteborg University Cirrhosis Index (GUCI), Lok index, cirrhosis discriminant score (CDS) and Hui score] in CHD and chronic hepatitis B (CHB). Liver stiffness was assessed by transient elastography (TE) in CHD. The ability of fibrosis markers to detect significant fibrosis and cirrhosis were evaluated in 202 CHB and 108 CHD patients using published and new cut‐offs through receiver operating characteristics (ROC) analysis. The latter was also applied to obtain cut‐offs for TE. APRI, Fib‐4, API and Hui score were assessed for significant fibrosis, and APRI, GUCI, Lok index, CDS and AAR for cirrhosis determination. Fibrosis markers ...

Chronic hepatitis delta with normal ALT and hepatitis D viremia

Journal of Hepatology

The course of COVID-19 infection in patients with chronic hepatitis B and Delta

Journal of Hepatology

Trends and causes of etiology in adult liver transplant patients: multicenter study

Journal of Hepatology

The effect of clinicopathologic findings of hepatocellular carcinoma on posttransplant survival: a multcenter cohort from TASL liver transplantation special interest group

Journal of Hepatology

Long Term Results of Entecavir versus Tenofovir in Treatment-naive Patients with Chronic Hepatitis B. A Single Center, Daily Practice Data

64th Annual Meeting and Postgraduate Course of the American-Association-for-the-Study-of-Liver-Di... more

Circadian changes in Critical Flicker Frequency in Cirrhotics and its relation with Sleep Disturbances

63rd Annual Meeting of the American-Association-for-the-Study-of-Liver-Diseases (AASLD) -- NOV 09... more

Etiology of Cirrhosis in Turkey: A National Cohort Study

Covid-19 in Liver Transplant Recipients: A National Cohort

Journal of Hepatology, 2021

Determination of Turkish Norms of Psychometric Tests For Diagnosing Minimal Hepatic Encephalopathy and Proposal of a Simplified Paper Pencil Test Battery

Background: Psychometric hepatic encephalopathy score (PHES) needs standardization for countries ... more Background: Psychometric hepatic encephalopathy score (PHES) needs standardization for countries and is used for minimal hepatic encephalopathy (mHE) diagnosis. Assessing it is cumbersome.Aims: To standardize PHES for Turkish patients and compare it with German norms; to determine mHE prevalence with two different methods and to assess whether the PHES test can be simplified.Methods: Healthy volunteers (n=816; 400 male) and cirrhotics (n=124; 58 male) were included. PHES score threshold was set at ≤-5 points and that of critical flicker frequency (CFF) at <39 Hz for mHE diagnosis. For comparing German and Turkish norms, datasets were combined. Multiple backward procedure was applied. Receiver operating characteristic (ROC) curves were created for assessing diagnostic capabilities of single subtests of the PHES test. Results: Turkish norms displayed non-linear dependence on age and education. Rate of mHE in compensated cirrhotics was 29.8% and 27.4% with PHES and CFF tests, respec...

Kemik İliği Nakli Alıcılarında Gastrointestinal Komplikasyonlar

Recommendations for Hepatitis B Immunoglobulin and Antiviral Prophylaxis Against Hepatitis B Recurrence After Liver Transplantation

The Turkish Journal of Gastroenterology, 2021

The combination of hepatitis B immunoglobulin and potent nucleos(t)ide analogs after liver transp... more The combination of hepatitis B immunoglobulin and potent nucleos(t)ide analogs after liver transplantation is considered as the standard of care for prophylaxis against hepatitis B virus recurrence. However, the recommended doses, route of administration, and duration of HBIG administration remain unclear. Moreover, hepatitis B immunoglobulin-free prophylaxis with potent nucleos(t)ide analogs has shown promising disease outcomes in preventing hepatitis B virus recurrence. The current recommendations, produced by the Turkish Association for the Study of the Liver, Acute Liver Failure and Liver Transplantation Special Interest Group, suggest a reduced need for hepatitis B immunoglobulin administration with effective long-term suppression of hepatitis B virus replication using potent nucleos(t) ide analogs after liver transplantation.

Outcomes following deceased and live donor liver transplantation for the indication of acute liver failure: a multicenter experience

Journal of Hepatology, 2020

(H&E) staining and immunohistochemistry were used to examine liver injury and regeneration. Resul... more (H&E) staining and immunohistochemistry were used to examine liver injury and regeneration. Results: iHepLPCs exhibited efficient expansion without growth arrest. Overexpression of FOXA3 significantly improved the synthesis, secretion and detoxification functions of iHepLPCs. When cultured on macroporous carriers in Ali-BAL, not only sufficient cell yield was obtained, but the cells formed 3-D constructs, leading to further enhanced liver functions. After Ali-BAL treatment, ALF porcine had markedly improved survival (83%, n = 6) compared to ALF control (17%, n = 6, p = 0.02) and No-cell device therapy (0%, n = 6, p = 0.003). The blood ammonia levels, as well as biochemical and coagulation indices were significantly reduced in Ali-BAL-treated pigs. Ali-BAL treatment attenuated liver damage, ameliorated inflammation and enhanced liver regeneration. Conclusion: Novel air-liquid interactive bioartificial liver embedded with 3D-layered iHepLPCs can improve ALF porcine survival. The Ali-BAL might be considered as a new therapeutic device for ALF treatment.

Comparing computerized tomography indices and liver biopsy in liver transplantation donors for hepatosteatosis

Journal of Clinical Medicine of Kazakhstan, 2020

Background: Selecting the right donor to achieve a successful liver transplantation is very impor... more Background: Selecting the right donor to achieve a successful liver transplantation is very important; thus computerized tomography and liver biopsy are frequently applied in the diagnosis of steatosis in donors. Purpose: We sought to investigate the efficacy of computerized tomography in the evaluation of hepatosteatosis in living donor liver transplantation donors. Material and methods: The living donor liver transplantation cases between January 2015 and December 2017 were screened retrospectively. The study participants were divided into three groups according to the degree of steatosis determined during LB as follows: grade 0: less than 5%, grade 1: 6% to 20%, and grade 2: greater than 20%. Using computerized tomography scans, hepatic attenuation value (CTL), hepatic attenuation value and spleen attenuation value ratio (CTL/S), and the difference between hepatic attenuation value and splenic attenuation values (CTL−S) were determined and the correlations of these indices and the findings of LB were compared. Results: Of the 60 patients (42 males, mean age: 32.4±7.7 years), 43 had grade 0, 15 had grade 1, and two had grade 2 hepatosteatosis, respectively. The CTL, CTL/S, and CTL−S cutoff values were 48.3, 1.06, and 3.2, respectively, while the sensitivity and specificity results of these cutoff values were 64.7% and 88.3%, 64.7% and 86%, and 64.7% and 86% and the area under the curve values were determined to be 0.81, 0.79, and 0.80 (p< 0.001). Conclusion: The use of these noninvasive indices can reduce the need for liver biopsy, which is an invasive procedure, as well as lessen the associated complication and cost rates. Future prospective studies are needed on this subject.

Association of LCT-13910 C/T Polymorphism and Colorectal Cancer

Annals of Coloproctology, 2017

The activity of epithelial lactase (LCT) is associated with a polymorphism 13910 bp upstream in t... more The activity of epithelial lactase (LCT) is associated with a polymorphism 13910 bp upstream in the lactase encoding gene. Because the association between the LCT-13910 polymorphism and the risk for colorectal cancer is not clear, we investigated the role of the LCT-13910 polymorphism as a potential risk factor for colorectal cancer and colorectal polyps in the Turkish population. Methods: One hundred sixty-six subjects (74 with polyps, 44 with colorectal cancer, 48 controls), who had undergone a total colonoscopy between January 2012 and November 2012 in our endoscopy unit were genotyped for the LCT-13910 polymorphism by using the polymerase chain reaction and minisequencing. Results: The CC genotype in the lactose gene 13910 locus, which is accepted as the genetic indicator of lactase deficiency, was determined as 83.7%. The CC genotype rate was determined as 89.1% in patients who had a history of lactose intolerance and 81.5% in those without a history of lactose intolerance (P = 0.236). No difference was detected between the patients who had colorectal polyp(s) and/or cancer and the controls with regard to the LCT-13910 polymorphism. No differences were determined between groups when they were compared with regard to the C or the T allele. Conclusion: No differences were detected between the patients who had colorectal polyp(s) and/or cancer and those with normal colonoscopy findings with regard to lactase gene polymorphisms. No differences were determined between the groups when they were compared with regard to the C or the T allele.

Assessment of sleep pattern and quality before and after liver transplantation using different methods

The Turkish Journal of Gastroenterology, 2019

Anti-colon cancer activity of Bifidobacterium metabolites on colon cancer cell line SW742