1
|
Kahveci F, Gün E, Balaban B, Ucmak H, Tuna Kirsaçlioğlu C, Balci D, Koloğlu M, Kendirli T. Diagnostic Dilemma of Lactic Acidosis in an Infant After Liver Transplant: A Case Report. EXP CLIN TRANSPLANT 2023; 21:623-625. [PMID: 34763632 DOI: 10.6002/ect.2021.0249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Thiamine is the cofactor of many enzymes involved in energy metabolism. Patients under total parenteral nutrition are at risk for thiamine deficiency if there is renal thiamine loss or increased thiamine requirements to mitigate systemic diseases. Thiamine deficiency symptoms include seizures, neuropathy, ataxia, peripheral vasodilation, myocardial insufficiency, sudden collapse, and death. In this report, we present an infant liver transplant recipient with progressive lactic acidosis that responded well to thiamine replacement to mitigate a lack of thiamine in total parenteral nutrition.
Collapse
Affiliation(s)
- Fevzi Kahveci
- From the Department of Pediatrics, Division of Critical Care Medicine, Ankara University School of Medicine, Ankara, Turkey
| | | | | | | | | | | | | | | |
Collapse
|
2
|
Karakaya MF, Er E, Kırımker O, Gümüşsoy M, Bodakçi E, Özercan M, Doğanay Erdoğan B, Gökcan H, Koloğlu M, Karayalçın K, Yurdaydın C, Tüzüner A, Haznedaroğlu S, Çınar K, Özkan H, Idilman R, Idilman R. Management of Biliary Complications in Liver Transplant Recipients with Duct-To-Duct Anastomosis: A Single-Center Experience. Turk J Gastroenterol 2023; 34:177-181. [PMID: 36843302 PMCID: PMC10081117 DOI: 10.5152/tjg.2023.22724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
BACKGROUND The aims of this study were to investigate biliary complications in liver transplant recipients with choledochocholedocho stomy anastomosis, to identify the risk factors for the development of such complications, and to evaluate the success of endoscopic approaches in liver transplant recipients. METHODS Between January 2013 and May 2021, a total of 238 patients with liver diseases underwent liver transplantation: 174 recipients undergoing choledochocholedochostomy anastomosis were included in the analysis. RESULTS Their median age was 54.0 years. The median posttransplant follow-up period was 29 months. Hepatitis B virus infection (33%) was the most common indication for liver transplantation. Most patients (87%) received living donor liver transplantation. The overall prevalence of posttransplant biliary complications was 31%. Anastomotic biliary strictures were the most common biliary complications (72%), followed by biliary leakage (13%). The median time between endoscopic retrograde cholangiography and liver transplantation was 4 months, with a mean of 3 ± 1.6 sessions. Endoscopic retrograde cholangiography-guided drainage and balloon dilation with or without stent placement was the most common treatment modalities for recipients with biliary strictures. The overall success rate of endoscopic treatment modalities was 83.3%, with 65% of the recipients exhibiting complete biochemical and endoscopic responses. The response did not differ significantly between living donor liver transplantation and cadaveric donor liver transplant recipients (P > .05). Three recipients required revision surgery for biliary complication repair. Six patients died due to biliary sepsis. CONCLUSION Biliary stricture and leakages were the most common biliary complications after liver transplantation. Endoscopic treatment was successful in most recipients.
Collapse
Affiliation(s)
| | - Erdem Er
- Department of Gastroenterology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Onur Kırımker
- Department of General Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Mesut Gümüşsoy
- Department of Gastroenterology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Emin Bodakçi
- Department of Gastroenterology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Mubin Özercan
- Department of Gastroenterology, Ankara University Faculty of Medicine, Ankara, Turkey
| | | | - Hale Gökcan
- Department of Gastroenterology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Meltem Koloğlu
- Department of General Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Kaan Karayalçın
- Department of General Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Cihan Yurdaydın
- Department of Gastroenterology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Acar Tüzüner
- Department of General Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Selçuk Haznedaroğlu
- Department of General Surgery, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Kubilay Çınar
- Department of Gastroenterology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Hasan Özkan
- Department of Gastroenterology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Ramazan Idilman
- Department of Gastroenterology, Ankara University Faculty of Medicine, Ankara, Turkey
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
3
|
Botan E, Gün E, Güneş SA, Gurbanov A, Özen H, Kuloglu Z, Kırsaçlıoğlu C, Kırımker EO, Selvi ÖC, Çiftçi E, Fitöz S, Koloğlu M, Kansu A, Balcı D, Kendirli T. Early period intensive care follow-up after liver transplantation in children: a single center experience. Turk J Pediatr 2023; 65:489-499. [PMID: 37395968 DOI: 10.24953/turkjped.2022.743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
BACKGROUND Liver transplantation (LT) is a well-established, life-saving treatment for children with irreversible acute and chronic liver failure (LF). We aimed to evaluate the factors associated with morbidity and mortality in the early period of LT in children by reviewing our pediatric intensive care unit (PICU) experience. METHODS We reviewed children`s medical records followed in the PICU after LT between May 2015-August 2021, including demographic parameters, indications for LT, operative variables, respiratory and circulatory support requirements, LT-related complications and survival. RESULTS During this period, 40 pediatric patients who underwent LT were evaluated. LT was performed in 35 (87.5%) cases of chronic liver disease and 5 (12.5%) cases of acute liver failure. Twenty-four patients had chronic liver failure due to cholestatic liver disease. The patients` Pediatric Risk of Mortality (PRISM) III score was 18.82±SD (2-58) at PICU admission. 1-year survival was 87.5%, and overall survival was 85%. Younger age, low body weight, preoperative pediatric end-stage liver disease (PELD), and model for end-stage liver disease (MELD) values of 20 and higher were important risk factors for unfavorable outcomes after living donor liver transplantation (LDLT). These risk factors are both associated with technically more challenging vascular and bile duct reconstruction and higher complication rates, and increased mortality during the early period after LT. CONCLUSIONS The early period of optimum PICU management in pediatric LT recipients is crucial for successful outcomes, which is also related to the patients` characteristics, disease severity scores, and surgical procedures.
Collapse
Affiliation(s)
- Edin Botan
- Division of Pediatric Critical Care Medicine, Ankara University Faculty of Medicine, Ankara
| | - Emrah Gün
- Division of Pediatric Critical Care Medicine, Ankara University Faculty of Medicine, Ankara
| | | | - Anar Gurbanov
- Division of Pediatric Critical Care Medicine, Ankara University Faculty of Medicine, Ankara
| | - Hasan Özen
- Division of Pediatric Critical Care Medicine, Ankara University Faculty of Medicine, Ankara
| | - Zarife Kuloglu
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Ankara University Faculty of Medicine, Ankara
| | - Ceyda Kırsaçlıoğlu
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Ankara University Faculty of Medicine, Ankara
| | - Elvan Onur Kırımker
- Department of General Surgery and Liver Transplantation, Ankara University Faculty of Medicine, Ankara
| | - Özlem Can Selvi
- Department of Anaesthesia and Intensive Care, Ankara University Faculty of Medicine, Ankara
| | - Ergin Çiftçi
- Division of Pediatric Infectious Diseases, Ankara University Faculty of Medicine, Ankara
| | - Suat Fitöz
- Department of Radiology, Ankara University Faculty of Medicine, Ankara
| | - Meltem Koloğlu
- Department of Pediatric Surgery, Ankara University Faculty of Medicine, Ankara
| | - Aydan Kansu
- Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Ankara University Faculty of Medicine, Ankara
| | - Deniz Balcı
- Department of General Surgery and Liver Transplantation, Ankara University Faculty of Medicine, Ankara
| | - Tanıl Kendirli
- Division of Pediatric Critical Care Medicine, Ankara University Faculty of Medicine, Ankara
| |
Collapse
|
4
|
Kahveci F, Kendirli T, Gurbanov A, Botan E, Koloğlu M, Bektaş Ö, Kuloglu Z, Balcı D, Kansu A. Tacrolimus toxicity-related chorea in an infant after liver transplantation. Acute Crit Care 2022; 37:477-479. [PMID: 35977888 PMCID: PMC9475155 DOI: 10.4266/acc.2021.01431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 04/18/2022] [Indexed: 11/30/2022] Open
|
5
|
Duman B, Herdi O, Sayar-Akaslan D, Onur Kırımker E, Çolak B, Ağtaş-Ertan E, Çakar G, Hasanlı J, Kocaay AF, Tüzüner A, Koloğlu M, Karayalçın K, Doğanay-Erdoğan B, Balcı D, Kumbasar H, Iacoviello BM. Live Donor Assessment Tool (LDAT): A Turkish validity and reliability study. Turk J Gastroenterol 2021; 31:917-922. [PMID: 33626005 DOI: 10.5152/tjg.2020.19980] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND/AIMS Psychosocial and psychiatric evaluations are crucial components of the assessment of a live donor candidate. The Live Donor Assessment Tool (LDAT) was developed for this purpose. This study aims to evaluate the validity and reliability of the Turkish version of LDAT. MATERIALS AND METHODS 132 live kidney or liver donor were referred to assess their psychosocial/psychiatric appropriateness for donation and were randomized for clinical evaluation as usual or with LDAT. The internal consistency of LDAT was measured by Chronbach's alpha coefficient. Inter-rater reliability was measured by using Spearman's correlation coefficient. The potential validity of LDAT was assessed by comparing LDAT scores to clinical decisions. The Mann-Whitney U test was used to compare LDAT scores across two clinically classified groups (acceptable/declined). Logistic regression was performed using LDAT scores to predict the clinical decision. RESULTS The Turkish version of LDAT items demonstrate good internal consistency (α=0.773). Inter-rater reliability of LDAT demonstrated strong correlation (ICC=0.72). LDAT scores differentiated the accepted/declined groups, and strongly predicted the clinical decision. With a cut-off score of 60.5, LDAT was found to have high sensitivity and specificity. CONCLUSION The Turkish version of LDAT was found to be a valid and reliable tool. LDAT could be an appropriate tool to assess live donor candidates.
Collapse
Affiliation(s)
- Berker Duman
- Division of Consultation-Liaison Psychiatry, Department of Psychiatry, Ankara University School of Medicine, Ankara, Turkey
| | - Oğuzhan Herdi
- Department of Psychiatry, Ankara University School of Medicine, Ankara, Turkey
| | - Damla Sayar-Akaslan
- Department of Psychiatry, Ankara University School of Medicine, Ankara, Turkey
| | | | - Burçin Çolak
- Department of Psychiatry, Ankara University School of Medicine, Ankara, Turkey
| | - Ece Ağtaş-Ertan
- Department of Psychiatry, Ankara University School of Medicine, Ankara, Turkey
| | - Gülsüm Çakar
- Department of Psychiatry, Ankara University School of Medicine, Ankara, Turkey
| | - Jamal Hasanlı
- Department of Psychiatry, Ankara University School of Medicine, Ankara, Turkey
| | - Akın Fırat Kocaay
- Department of Surgery, Ankara University School of Medicine, Ankara, Turkey
| | - Acar Tüzüner
- Department of Surgery, Ankara University School of Medicine, Ankara, Turkey
| | - Meltem Koloğlu
- Department of Pediatric Surgery, Ankara University School of Medicine, Ankara, Turkey
| | - Kaan Karayalçın
- Department of Surgery, Ankara University School of Medicine, Ankara, Turkey
| | | | - Deniz Balcı
- Department of Surgery, Ankara University School of Medicine, Ankara, Turkey
| | - Hakan Kumbasar
- Division of Consultation-Liaison Psychiatry, Department of Psychiatry, Ankara University School of Medicine, Ankara, Turkey
| | - Brian M Iacoviello
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA
| |
Collapse
|