1
|
Ekinci NS, Yilmaz VT, Kilinc Y, Kocak H, Darbas S, Kisaoglu A, Aydinli B, Uzuner SY, Ucar F. Evaluation of the relationship between de-novo DSA development and CXCR5+PD-1+CD8+ T cells and PD-1/PD-L1 mRNA expression in kidney transplant recipients. Clin Transplant 2023; 37:e15104. [PMID: 37589946 DOI: 10.1111/ctr.15104] [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] [Received: 05/18/2023] [Revised: 07/13/2023] [Accepted: 08/07/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND AND AIMS The relationship between the Follicular Cytotoxic T cell subgroup and expression levels of PD1/PD-L1 genes and the development of donor specific antibody (DSA) is unknown. In this study, we aimed to examine CD8+CXCR5+PD-1+ follicular cytotoxic T cell levels and expression levels of PD1/PD-L1 genes in peripheral blood lymphocytes in de-novo DSA positive and negative kidney transplant recipients (KTR). METHODS In our study, expression of PD-1/ PD-L1 genes by Real-Time Quantitative PCR method and CD8+CXCR5+PD-1+ T cell expression levels by flow cytometric method were obtained from peripheral blood samples. 63 participants were included in the study (de-novo DSA positive recipients (n = 22, group 1), de-novo DSA negative recipients (n = 20, group 2) and healthy control (n = 21, group 3). All patients had negative PRA before kidney transplantation. Expression (%) levels of target cells were evaluated by flow cytometry method. IBM SPSS Statistics for Windows Version 22 and R.3.3.2 software were used to evaluate the data. RESULTS The demographic data of the groups were similar. PD-1 mRNA expression was higher in de-novo DSA positive KTR than negative (respectively, 1.03 ± .29/.82 ± .15, p: .001). CD8+CXCR5+PD-1+ T cell expression levels were found to be higher in the de-novo DSA positive group than in the negative group and similar to the healthy group (respectively, 3.06 ± 1.98/.52 ± .40, p:.001, 3.06 ± 1.98/2.78 ± .59, p:.62). The percentage of CD8+CXCR5+PD-1+ expressing T cells was significantly lower in the HLA-Class II+ group than other groups (HLA CI/II/ I+II, respectively, 3.63 ± 2.72/1.65 ± .50/3.68 ± 1.67, p: .04). CONCLUSIONS In our study, a significant relationship was found between DSA formation and PD-1 mRNA level and CD8+CXCR5+PD-1+ follicular cytotoxic T cell in KTR.
Collapse
Affiliation(s)
- Nurten Sayin Ekinci
- Department of Medical Biology and Genetics, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Vural Taner Yilmaz
- Division of Nephrology, Department of Internal Medicine, Akdeniz University Faculty of Medicine, Antalya, Turkey
- Prof. Dr. Tuncer Karpuzoglu Transplantation Center, Akdeniz University Hospital, Antalya, Turkey
| | - Yahya Kilinc
- Department of Medical Biology and Genetics, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Huseyin Kocak
- Division of Nephrology, Department of Internal Medicine, Akdeniz University Faculty of Medicine, Antalya, Turkey
- Prof. Dr. Tuncer Karpuzoglu Transplantation Center, Akdeniz University Hospital, Antalya, Turkey
| | - Sule Darbas
- Department of Medical Biology and Genetics, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Abdullah Kisaoglu
- Prof. Dr. Tuncer Karpuzoglu Transplantation Center, Akdeniz University Hospital, Antalya, Turkey
- Department of General Surgery, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Bulent Aydinli
- Prof. Dr. Tuncer Karpuzoglu Transplantation Center, Akdeniz University Hospital, Antalya, Turkey
- Department of General Surgery, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Sezin Yakut Uzuner
- Department of Medical Biology and Genetics, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Fahri Ucar
- Department of Medical Biology and Genetics, Akdeniz University Faculty of Medicine, Antalya, Turkey
- Prof. Dr. Tuncer Karpuzoglu Transplantation Center, Akdeniz University Hospital, Antalya, Turkey
| |
Collapse
|
2
|
Vural T, Yilmaz VT, Koksoy S, Kisaoglu A, Ozel D, Demiryilmaz I, Aydinli B, Kocak H, Suleymanlar G. Evaluation of the effect and predictive role of vitamin D and vitamin D receptor expression in CD4 + , CD8 + , CD14 + , CD56 + cells on the development of chronic rejection and graft functions in kidney transplant patients. Int Urol Nephrol 2023; 55:2589-2598. [PMID: 36930397 DOI: 10.1007/s11255-023-03550-z] [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] [Received: 11/14/2022] [Accepted: 03/07/2023] [Indexed: 03/18/2023]
Abstract
PURPOSE It is known that vitamin D has positive effects on graft functions (reduce fibrosis, suppress excessive inflammatory response, improve graft functions). In our study, it was aimed to evaluate the effects and predictive roles of vitamin D, the expression of vitamin D receptor (VDR) in lymphocytes, monocytes, natural killer cells on chronic rejection and graft functions in kidney transplant patients. METHODS Seventy one people were included in the study and analyses were made by dividing them into 3 groups. Group 1: Healthy control (n = 29), Group 2: Kidney transplant patients with stable kidney function (n = 17), and Group 3: Kidney transplant patients with chronic rejection diagnosis (n = 25). Serum 25-hydroxycholecalciferol, 1.25 dihydroxycholecalciferol levels and VDR percentages in CD4 + , CD8 + , CD14 + , CD56 + cells were measured in 3 groups. ROC analyses and logistic regression models were performed to predict rejection and long-term graft functions. RESULTS The percentage of VDR expression in CD4 + lymphocytes (p < 0.001) and CD14( +) monocytes (p < 0.001), 25-hydroxycholecalciferol and 1.25 dihydroxycholecalciferol levels were lower in group 3 was detected. In ROC analyses and logistic regression models, VDR expression in CD4( +)T lymphocytes was shown to have a statistically significant value in the development of chronic rejection (Odds ratio 0.86: 0.76-0.92; p = 0.001/AUC = 0.941, p < 0.001) and prediction of 5th-year graft functions (Odds ratio 0.93: 0.88-0.98; p = 0.017/AUC = 0.745, p = 0.007). CONCLUSION In our study, it was shown that low vitamin D and VDR expression is associated with poor outcome and VDR expression in CD4( +)T lymphocytes is predictive in terms of graft function and rejection.
Collapse
Affiliation(s)
- Tuba Vural
- Department of Internal Medicine, Division of Allergy and Immunology, Akdeniz University Medical School, Antalya, Turkey
| | - Vural Taner Yilmaz
- Department of Internal Medicine, Division of Nephrology, Akdeniz University Medical School, Antalya, Turkey.
| | - Sadi Koksoy
- Department of Microbiology and Clinical Immunology, Akdeniz University Medical School, Antalya, Turkey
| | - Abdullah Kisaoglu
- Department of General Surgery, Akdeniz University Medical School, Antalya, Turkey
| | - Deniz Ozel
- Department of Biostatistics and Medical Informatics, Akdeniz University Medical School, Antalya, Turkey
| | - Ismail Demiryilmaz
- Department of General Surgery, Akdeniz University Medical School, Antalya, Turkey
| | - Bulent Aydinli
- Department of General Surgery, Akdeniz University Medical School, Antalya, Turkey
| | - Huseyin Kocak
- Department of Internal Medicine, Division of Nephrology, Akdeniz University Medical School, Antalya, Turkey
| | - Gultekin Suleymanlar
- Department of Internal Medicine, Division of Nephrology, Akdeniz University Medical School, Antalya, Turkey
| |
Collapse
|
3
|
Avanaz A, Adanir H, Kisaoglu A, Yilmaz VT, Avanaz E, Dinc B, Demiryilmaz I, Elpek GÖ, Kocak H, Aydinli B. Evaluation of Overall Survival and Disease-Free Survival in Patients Receiving Liver Transplantation for Hepatocellular Carcinoma and Comparison of Living Versus Deceased Donor Liver Transplants: Results of 15 Years of Experience. Eurasian J Med 2023; 55:254-258. [PMID: 37909200 PMCID: PMC10724738 DOI: 10.5152/eurasianjmed.2023.23163] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 09/15/2023] [Indexed: 11/02/2023] Open
Abstract
OBJECTIVE Research comparing patients who received liver transplantation (LT) for hepatocellular carcinoma (HCC) has produced varying outcomes regarding survival and disease-free survival. The objective of this study is to determine the factors that influence the disease-free and overall survivals of those who have undergone LT for HCC and to compare the outcomes of living versus deceased donor liver transplants. MATERIALS AND METHODS We retrospectively analyzed data on patients aged 18 and above who received LT for HCC from 2006 to 2022. Patients with a follow-up period of less than 6 months and who did not meet the University of California San Francisco criteria were excluded. The data from 58 patients were analyzed. We split the patients into living donor liver transplantation (LDLT) (group 1) and deceased donor liver transplantation (DDLT) (group 2). RESULTS The mean age was 56 ± 8.1 years. There were 49 males and 9 females. The median of the alphafetoprotein (AFP) level and model for end-stage liver disease score was 10.1 ng/mL and 11, respectively. The 1-, 3-, 5-, and 10-year disease-free survival rates were 86%, 76.5%, 76.5%, and 76.5%, respectively. The survival rates for the same periods were 94.8%, 74.9%, 70.6%, and 67.4%. The receiver operating characteristic analysis revealed that AFP > 31.8 ng/mL and a total tumor size >3.85 cm raise the likelihood of HCC recurrence post-LT. CONCLUSION Based on the current literature, the overall survival and disease-free survival rates are influenced by factors such as AFP value, total tumor number, and total tumor diameter. In our study, the AFP value and total tumor size had an impact on the recurrence of HCC, and the survival rates were comparable on LDLT and DDLT.
Collapse
Affiliation(s)
- Ali Avanaz
- Department of Organ Transplantation, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Haydar Adanir
- Department of Gastroenterology, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Abdullah Kisaoglu
- Department of Organ Transplantation, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Vural Taner Yilmaz
- Department of Organ Transplantation, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Ezgi Avanaz
- Department of Nephrology, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Bora Dinc
- Department of Anesthesiology and Reanimation, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Ismail Demiryilmaz
- Department of Organ Transplantation, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Gülsüm Özlem Elpek
- Department of Pathology, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Huseyin Kocak
- Department of Organ Transplantation, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Bulent Aydinli
- Department of Organ Transplantation, Akdeniz University Faculty of Medicine, Antalya, Turkey
| |
Collapse
|
4
|
Yilmaz VT, Kisaoglu A, Avanaz A, Dandin O, Ozel D, Mutlu D, Akkaya B, Aydinli B, Kocak H. Predictive Factors of BK Virus Development in Kidney Transplant Recipients and the Effect of Low-Dose Tacrolimus Plus Everolimus on Clinical Outcomes. EXP CLIN TRANSPLANT 2023; 21:727-734. [PMID: 37885288 DOI: 10.6002/ect.2023.0065] [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: 10/28/2023]
Abstract
OBJECTIVES This study aimed to determine the predictive factors of BK virus viremia/nephropathy in kidney transplant recipients and to evaluate the effects of low-dose tacrolimus plus everolimus. MATERIALS AND METHODS This study included 3654 kidney transplant recipients. The patients were divided into 2 groups: group 1 were BK virus negative (n = 3525, 96.5%) and group 2 were BK virus positive (n = 129, viremia 3.5%, nephropathy 1%). Predictive factors were determined by receiver operating characteristic curve analysis and logistic regression models.We also divided and analyzed patients with BK virus viremia/nephropathy into 2 groups according to immunosuppressive changes. Group 2a had been switched to low-dose tacrolimus plus everolimus (n = 54, 41.9%), and group 2b had been switched to other immunosuppressive protocols (n = 75, 58.1%). RESULTS We found that use of anti-T-cell lymphocyte globulin and tacrolimus, deceased donor transplant, and rejection were predictive factors for BK virus viremia/nephropathy. In addition, patients who had low-dose calcineurin inhibitor plus mammalian target of rapamycin inhibitor regimens showed a low rate of BK virus development(only 6.2% of all cases). In Group 2a, both the BK polyomavirus-associated nephropathy rate (n = 23 [42.6%] vs n = 12 [16%] in group 2b; P = .001) and viral load (DNA > 104 copies/mL) (n = 49 [90.7%] vs n = 27 [36%] in group 2b; P = .001) were increased versus group 2b. Graft function, graft survival, viral clearance, and rejection rate were similar between the groups after protocol change. CONCLUSIONS BK virus viremia/nephropathy rate was lower in patients who received low-dose calcineurin inhibitor plus mammalian target of rapamycin inhibitor protocols; the low-dose tacrolimus plus everolimus switch protocol after BK virus was more effective and safe than other protocols.
Collapse
Affiliation(s)
- Vural Taner Yilmaz
- From the Department of Internal Medicine, Division of Nephrology Akdeniz University Medical School, Antalya, Turkey
| | | | | | | | | | | | | | | | | |
Collapse
|
5
|
Avanaz A, Ünal DS, Kisaoglu A, Yilmaz VT, Moharer PS, Demiryilmaz I, Aydinli B. The Factors Affecting Mortality After Pediatric Liver Transplantation and Long-Term Survival Outcomes: A Single Center Experience. Transplant Proc 2023:S0041-1345(23)00165-3. [PMID: 37105828 DOI: 10.1016/j.transproceed.2023.01.036] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 01/05/2023] [Indexed: 04/29/2023]
Abstract
BACKGROUND Liver transplantation (LT) is a treatment modality in the pediatric population for several diseases like biliary atresia, metabolic liver disease, hepatoblastoma, and so on. According to the Organ Procurement and Transplantation Network, 5-year survival was reported as 85.4% to 93.5% by age after pediatric liver transplantation (PLT). This study aimed to evaluate our single-center experience of PLT by analyzing long-term results, comparing the outcomes with the literature, and identifying predictors of patient survival. METHODS The data of 40 patients who underwent LT at <18 years of age between June 2015 and June 2021 were studied retrospectively. Recipient characteristics such as age, sex, etiology of liver disease follow-up time, postoperative vascular and biliary complications, and donor characteristics were evaluated. RESULTS There were 20 (50%) girls and 20 (50%) boys, and the median age was 42 (IQR = 9-117) months. The most common indications of LT were biliary disorders (45%). A whole liver graft was used in 7 (17%), a right lobe graft in 9 (23%), a left lobe graft in 4 (10%), and a left lateral lobe graft in 20 (50%) of the recipients. The 1-, 3-, 5-, and 7-year survival rates were 85%, 82.1%, 82.1%, and 82.1%, respectively. The multivariate survival analysis revealed that the pediatric end-stage liver disease score, hepatic artery thrombosis, and portal vein thrombosis are associated with overall mortality. CONCLUSION In conclusion, our long-term survival is similar to the literature, with satisfactory results. However, reducing the vascular complication rates can provide superior results on PLT.
Collapse
Affiliation(s)
- Ali Avanaz
- Department of General Surgery, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Demet Sarıdemir Ünal
- Department of General Surgery, Akdeniz University Faculty of Medicine, Antalya, Turkey.
| | - Abdullah Kisaoglu
- Department of General Surgery, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Vural Taner Yilmaz
- Department of Internal Medicine, Division of Nephrology, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | | | - Ismail Demiryilmaz
- Department of General Surgery, Akdeniz University Faculty of Medicine, Antalya, Turkey
| | - Bulent Aydinli
- Department of General Surgery, Akdeniz University Faculty of Medicine, Antalya, Turkey
| |
Collapse
|
6
|
Guzel HG, Yilmaz VT, Koksoy S, Kocak H, Kisaoglu A, Soylu M, Akkaya B, Demiryilmaz I, Aydinli B, Suleymanlar G. Regulatory B Cells Profile in Kidney Transplant Recipients With Chronic-Active Antibody-Mediated Rejection. Transplant Proc 2023:S0041-1345(23)00153-7. [PMID: 37061353 DOI: 10.1016/j.transproceed.2023.03.029] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 01/09/2023] [Accepted: 03/14/2023] [Indexed: 04/17/2023]
Abstract
This study aims to reveal the relationship between regulatory B cell (Breg) subsets and chronic-active antibody-mediated rejection (c-aABMR) in renal transplant recipients. Our study involved 3 groups of participants: renal transplant recipients with biopsy-proven c-aABMR as the chronic rejection group (c-aABMR, n = 23), recipients with stable graft functions as the patient control group (PC; n = 11), and healthy volunteers (HV; n = 11). Breg subsets, immature/transitional B cells, plasmablastic cells, B10 cells, and BR1 cells were isolated from venous blood samples by flow cytometry. The median values of Breg frequencies in the total lymphocyte population were analyzed. There were no significant differences between the study groups for immature and/or transitional B cell frequencies. Plasmablastic cell frequencies of the c-aABMR group (7.80 [2.10-27.40]) and the PC group (6.00 [1.80-55.50]) were similar, but both of these values were significantly higher than the HVs' (3.40 [1.20-8.50]), (respectively, P = .005 and P = .039). B10 cell frequencies were also similar, comparing the c-aABMR (4.20 [0.10-7.40]) and the PC groups (4.10 [0.10-5.90]), whereas the HVs (5.90 [2.90-8.50]) had the highest B10 cell frequency with an only statistical significance against the PC group (respectively, P = .09 and P = .028). The c-aABMR and the PC groups were similar regarding BR1 cell frequencies. However, the HV group significantly had the highest frequency of BR1 cells (5.50 [2.80-10.80]) than the other groups (P < .001 for both). We demonstrated that frequencies of B10 and BR1 cells were higher in HVs than in transplant recipients, regardless of rejection state. However, there was no significant relation between Breg frequencies and the c-aABMR state.
Collapse
Affiliation(s)
- Halil Goksel Guzel
- Department of Internal Medicine, Akdeniz University School of Medicine, Antalya, Turkey
| | - Vural Taner Yilmaz
- Department of Internal Medicine, Division of Nephrology, Akdeniz University School of Medicine, Antalya, Turkey.
| | - Sadi Koksoy
- Department of Microbiology, Division of Immunology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Huseyin Kocak
- Department of Internal Medicine, Division of Nephrology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Abdullah Kisaoglu
- Department of General Surgery, Akdeniz University School of Medicine, Antalya, Turkey
| | - Mehmet Soylu
- Department of Microbiology, Division of Immunology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Bahar Akkaya
- Department of Pathology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Ismail Demiryilmaz
- Department of General Surgery, Akdeniz University School of Medicine, Antalya, Turkey
| | - Bülent Aydinli
- Department of General Surgery, Akdeniz University School of Medicine, Antalya, Turkey
| | - Gultekin Suleymanlar
- Department of Internal Medicine, Division of Nephrology, Akdeniz University School of Medicine, Antalya, Turkey
| |
Collapse
|
7
|
Yilmaz VT, Kisaoglu A, Avanaz A, Demiryilmaz I, Ucar F, Aydinli B, Kocak H. Successful Kidney Transplantation in a Patient with Marfan’s Syndrome with a History of Aortic Dissection Operation and a Dissection Flap Up to the Iliac Bifurcation Level. Turk J Nephrol 2023. [DOI: 10.5152/turkjnephrol.2023.2272359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
|
8
|
Aras A, Avanaz A, Inan Aydemir N, Kayaalp E, Ulgen Tekerek N, Kisaoglu A, Demiryilmaz I, Soyucen E, Dursun O, Yilmaz A, Artan R, Aydinli B. Long-term results of liver transplantation for maple syrup urine disease: A single-center experience in Turkey. Pediatr Transplant 2023; 27:e14464. [PMID: 36588190 DOI: 10.1111/petr.14464] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 09/25/2022] [Accepted: 12/18/2022] [Indexed: 01/03/2023]
Abstract
OBJECTIVES Maple syrup urine disease (MSUD) is an autosomal recessive inherited disorder. Despite the advances in medical nutrition therapies, classical phenotype causes severe neurological disorders and sudden death. It is known that MSUD patients do not experience metabolic attacks despite their free diet after liver transplantation (LT). This study aims to reveal the long-term results, development, mental, motor, intellectual and nutritional status of MSUD patients who underwent LT. METHODS The data of 12 patients who underwent deceased donor (5 recipients) and living donor liver transplantation (7 recipients) were retrospectively analyzed. The age, genotype, psychometric and mental status, development, BCAA values, type of LT, donor-recipient proximity, complications, and survival were assessed. RESULTS There were 4 (33%) girls and 8 (67%) boys. The mean current age was 9.33 ± 4.58 years. The mean follow-up time was 3 ± 2.5 years. The repeated measures of leucine and isoleucine values revealed that there were no significant differences from the pre-LT to post-LT 1-year. The protein-restricted nutrition was switched to a free diet when oral intake was opened after LT. None of the recipients experienced metabolic attacks after the living donor or deceased donor LT. The 1-, 3-, and 5-year survival rate of the patients is 83.3%. There was no significant difference in survival between living and deceased donor liver transplantation. CONCLUSIONS Liver transplantation is a treatment option for MSUD in proper conditions to save the patient life, increase the quality of life, and provide essential amino acids with free diet intake for growth and development.
Collapse
Affiliation(s)
- Arzu Aras
- Department of Pediatric Gastroenterology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Ali Avanaz
- Department of Organ Transplantation, Akdeniz University School of Medicine, Antalya, Turkey
| | - Nurel Inan Aydemir
- Department of Pediatric Gastroenterology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Ece Kayaalp
- Department of Pediatric Nutrition and Metabolism, Akdeniz University School of Medicine, Antalya, Turkey
| | - Nazan Ulgen Tekerek
- Department of Pediatric Intensive Care, Akdeniz University School of Medicine, Antalya, Turkey
| | - Abdullah Kisaoglu
- Department of Organ Transplantation, Akdeniz University School of Medicine, Antalya, Turkey
| | - Ismail Demiryilmaz
- Department of Organ Transplantation, Akdeniz University School of Medicine, Antalya, Turkey
| | - Erdogan Soyucen
- Department of Pediatric Nutrition and Metabolism, Akdeniz University School of Medicine, Antalya, Turkey
| | - Oguz Dursun
- Department of Pediatric Intensive Care, Akdeniz University School of Medicine, Antalya, Turkey
| | - Aygen Yilmaz
- Department of Pediatric Gastroenterology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Reha Artan
- Department of Pediatric Gastroenterology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Bulent Aydinli
- Department of Organ Transplantation, Akdeniz University School of Medicine, Antalya, Turkey
| |
Collapse
|
9
|
Kisaoglu A, Avanaz A, Demiryilmaz I, Sarıdemir Ünal D, Özkan Ö, Aydinli B. Rare Relationship Between the Right Hepatic Artery and Common Hepatic Duct in Living Donor Right Hepatectomy. EXP CLIN TRANSPLANT 2023; 21:63-65. [PMID: 35607799 DOI: 10.6002/ect.2022.0042] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
In living donor liver transplant, it is vital to perceive the hepatic artery anatomy and its variants. In the normal hepatic artery pattern, the common hepatic artery originates from the celiac artery to form the proper hepatic artery and gastroduodenal artery. The proper hepatic artery divides into right and left branches that supply the right and left lobes of the liver, respectively. Here, we report a rare variation of the right hepatic artery that was detected during a living liver right lobe hepatectomy. A 59-year-old man with alcoholic liver cirrhosis underwent living donor liver transplant. The patient's niece (a 47-year-old woman) volunteered to be a living donor. During the hilar dissection, we noticed that the anterior and posterior branches of the right hepatic artery passed through points anterior and posterior to the common hepatic duct, respectively. The right anterior hepatic artery and the right hepatic artery were divided separately. Although previously defined classifications have described anatomical variations of origin, branching, and course of hepatic artery, the topographical relationship of the anterior right hepatic artery and the posterior right hepatic artery versus the common hepatic duct has not been a matter of concern. Awareness must be maintained of this rare anatomical course of the right hepatic artery, especially in living liver right lobe donors. In the event of donors with rare variations, living donor liver transplant should be performed by an experienced team.
Collapse
Affiliation(s)
- Abdullah Kisaoglu
- From the Department of Organ Transplantation, Akdeniz University School of Medicine, Antalya, Turkey
| | | | | | | | | | | |
Collapse
|
10
|
Cebisli E, Ulgen-Tekerek N, Dursun O, Koker A, Kisaoglu A, Artan R, Soyucen E, Elpek GO. Intestinal Mucormycosis in a Child With Maple Syrup Urine Disease After Orthotopic Liver Transplant. EXP CLIN TRANSPLANT 2022; 21:375-379. [PMID: 36259617 DOI: 10.6002/ect.2021.0257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Mucormycosis can result in serious morbidity and mortality, especially in transplant recipients. In this case report, we present a 3-year-old female patient with maple syrup urine disease who developed mucormycosis infection after deceased donor split liver transplant. Progressive segmental necrosis of the small intestines and new ischemic areas were observed after repeated abdominal surgeries. Microscopic examination of biopsy material revealed mucormycosis. Early recognition is crucial for treatment, and patients with clinical suspicion can be treated empirically with antifungal medicine. However, diagnostic tests with accurate and fast results are needed and more effective therapeutic methods should be developed for better outcomes.
Collapse
|
11
|
Yilmaz VT, Dandin O, Kisaoglu A, Avanaz A, Kamaci D, Toru HS, Demiryilmaz I, Koksoy S, Aydinli B, Kocak H. Prognosis and Treatment for Active and Chronic Antibody-Mediated Rejection in Renal Transplant Recipients; Single Center Experience. Transplant Proc 2022; 54:1809-1815. [PMID: 35907695 DOI: 10.1016/j.transproceed.2022.03.060] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 03/01/2022] [Accepted: 03/26/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND The aim of the study was to evaluate the prognostic factors and treatment alternatives of antibody-mediated rejection (ABMR) in renal transplant patients. METHODS Three thousand renal transplant patients were included in the study. The patients were first divided into 2 groups. Group 1: ABMR [-] recipients (n = 2871), Group 2: ABMR (+) recipients (n = 129). ABMR patients were compared among themselves by dividing them into 3 subgroups (early-active, late-active, chronic-active). The study was performed retrospectively. Different combinations of methylprednisolone, intravenous immunoglobulin (IVIG), rituximab, plasmapheresis (PP), anti-thymocyte globulin (ATG) were used in the treatment and the results were compared. RESULTS Graft survival and functions were worse and the rates of CAD, delayed graft function, BK virus, and cytomegalovirus higher in patients with ABMR. Also, graft survival was lower in patients with serum creatinine ≥3 (P = 0.001), GFR <30 (P <0.001), and spot urine protein to creatinine ratio ≥1 (P = 0.042) at the time of diagnosis. High interstitial fibrosis and tubular atrophy scores in chronic ABMR cases and high intimal arteritis scores in active ABMR cases were poor prognostic factors. CONCLUSIONS The study showed that ABMR has a poor prognosis in terms of clinical parameters, and treatment should be individualized according to pathologic findings and graft functions at the time of diagnosis. Pulse methylprednisolone and IVIG should be used in the treatment of all ABMR patients, but PP, rituximab, and ATG should be used in selected cases. ABMR has a poor prognosis and treatment should be individualized.
Collapse
Affiliation(s)
- Vural Taner Yilmaz
- Department of Internal Medicine, Division of Nephrology, Akdeniz University Medical School, Antalya, Turkey.
| | - Ozgur Dandin
- Department of General Surgery, Akdeniz University Medical School, Antalya, Turkey
| | - Abdullah Kisaoglu
- Department of General Surgery, Akdeniz University Medical School, Antalya, Turkey
| | - Ali Avanaz
- Department of General Surgery, Akdeniz University Medical School, Antalya, Turkey
| | - Davut Kamaci
- Department of Urology, Ankara City Hospital, Ankara, Turkey
| | - Havva Serap Toru
- Department of Pathology, Akdeniz University Medical School, Antalya, Turkey
| | - Ismail Demiryilmaz
- Department of General Surgery, Akdeniz University Medical School, Antalya, Turkey
| | - Sadi Koksoy
- Department of Microbiology and Clinical Immunology, Akdeniz University Medical School, Antalya, Turkey
| | - Bulent Aydinli
- Department of General Surgery, Akdeniz University Medical School, Antalya, Turkey
| | - Huseyin Kocak
- Department of Internal Medicine, Division of Nephrology, Akdeniz University Medical School, Antalya, Turkey
| |
Collapse
|
12
|
Avanaz A, Avanaz E, Kisaoglu A, Yilmaz VT, Demiryilmaz I, Aydinli B. Diagnosis and treatment of splenic artery steal syndrome after liver transplantation. Surgical Practice 2022. [DOI: 10.1111/1744-1633.12542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Ali Avanaz
- Department of Organ Transplantation Akdeniz University School of Medicine Antalya Turkey
| | - Ezgi Avanaz
- Department of Nephrology Akdeniz University School of Medicine Antalya Turkey
| | - Abdullah Kisaoglu
- Department of Organ Transplantation Akdeniz University School of Medicine Antalya Turkey
| | - Vural Taner Yilmaz
- Department of Organ Transplantation Akdeniz University School of Medicine Antalya Turkey
| | - Ismail Demiryilmaz
- Department of Organ Transplantation Akdeniz University School of Medicine Antalya Turkey
| | - Bulent Aydinli
- Department of Organ Transplantation Akdeniz University School of Medicine Antalya Turkey
| |
Collapse
|
13
|
Kisaoglu A, Doğru V, Yilmaz VT, Demiryilmaz I, Avanaz A, Sarikaya SM, Dinc B, Aydinli B. Safety and Threshold Analysis of Preoperative Platelets in Right Lobe Living Donors for Liver Transplantation. J Gastrointest Surg 2022; 26:77-85. [PMID: 34100245 DOI: 10.1007/s11605-021-05047-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 05/17/2021] [Indexed: 01/31/2023]
Abstract
BACKGROUND Low perioperative platelet count is a powerful independent risk factor for posthepatectomy liver failure. Usually, categorical effect of thrombocytopenia was taken into account; upper thresholds were not studied in depth, exclusively in living liver donors. METHODS Living liver donors who underwent right hepatectomy were included. Preoperative characteristics of donors were identified and examined to predict posthepatectomy liver failure. To eliminate selection bias, one-to-one propensity score matching was performed. RESULTS There were a total of 139 living donors and 40 (29%) donors developed posthepatectomy liver failure in the aftermath of the operation. Remnant liver volume ratio and preoperative platelet count were identified as adjustable independent risk factors (OR: 0.89 and 0.99, 95% CI: 0.79-0.99 and 0.98-0.99, respectively). After propensity score matching, odds ratio of preoperative platelet count was 0.99 (95% CI: 0.98-1.00). CONCLUSIONS Preoperative platelet count, in addition to remnant liver volume ratio, can be used as a surrogate marker to predict the risk of posthepatectomy liver failure in living liver right lobe donors. Probability curves figured out from logistic regression analysis, in this regard, provided an explicit perspective of platelets having a decisive role on liver donor safety. Thus, remaining in safer remnant liver volume ratio limits with respect to preoperative platelet count should be addressed in safe donor selection strategies.
Collapse
Affiliation(s)
- Abdullah Kisaoglu
- Department of Organ Transplantation, Akdeniz University School of Medicine, Antalya, Turkey
| | - Volkan Doğru
- Department of General Surgery, Akdeniz University School of Medicine, Antalya, Turkey.
| | - Vural Taner Yilmaz
- Department of Organ Transplantation, Akdeniz University School of Medicine, Antalya, Turkey
| | - Ismail Demiryilmaz
- Department of Organ Transplantation, Akdeniz University School of Medicine, Antalya, Turkey
| | - Ali Avanaz
- Department of Organ Transplantation, Akdeniz University School of Medicine, Antalya, Turkey
| | | | - Bora Dinc
- Department of Anesthesiology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Bulent Aydinli
- Department of Organ Transplantation, Akdeniz University School of Medicine, Antalya, Turkey
| |
Collapse
|
14
|
Avanaz A, Doğru V, Kisaoglu A, Yilmaz VT, Ünal DS, Demiryilmaz I, Dinc B, Adanir H, Aydinli B. The impact of older age on long term survival in living donor liver transplantation: A propensity score matching analysis. Asian J Surg 2021; 45:2239-2245. [PMID: 34955343 DOI: 10.1016/j.asjsur.2021.11.061] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 11/15/2021] [Accepted: 11/26/2021] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND Prevalence of the end-stage liver disease in the elderly patients indicating a liver transplantation (LT) has been increasing. There is no universally accepted upper age limit for LT candidates but the functional status of older patients is important in pre-LT evaluation. This study aimed to examine the impact of older age on survival after living donor liver transplantation (LDLT). METHOD A total of 171 LDLT recipients were assessed in two groups: age ≥65 and < 65. To eliminate selection bias propensity score matching (PSM) was performed, and 56 of 171 recipients were included in this study. RESULTS There were 20 recipients in the older group and 36 in the younger. The 1-, 3-, and 5-year survival rates were 65.0%, 60.0%, and 60.0% in group 1; 88.9%, 84.7%, and 71.4% in group 2, respectively. The 1-year survival was significantly lower in the older recipients; however, overall survival rates were similar between the groups. Of the 56 recipients, 15 (27%) deaths were observed in overall, and 11 (20%) in 1-year follow-up. The univariate regression analysis after PSM revealed that MELD score affected 1- year survival and the multivariate analysis revealed that age ≥65 years and MELD score were the predictors of 1-year survival. CONCLUSION At first sight, before PSM, survival appeared to be worse for older recipients. However, we have shown that there were confounding effects of clinical variables in the preliminary evaluation. After the elimination of this bias with PSM, This study highlights that older recipients have similar outcomes as youngers in LDLT for long-term survival.
Collapse
Affiliation(s)
- Ali Avanaz
- Department of Organ Transplantation, Akdeniz University School of Medicine, Antalya, Turkey.
| | - Volkan Doğru
- Department of General Surgery, Akdeniz University School of Medicine, Antalya, Turkey
| | - Abdullah Kisaoglu
- Department of Organ Transplantation, Akdeniz University School of Medicine, Antalya, Turkey
| | - Vural Taner Yilmaz
- Department of Organ Transplantation, Akdeniz University School of Medicine, Antalya, Turkey
| | - Demet Sarıdemir Ünal
- Department of General Surgery, Akdeniz University School of Medicine, Antalya, Turkey
| | - Ismail Demiryilmaz
- Department of Organ Transplantation, Akdeniz University School of Medicine, Antalya, Turkey
| | - Bora Dinc
- Department of Anesthesiology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Haydar Adanir
- Department of Gastroenterology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Bulent Aydinli
- Department of Organ Transplantation, Akdeniz University School of Medicine, Antalya, Turkey
| |
Collapse
|
15
|
Dinc B, Yılmaz VT, Aslan M, Aycan IO, Kiraz N, Kisaoglu A, Dandin O, Hadimioglu N, Ertug Z. Serum Levels of S100β, Neuron-Specific Enolase, Glial Fibrillary Acidic Protein in Kidney Transplant Recipients and Donors: A Prospective Cohort Study. Transplant Proc 2021; 53:2227-2233. [PMID: 34412916 DOI: 10.1016/j.transproceed.2021.07.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 06/28/2021] [Accepted: 07/19/2021] [Indexed: 01/26/2023]
Abstract
BACKGROUND The aim of this study was to evaluate changes in serum levels of S100β, neuron-specific enolase, glial fibrillary acidic protein in living donors and recipients after kidney transplantation. METHODS We enrolled 56 patients into the study. Of these, 27 underwent donor nephrectomy (group D), and the remaining 29 underwent kidney transplantation (recipient, group R). Neuromarkers were measured in samples obtained before the procedure, on postoperative day 7, and at 1 month postoperatively. RESULTS Postoperative kidney functions were impaired in patients who underwent living donor nephrectomy compared with their preoperative levels (P < .001), although no significant difference was observed in their neuromarkers. The postoperative delirium rating scale was also impaired after living donor nephrectomy compared with preoperative levels (P < .05). Postoperative kidney functions were improved (P < .001), and a progressive decrease in neuromarker levels (P < .05) was observed in kidney transplant recipients compared with their preoperative levels. Linear regression analysis showed a significant correlation between neuron-specific enolase, glial fibrillary acidic protein levels and kidney functions in recipients. CONCLUSION The present study demonstrated that neuron-specific enolase and glial fibrillary acidic protein levels decrease in kidney transplant recipients and do not change in donors. This result indicated that there is no evidence of neurotoxicity in either recipients and donors in kidney transplantation.
Collapse
Affiliation(s)
- Bora Dinc
- Akdeniz University Medical Faculty, Department of Anesthesiology and Reanimation, Antalya, Turkey
| | - Vural Taner Yılmaz
- Akdeniz University Medical Faculty, Department of Internal Medicine, Division of Nephrology, Antalya, Turkey
| | - Mutay Aslan
- Akdeniz University Medical Faculty, Department of Biochemistry, Antalya, Turkey
| | - Ilker Onguc Aycan
- Akdeniz University Medical Faculty, Department of Anesthesiology and Reanimation, Antalya, Turkey.
| | - Nihal Kiraz
- Akdeniz University Medical Faculty, Department of Nursing, Organ Transplantation clinic, Antalya, Turkey
| | - Abdullah Kisaoglu
- Akdeniz University Medical Faculty, Department of General Surgery, Antalya, Turkey
| | - Ozgur Dandin
- Akdeniz University Medical Faculty, Department of General Surgery, Antalya, Turkey
| | - Necmiye Hadimioglu
- Akdeniz University Medical Faculty, Department of Anesthesiology and Reanimation, Antalya, Turkey
| | - Zeki Ertug
- Akdeniz University Medical Faculty, Department of Anesthesiology and Reanimation, Antalya, Turkey
| |
Collapse
|
16
|
Darbas S, Yilmaz VT, Kocak H, Kisaoglu A, Demiryilmaz I, Aydinli B, Arslan HS, Ucar F. New markers for predictions of acute and chronic rejection and graft outcomes in kidney transplant recipients; HLA-G gene 3'UTR 14 bp polymorphism and sHLA-G. Gene 2021; 790:145712. [PMID: 33984446 DOI: 10.1016/j.gene.2021.145712] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 04/19/2021] [Accepted: 05/06/2021] [Indexed: 01/10/2023]
Abstract
The aim of this study was to evaluate the relation of Human Leukocyte Antigen-G (HLA-G) 14 bp ins/del (insertion/deletion) polymorphism and soluble HLA-G (sHLA-G) level with rejection in kidney transplant recipients. The study was planned as a case-control study involving two hundred fifty kidney transplant recipients. The case group consisted of 125 (female/male: 56/69) kidney transplant recipients diagnosed with acute (n = 52) and chronic rejection (n = 73). The control group consisted of one hundred twenty-five kidney transplant patients with no acute or chronic rejection matched by gender and age in the case group. The sHLA-G level in the recipient's plasma (at the time of rejection for the case, the same time as the case after the transplant for control) was analyzed by Enzyme-Linked Immunosorbent Assay (ELISA). HLA-G 3' untranslated region (3'UTR) polymorphism of recipient and donor was determined using agarose gel electrophoresis and DNA sequencing method. In our study, it was shown that acute rejection rate increased 1.06 times and chronic rejection rate increased 1.14 times in kidney transplant recipients with low serum sHLA-G levels. The rejection patients with the HLA-G 14 bp del/del genotype had higher sHLA-G levels post-transplantation. The frequency of acute rejection was lower in patients with HLA-G 14 bp del/del polymorphism than those with ins/ins and ins/del polymorphisms. This study proposes that HLA-G 3'UTR polymorphism and sHLA-G level might be useful in prediction of rejection in kidney transplant recipients.
Collapse
Affiliation(s)
- Sule Darbas
- Department of Medical Biology and Genetics, Akdeniz University Faculty of Medicine, Antalya, Turkey.
| | - Vural Taner Yilmaz
- Division of Nephrology, Department of Internal Medicine, Akdeniz University Faculty of Medicine, Antalya, Turkey; Tuncer Karpuzoglu Transplantation Center, Akdeniz University Hospital, Antalya, Turkey.
| | - Huseyin Kocak
- Division of Nephrology, Department of Internal Medicine, Akdeniz University Faculty of Medicine, Antalya, Turkey; Tuncer Karpuzoglu Transplantation Center, Akdeniz University Hospital, Antalya, Turkey.
| | - Abdullah Kisaoglu
- Department of General Surgery, Akdeniz University Faculty of Medicine, Antalya, Turkey; Tuncer Karpuzoglu Transplantation Center, Akdeniz University Hospital, Antalya, Turkey.
| | - Ismail Demiryilmaz
- Department of General Surgery, Akdeniz University Faculty of Medicine, Antalya, Turkey; Tuncer Karpuzoglu Transplantation Center, Akdeniz University Hospital, Antalya, Turkey.
| | - Bulent Aydinli
- Department of General Surgery, Akdeniz University Faculty of Medicine, Antalya, Turkey; Tuncer Karpuzoglu Transplantation Center, Akdeniz University Hospital, Antalya, Turkey.
| | - Habibe Sema Arslan
- Department of Medical Biology and Genetics, Akdeniz University Faculty of Medicine, Antalya, Turkey.
| | - Fahri Ucar
- Department of Medical Biology and Genetics, Akdeniz University Faculty of Medicine, Antalya, Turkey; Tuncer Karpuzoglu Transplantation Center, Akdeniz University Hospital, Antalya, Turkey.
| |
Collapse
|
17
|
Dinc B, Yilmaz VT, Aycan İO, Kisaoglu A, Dandin O, Aydinli B, Hadimioglu N, Ertug Z. Effect of post-perfusion hyperoxemia on early graft function in renal transplant recipients: a retrospective observational cohort study. Ir J Med Sci 2021; 190:1539-1545. [PMID: 33398714 DOI: 10.1007/s11845-020-02499-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 12/25/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND The effects of hyperoxemia on the transplanted grafts arouse interest nowadays, particularly intraoperative hyperoxemia, on transplant kidney function and survival in the 1-year post-operative period. AIMS We aimed to investigate the effect of post-perfusion (5 min after perfusion) hyperoxemia on early graft function and survival in renal transplant recipients. METHODS Two hundred forty-seven living donor kidney transplant recipients were included in the study. Patients were divided into the three groups according to their partial arterial oxygen pressure in post-perfusion blood gas samples: group 1: normoxia (n = 52, PaO2 pressure: < 120 mmHg, 103 ± 13); group 2: moderate hyperoxemia (n = 121, PaO2: 120-200 mmHg, 169 ± 21); group 3: severe hyperoxemia (n = 74, PaO2: > 200 mmHg, 233 ± 25). Graft functions (serum creatinine levels, estimated-glomerular filtration rate values, spot urine protein/creatinine ratio), survival rates, and groups' clinical outcomes were compared in the first year after transplantation. RESULTS Graft survival rates were similar in the groups and the rate of BK virus viremia was the lowest in the group 3 (groups 1, 2, and 3: 15.4% (n = 8), 6.6% (n = 8), 1.4% (n = 1), respectively, P: 0.009). Serum creatinine and proteinuria levels were lower, and estimated-glomerular filtration rate values were higher in group 3. A negative correlation between partial arterial oxygen pressure and serum creatinine levels and a positive correlation with estimated-glomerular filtration rate value were noted. These results were confirmed by univariate and multivariate analyses. CONCLUSIONS We demonstrated that the kidney transplant recipients with post-perfusion hyperoxemia have better early graft functions and lower BK virus viremia rates. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04420897.
Collapse
Affiliation(s)
- Bora Dinc
- Department of Anaesthesiology and Reanimation, Akdeniz University Medical School, Antalya, Turkey
| | - Vural T Yilmaz
- Division of Nephrology, Department of Internal Medicine, Akdeniz University Medical School, Antalya, Turkey.
| | - İlker O Aycan
- Department of Anaesthesiology and Reanimation, Akdeniz University Medical School, Antalya, Turkey
| | - Abdullah Kisaoglu
- Department of General Surgery, Akdeniz University Medical School, Antalya, Turkey
| | - Ozgur Dandin
- Department of General Surgery, Akdeniz University Medical School, Antalya, Turkey
| | - Bulent Aydinli
- Department of General Surgery, Akdeniz University Medical School, Antalya, Turkey
| | - Necmiye Hadimioglu
- Department of Anaesthesiology and Reanimation, Akdeniz University Medical School, Antalya, Turkey
| | - Zeki Ertug
- Department of Anaesthesiology and Reanimation, Akdeniz University Medical School, Antalya, Turkey
| |
Collapse
|
18
|
Dinc B, Aycan IO, Ozdemir S, Dandin O, Hadimioglu N, Mercan T, Yamasan BE, Kisaoglu A. The relevance between graft preservation solutions and QTc interval during living donor kidney transplantation and rat cardiomyocytes sampling. Hippokratia 2021; 25:22-30. [PMID: 35221652 PMCID: PMC8877929] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND The purpose of the retrospective study was to identify the impacts of different solutions on the electrocardiogram and cardiovascular changes. Moreover, the differences between these solutions were analyzed by examining their impacts on rat ventricular cardiomyocytes. METHODS Eighty renal transplant patients were evaluated retrospectively. The patients were divided into two groups: Group UW (n =40) used the University of Wisconsin solution, and Group HTK (n =40) used the Histidine-Tryptophan-Ketoglutarate solution. Electrocardiograms of the subjects were obtained three times at different periods; during the pre-perfusion, intraoperative kidney reperfusion, and postperfusion phase at the end of the surgery. Any Electrocardiogram or cardiovascular alterations were noted and analyzed. Adult male Wistar rats were used for in vitro experiments. Myocyte contractility, action potentials, and membrane current were recorded in enzymatically isolated ventricular myocytes. RESULTS Sinus bradycardia was detected in 19 patients of Group UW, while there was short-term asystole in eight patients. However, no cardiac changes were observed in Group HTK patients. In both Groups, reperfusion and postperfusion corrected QT (QTc) intervals were different from pre-perfusion QTc intervals. Group UW patients' reperfusion and postperfusion QTc's values were higher than those of the Group HTK patients. In rat myocytes, prominent asystole episodes were observed at specific concentrations of the UW solution compared to the HTK solution. The UW solution depolarized the resting membrane potential significantly and decreased the peak value of action potential, whereas the HTK solution did not elicit a significant change in those parameters. Accordingly, the UW solution elicited a significant inward current at -70 mV, while the HTK solution activated only a modest current, which may not change the membrane potential. CONCLUSION Prolongation of QTc intervals was detected with reperfusion in both groups according to electrocardiography analysis. However, the QTc interval was observed to be longer in cases using the UW solution and required intervention intraoperatively. HIPPOKRATIA 2021, 25 (1):22-30.
Collapse
Affiliation(s)
- B Dinc
- Department of Anesthesiology and Reanimation, Akdeniz University Medical Faculty, Antalya, Turkey
| | - I O Aycan
- Department of Anesthesiology and Reanimation, Akdeniz University Medical Faculty, Antalya, Turkey
| | - S Ozdemir
- Department of Biophysics, Akdeniz University Medical Faculty, Antalya, Turkey
| | - O Dandin
- Department of General Surgery, Akdeniz University Medical Faculty, Antalya, Turkey
| | - N Hadimioglu
- Department of Anesthesiology and Reanimation, Akdeniz University Medical Faculty, Antalya, Turkey
| | - T Mercan
- Department of Biophysics, Akdeniz University Medical Faculty, Antalya, Turkey
| | - B E Yamasan
- Department of Biophysics, Akdeniz University Medical Faculty, Antalya, Turkey
| | - A Kisaoglu
- Department of General Surgery, Akdeniz University Medical Faculty, Antalya, Turkey
| |
Collapse
|
19
|
Yilmaz VT, Kisaoglu A, Dandin O, Demiryilmaz I, Koksoy S, Aydinli B, Kocak H. Living donor kidney transplantation after desensitization in cross-match positive high sensitized patients. Hippokratia 2020; 24:182-190. [PMID: 35023894 PMCID: PMC8747584] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND We aimed to evaluate the long-term results of the patients who had positive cross-match (XM) test results and underwent living donor renal transplantation after desensitization with different combinations of intravenous immunoglobulin (IVIG), plasmapheresis (PP), and rituximab. MATERIAL AND METHODS Forty-nine patients who were positive for complement-dependent cytotoxicity (CDC), flow cytometric (FC), and Luminex-XM test were included in the study. Renal transplantation was performed in 16 patients who had XM (-) test after desensitization with different combinations of IVIG (n =15), PP (n =13), and rituximab (n =10). Anti-human leukocyte antigens (HLA) antibodies (anti-HLA Abs) were detected by the Luminex single antigen bead assay. Anti-thymocyte globulin was used for induction, and tacrolimus, mycophenolic acid, and prednisolone were used for maintenance therapy. Also, we evaluated the relationship between different donor-specific anti-HLA Abs and the parameters mentioned above. RESULTS Antibody-mediated rejection (AMR) and acute T cell-mediated rejection rates were 18.8 % and 6.3 %, respectively. Graft survival rates at the first, third, and fifth years post-transplantation were 93.8 %, 85.2 %, and 85.2 %, respectively, and the patients' survival rates were found to be 100 %. Serum creatinine level and glomerular filtration rate were 1.5 ± 1.2 mg/dl and 69.9 ± 30.4 ml/min, respectively. The mean follow-up time was 39 ± 24 months. CONCLUSIONS Our study showed that kidney transplantation could be performed by effective desensitization in XM test positive patients. It was also shown that donor-specific anti-HLA DQ Ab and non-HLA Ab determination might be useful in diagnosing patients with positive cross-test and/or diagnosis of AMR. HIPPOKRATIA 2020, 24(4): 182-190.
Collapse
Affiliation(s)
- V T Yilmaz
- Department of Internal Medicine, Division of Nephrology
| | | | | | | | - S Koksoy
- Department of Microbiology and Clinical Immunology Akdeniz University Medical School, Antalya, Turkey
| | | | - H Kocak
- Department of Internal Medicine, Division of Nephrology
| |
Collapse
|
20
|
Kisaoglu A, Dandin O, Demiryilmaz I, Dinc B, Adanir H, Yilmaz VT, Aydinli B. A Single-Center Experience in Portal Flow Augmentation in Liver Transplantation With Prior Large Spontaneous Splenorenal Shunt. Transplant Proc 2020; 53:54-64. [PMID: 32605772 DOI: 10.1016/j.transproceed.2020.05.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 03/30/2020] [Accepted: 05/12/2020] [Indexed: 12/31/2022]
Abstract
Large portosystemic shunts may cause portal steal syndrome in liver transplantation (LT). Because of the possible devastating consequences of the syndrome, the authors recommend perioperative management of these large shunts. Fourteen adult recipients who underwent portal flow augmentation, including left renal vein ligation (LRVL), renoportal anastomosis (RPA), shunt ligation (SL), and splenic vein ligation (SVL) for large spontaneous splenorenal shunt (SSRS), are included in this study, and the results were analyzed. A total of 13 patients had a large SSRS, and in 1 patient, the large shunt was placed between the superior mesenteric vein and the right renal vein. LDLT was performed in 13 patients. LRVL (n = 5), SVL (n = 6), RPA (n = 2), SL (n = 1) were performed to the patients as graft inflow augmentation. The graft-recipient weight ratios (GRWR) were less than 0.8% in 5 patients (35.7%): 2 had LRVL, and 3 had SVL. Small-for-size syndrome (SFSS) occurred only in these 2 patients with LRVL (GRWR ≤0.8%) and, splenic artery ligation was performed for graft inflow modulation. No mortality or serious complications were reported during follow-up. We consider that in patients with large SSRS and small-for-size grafts, SVL can be performed safely and with satisfactory outcomes.
Collapse
Affiliation(s)
- Abdullah Kisaoglu
- Akdeniz University, Faculty of Medicine, Department of General Surgery, Tuncer Karpuzoglu Organ Transplantation Center, Antalya, Turkey
| | - Ozgur Dandin
- Akdeniz University, Faculty of Medicine, Department of General Surgery, Tuncer Karpuzoglu Organ Transplantation Center, Antalya, Turkey.
| | - Ismail Demiryilmaz
- Akdeniz University, Faculty of Medicine, Department of General Surgery, Tuncer Karpuzoglu Organ Transplantation Center, Antalya, Turkey
| | - Bora Dinc
- Akdeniz University, Faculty of Medicine, Department of Anesthesiology, Antalya, Turkey
| | - Haydar Adanir
- Akdeniz University, Faculty of Medicine, Department of Gastroenterology, Antalya, Turkey
| | - Vural Taner Yilmaz
- Akdeniz University, Faculty of Medicine, Department of Nephrology, Tuncer Karpuzoglu Organ Transplantation Center, Antalya, Turkey
| | - Bulent Aydinli
- Akdeniz University, Faculty of Medicine, Department of General Surgery, Tuncer Karpuzoglu Organ Transplantation Center, Antalya, Turkey
| |
Collapse
|
21
|
Kisaoglu A, Demiryilmaz I, Dandin O, Yilmaz VT, Aydinli B. Renoportal anastomosis in living donor liver transplantation. Hippokratia 2019; 23:140-142. [PMID: 32581501 PMCID: PMC7307504] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND In advanced cirrhotic patients, extensive mesenteric vein thrombosis extends the operative time, causes peri- and postoperative complications, and increases the mortality and morbidity in liver transplantation (LT). The anastomosis between the left renal vein and graft portal vein is one of the crucial options in such patients. However, especially in living donor liver transplantation (LDLT) practice, limited cases are published in the literature. CASE REPORT A thirty-seven years old female patient with hepatitis B virus (HBV) associated liver cirrhosis underwent LDLT. Her body mass index, graft weight, and graft-recipient weight ratio (GRWR) were noted 19.3 kg/m2, 990 g, and 1.9 %, respectively. During the surgical procedure, she had renoportal anastomosis (RPA) due to extensive portal vein thrombosis to provide an efficient portal inflow to the transplanted graft. No complication was observed in the early postoperative period, and the one year follow up passed without any problem. CONCLUSIONS In LT, for providing efficient portal flow to the graft, the RPAs should be considered as an option in case of extensive splanchnic vein thrombosis and large splenorenal shunt. Ensuring that graft volume is close to the recipient standard liver volume, RPA can be performed safely and effectively in LDLT as an acceptable and life-saving procedure. HIPPOKRATIA 2019, 23(3): 140-142.
Collapse
Affiliation(s)
- A Kisaoglu
- Department of General Surgery, Medicine Faculty Hospital, University of Akdeniz, Antalya, Turkey
| | - I Demiryilmaz
- Department of General Surgery, Medicine Faculty Hospital, University of Akdeniz, Antalya, Turkey
| | - O Dandin
- Department of General Surgery, Medicine Faculty Hospital, University of Akdeniz, Antalya, Turkey
| | - V T Yilmaz
- Department of Nephrology, Medicine Faculty Hospital, University of Akdeniz, Antalya, Turkey
| | - B Aydinli
- Department of General Surgery, Medicine Faculty Hospital, University of Akdeniz, Antalya, Turkey
| |
Collapse
|
22
|
Abstract
Colonoscopy, which is routinely performed in diagnosis and treatment of colorectal disorders, is a reliable procedure. Its most frequent complications are bleeding and perforation. Splenic rupture is a very rarely met complication of colonoscopy, and delay in its diagnosis leads to increased morbidity and mortality. We presented a 69 years old female patient, who was diagnosed by computerized abdominal tomography, performed for her abdominal pain, which started following the colonoscopy. After 15 days of medical treatment and follow-up, laparoscopic splenectomy was performed one month after her colonoscopy. The patient was discharged on her 4(th) postoperative day, with uneventful recovery. In patients who have complaint of abdominal pain following colonoscopy, an intraabdominal pathological condition should be considered and computerized abdominal tomography should be performed. If there is no detected intraperitoneal bleeding, in other words, if there is a sub-capsular hematoma of the spleen, medical management by monitoring the vital signs may be preferred. Then, splenectomy should be performed at an appropriate time.
Collapse
Affiliation(s)
- Bunyami Ozogul
- Department of General Surgery, Atatürk University School of Medicine, Erzurum, Turkey
| | - Abdullah Kisaoglu
- Department of General Surgery, Atatürk University School of Medicine, Erzurum, Turkey
| | - Atıf Bayramoglu
- Department of Emergency, Atatürk University School of Medicine, Erzurum, Turkey
| | - Salih Kara
- Department of General Surgery, Atatürk University School of Medicine, Erzurum, Turkey
| | - Nurhak Aksungur
- Department of General Surgery, Atatürk University School of Medicine, Erzurum, Turkey
| |
Collapse
|
23
|
Yilmaz M, Cimilli G, Saritemur M, Demircan F, Isaoglu U, Kisaoglu A, Emet M. Diagnostic Accuracy of Neutrophil/Lymphocyte Ratio, Red Cell Distribution Width and Platelet Distribution Width in Ovarian Torsion. J OBSTET GYNAECOL 2015; 36:218-22. [DOI: 10.3109/01443615.2015.1049989] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
24
|
Kisaoglu A, Bayramoglu A, Ozogul B, Atac K, Emet M, Atamanalp SS. Sensitivity and specificity of red cell distribution width in diagnosing acute mesenteric ischemia in patients with abdominal pain. World J Surg 2015; 38:2770-6. [PMID: 25096361 DOI: 10.1007/s00268-014-2706-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND We investigated the utility of the red cell distribution width (RDW) in diagnosing acute mesenteric ischemia (AMI) in patients with abdominal pain. METHODS The patients were divided into two groups in this retrospective case-control study: patients with AMI and patients with abdominal pain who did not require urgent surgery. Venous blood was collected from the patients upon admission to the emergency department, and abdominal computed tomography angiography was performed. The RDW and hematological and biochemical parameters of the groups were compared. The primary outcome was AMI among the patients with abdominal pain. The secondary outcome was mortality, complaint period, and size of ischemia/necrosis among the AMI patients. RESULTS The RDW, white blood cell lactate dehydrogenase, and blood urea nitrogen of the patients with AMI were significantly different from those of the control group. When the average RDW (15.04 %) of the patients with AMI was used as a cut-off value, the sensitivity, specificity, positive likelihood ratio (+LR), and negative likelihood (-LR) were 40.8 %, 81.2 %, 2.17, and 0.73, respectively. When patients with AMI and anemia were included in the group, the sensitivity and specificity values did not change. There was no relation between the RDW and mortality, size of the ischemia/necrosis, and complaint period. Furthermore, there was no significant difference in the average RDW between the patients with ischemia/necrosis in the small intestine only and those with ischemia/necrosis in the colon. CONCLUSION The RDW on admission is of marginal help to diagnose AMI among patients with abdominal pain.
Collapse
Affiliation(s)
- Abdullah Kisaoglu
- Department of General Surgery, School of Medicine, Ataturk University, 25070, Erzurum, Turkey,
| | | | | | | | | | | |
Collapse
|
25
|
Selcuk Atamanalp S, Ozogul B, Kisaoglu A, Arslan S, Korkut E, Karadeniz E. Typhoid Intestinal Perforations: Has the Clinical Importance Decreased in Eastern Anatolia for 36 Years? Eurasian J Med 2015; 47:135-7. [PMID: 26180499 DOI: 10.5152/eurasianjmed.2015.136] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2014] [Accepted: 12/29/2014] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Typhoid fever (TF) is an important health problem in developing countries, and typhoid intestinal perforation (TIP) is a serious complication of TF. The present report aims to determine the clinical importance of TIPs for the last 36 years in our region, eastern Anatolia. MATERIALS AND METHODS The clinical records of 84 surgically treated cases with TIPs were reviewed retrospectively. RESULTS When the last 36-year period was sectioned by 6-year periods, the distribution of TIPs was found as 39 (46.4% of total), 31 (36.9%), 7 (8.3%), 4 (4.8%), 2 (2.4%) and 1 (1.2%), respectively. The mean age of the patients was 37.1 years (range: 7-68 years), and 66 patients (78.6%) were male. As a surgical procedure, 34 patients (40.5%) had primary repair, 9 (10.7%) had wedge resection with primary repair, 9 (10.7%) had resection with primary anastomosis, 28 (33.3%) had resection with ileostomy, and 4 (4.8%) had exteriorization. Complications were seen in 71 patients (84.5%), while the mortality rate was 10.7% (9 patients). CONCLUSION Although eastern Anatolia is an endemic region for TF, a certain decrease in the incidence of TIPs was found for the last 36 years. Keeping in mind the TIP, patients with TF may improve the prognosis of this serious disease.
Collapse
Affiliation(s)
- S Selcuk Atamanalp
- Department of General Surgery, Atatürk University Faculty of Medicine, Erzurum, Turkey
| | - Bunyami Ozogul
- Department of General Surgery, Atatürk University Faculty of Medicine, Erzurum, Turkey
| | - Abdullah Kisaoglu
- Department of General Surgery, Atatürk University Faculty of Medicine, Erzurum, Turkey
| | - Sukru Arslan
- Department of General Surgery, Atatürk University Faculty of Medicine, Erzurum, Turkey
| | - Ercan Korkut
- Department of General Surgery, Atatürk University Faculty of Medicine, Erzurum, Turkey
| | - Erdem Karadeniz
- Department of General Surgery, Atatürk University Faculty of Medicine, Erzurum, Turkey
| |
Collapse
|
26
|
Atamanalp SS, Kisaoglu A, Ozogul B, Kantarci M, Disci E, Bulut OH, Aksungur N, Atamanalp RS. Sigmoid volvulus complicating pregnancy: a case report. Eurasian J Med 2015; 47:75-6. [PMID: 25745351 DOI: 10.5152/eajm.2014.0105] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 10/18/2014] [Indexed: 11/22/2022] Open
Abstract
Sigmoid volvulus during pregnancy is a rare complication, and as of 2012, fewer than 100 cases had been reported. In this report, we present a 30 year-old pregnant woman with sigmoid volvulus, and we discuss this rare entity.
Collapse
Affiliation(s)
| | - Abdullah Kisaoglu
- Department of General Surgery, Ataturk University Faculty of Medicine, Erzurum, Turkey
| | - Bunyami Ozogul
- Department of General Surgery, Ataturk University Faculty of Medicine, Erzurum, Turkey
| | - Mecit Kantarci
- Department of Radiology, Ataturk University Faculty of Medicine, Erzurum, Turkey
| | - Esra Disci
- Department of General Surgery, Ataturk University Faculty of Medicine, Erzurum, Turkey
| | - O Hakan Bulut
- Department of General Surgery, Ataturk University Faculty of Medicine, Erzurum, Turkey
| | - Nurhak Aksungur
- Department of General Surgery, Ataturk University Faculty of Medicine, Erzurum, Turkey
| | | |
Collapse
|
27
|
Ozogul B, Ozturk G, Kisaoglu A, Aydinli B, Yildirgan M, Atamanalp SS. The clinical importance of different localizations of the papilla associated with juxtapapillary duodenal diverticula. Can J Surg 2015; 57:337-41. [PMID: 25265108 DOI: 10.1503/cjs.021113] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Previous studies have evaluated the presence of juxtapapillary duodenal diverticula (JPDD) and the association with pancreatobiliary disease, but not the association of the papilla with an existing JPDD. We investigated the association of different localizations of the papilla with JPDD. METHODS We studied patients in whom JPDD was detected during endoscopic retrograde cholangiopancreatography. Patients were classified into 3 groups: 1) papilla located inside the diverticulum, 2) papilla located at the edge of the diverticulum and 3) papilla located closer than 3 cm to the diverticulum. The patients were examined with respect to localization of papilla-diverticula and to the association of the localization with pancreaticobiliary disease. RESULTS We enrolled 274 patients in our study. Biliary stone disease more frequently existed in group 3. The number of patients presenting with obstructive jaundice was higher in groups 2 (83.6%) and 3 (83.3%) than group 1 (66%). Cholangitis was more common in group 1 (21.3%) than in groups 2 (6.7%) and 3 (2.3%). The presence of biliary stone disease among patients presenting with pancreatitis was significantly different between groups 1 and 3 (p = 0.013) and between groups 2 and 3 (p = 0.017). The common bile duct more frequently contained stones or sludge in group 3 than in groups 1 and 2. CONCLUSION When the papilla is located close to the JPDD, the incidence of biliary stone disease decreases, and pancreatobiliary diseases are caused mostly in the absence of biliary stone disease.
Collapse
Affiliation(s)
- Bunyami Ozogul
- From the Department of General Surgery, Medical Faculty, Ataturk University, Erzurum, Turkey
| | - Gurkan Ozturk
- From the Department of General Surgery, Medical Faculty, Ataturk University, Erzurum, Turkey
| | - Abdullah Kisaoglu
- From the Department of General Surgery, Medical Faculty, Ataturk University, Erzurum, Turkey
| | - Bulent Aydinli
- From the Department of General Surgery, Medical Faculty, Ataturk University, Erzurum, Turkey
| | - Mehmet Yildirgan
- From the Department of General Surgery, Medical Faculty, Ataturk University, Erzurum, Turkey
| | - Sabri Selcuk Atamanalp
- From the Department of General Surgery, Medical Faculty, Ataturk University, Erzurum, Turkey
| |
Collapse
|
28
|
Kisaoglu A, Ozogul B, Yuce I, Bayramoglu A, Atamanalp SS. Obturator hernia, a rare cause of small bowel obstruction: case report. Eurasian J Med 2015; 46:224-6. [PMID: 25610330 DOI: 10.5152/eajm.2014.56] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2014] [Accepted: 06/02/2014] [Indexed: 11/22/2022] Open
Abstract
Obturator hernia is a rare hernia in the world, diagnosed late since it has no specific symptoms and findings and generally occur in thin and old women with comorbidity.For this reason obturator hernia has high morbidity and mortality rates. In this study, we present an obturator hernia case that Howship-Romberg sign is positive and has typical appearance in computerized tomography. Laparotomy was performed on 89 years old female patient with body mass index 18.08 kg/m(2) by low middle line incision. Following the segmentectomy to the strangulated small bowel loop, obturator canal is repaired by retroperitoneal application. No complication occurred in the postoperative period. Obturator hernia should be taken into consideration in old and thin female patients with intestinal obstruction. Computerized tomography should be performed for early diagnosis of the obturator hernia.
Collapse
Affiliation(s)
- Abdullah Kisaoglu
- Department of General Surgery, Ataturk University Faculty of Medicine, Erzurum, Turkey
| | - Bunyami Ozogul
- Department of General Surgery, Ataturk University Faculty of Medicine, Erzurum, Turkey
| | - Ihsan Yuce
- Department of Radiology, Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Atif Bayramoglu
- Department of Emergency Medicine, Ataturk University Faculty of Medicine, Erzurum, Turkey
| | | |
Collapse
|
29
|
Aydinli B, Ozogul B, Ozturk G, Kisaoglu A, Atamanalp SS, Kantarci M. Hepatic Alveolar Echinococcosis that Incidentally Diagnosed and Treated with R1 Resection. Eurasian J Med 2015; 44:127-8. [PMID: 25610224 DOI: 10.5152/eajm.2012.29] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2012] [Accepted: 07/23/2012] [Indexed: 02/04/2023] Open
Abstract
In this report, we present an incidentally diagnosed and surgically treated patient with hepatic alveolar echinococcosis.
Collapse
Affiliation(s)
- Bulent Aydinli
- Department of General Surgery, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Bunyami Ozogul
- Department of General Surgery, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Gurkan Ozturk
- Department of General Surgery, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Abdullah Kisaoglu
- Department of General Surgery, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - S Selcuk Atamanalp
- Department of General Surgery, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Mecit Kantarci
- Department of Radiology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| |
Collapse
|
30
|
Kisaoglu A, Ozogul B, Turan MI, Yilmaz I, Demiryilmaz I, Atamanalp SS, Bakan E, Suleyman H. Damage induced by paracetamol compared with N-acetylcysteine. J Chin Med Assoc 2014; 77:463-8. [PMID: 25028290 DOI: 10.1016/j.jcma.2014.01.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Accepted: 01/29/2014] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND This study investigated the effect of thiamine pyrophosphate (TPP) on oxidative liver damage induced in rats with high-dose paracetamol. METHODS Rats for this experiment were divided into the following groups: healthy control, paracetamol control, thiamine + paracetamol, TPP + paracetamol, and N-acetylcysteine + paracetamol. Oxidant and antioxidant parameters and liver function test levels were compared between the groups. RESULTS The results show that TPP and N-acetylcysteine with paracetamol equally prevented a rise in oxidants such as malondialdehyde and nitric oxide. They also prevented a decrease in enzymatic and nonenzymatic antioxidants such as glutathione, glutathione peroxidase, glutaredoxin, glutathione S-transferase, superoxide dismutase, and catalase in the rat liver. CONCLUSION Thiamine pyrophosphate and N-acetylcysteine had a similar positive effect on oxidative damage caused by paracetamol hepatotoxicity. These findings show that TPP may be beneficial in paracetamol hepatotoxicity.
Collapse
Affiliation(s)
| | - Bunyami Ozogul
- Department of General Surgery, Ataturk University, Erzurum, Turkey
| | - Mehmet Ibrahim Turan
- Department of Pediatric Neurology, Diyarbakir Research and Educational Hospital, Diyarbakir, Turkey.
| | - Ismayil Yilmaz
- Department of General Surgery, Erzincan University, Erzincan, Turkey
| | | | | | - Ebubekir Bakan
- Department of Biochemistry, Ataturk University, Erzurum, Turkey
| | - Halis Suleyman
- Department of Pharmacology, Recep Tayyip Erdogan University, Rize, Turkey
| |
Collapse
|
31
|
Demiryilmaz I, Turan MI, Kisaoglu A, Gulapoglu M, Yilmaz I, Suleyman H. Protective effect of nimesulide against hepatic ischemia/reperfusion injury in rats: Effects on oxidant/antioxidants, DNA mutation and COX-1/COX-2 levels. Pharmacol Rep 2014; 66:647-52. [DOI: 10.1016/j.pharep.2014.02.015] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Revised: 02/14/2014] [Accepted: 02/20/2014] [Indexed: 10/25/2022]
|
32
|
|
33
|
Cankaya E, Cetinkaya R, Keles M, Gulcan E, Uyanik A, Kisaoglu A, Ozogul B, Ozturk G, Aydinli B. Does a predialysis education program increase the number of pre-emptive renal transplantations? Transplant Proc 2013; 45:887-9. [PMID: 23622579 DOI: 10.1016/j.transproceed.2013.02.075] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Renal transplantation (RT) is the most appropriate form of treatment for end-stage renal disease (ESRD). Pre-emptive RT decreases the rates of delayed graft function and acute rejection episodes, increasing patient and graft survival, while reducing costs and complications associated with dialysis. In this study, we investigated the relationship between a predialysis education program (PDEP) for patients and their relatives and pre-emptive RT. METHODS We divided 88 live donor kidney transplant recipients into 2 groups: transplantation without education (non-PDEP group; n = 27), and enrollment in an education program before RT (PDEP group n = 61). RESULTS Five patients in the non-PDEP group underwent pre-emptive transplantation, versus 26 of the PDEP group. The rate of pre-emptive transplantations was significantly higher among the educated (42.62%) versus the noneducated group (18.51%; P < .001). CONCLUSION PDEP increased the number of pre-emptive kidney transplantations among ESRD patients.
Collapse
Affiliation(s)
- E Cankaya
- Department of Nephrology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Ozogul B, Kisaoglu A, Ozturk G, Atamanalp SS, Yıldırgan Mİ, Aköz A, Aydinli B. Adult Intussusception: Clinical Experience from a Single Center. Indian J Surg 2013; 77:490-4. [PMID: 26730051 DOI: 10.1007/s12262-013-0889-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Accepted: 02/07/2013] [Indexed: 11/28/2022] Open
Abstract
Though frequently observed in children, intussusception is a rare state in adults. The treatment of intussusception in adults is different. In this trial, we have presented intussusception cases in adults that were treated and followed up in our department. The records of 31 adult intussusception cases surgically treated in our department between January 1993 and July 2012 were evaluated retrospectively. Among the 31 adult cases of intussusception that were treated during a period of 19 years, 10 were men, and 21 were women. The mean age was determined as 39.7 ± 5.3. The presentation symptom was abdominal pain in all the patients. Failure to pass gas or feces was observed in 23 patients (74.2 %); nausea and vomiting, in 22 patients (70.9 %); hematochezia, in 16 patients (51.6 %); and weight loss, in 3 patients (9.6 %). The mean duration of symptoms was 4.8 days. Abdominal tenderness was found in all the patients. Muscular defense and rebound tenderness were determined in 13 patients (41.9 %). Findings of intussusception were found in 80.9 % of patients examined by abdominal ultrasonography and in 63.1 % of cases examined by computerized tomography. Resection of the intussuscepted bowel segment was performed in 87 % of the patients. In conclusion, intussusception in adults is a rare clinical entity. Intussusception should be considered in the differential diagnosis in patients presenting with spasmodic abdominal pain, especially in cases with intestinal obstruction. The recommended surgical method is en bloc resection of the intussuscepted segment in cases suspected to carry a risk of malignancy.
Collapse
Affiliation(s)
- Bunyami Ozogul
- Department of General Surgery, Faculty of Medicine, Ataturk University, 25040 Erzurum, Turkey
| | - Abdullah Kisaoglu
- Department of General Surgery, Faculty of Medicine, Ataturk University, 25040 Erzurum, Turkey
| | - Gurkan Ozturk
- Department of General Surgery, Faculty of Medicine, Ataturk University, 25040 Erzurum, Turkey
| | - Sabri Selcuk Atamanalp
- Department of General Surgery, Faculty of Medicine, Ataturk University, 25040 Erzurum, Turkey
| | - Mehmet İlhan Yıldırgan
- Department of General Surgery, Faculty of Medicine, Ataturk University, 25040 Erzurum, Turkey
| | - Ayhan Aköz
- Department of Emergency Medicine, School of Medicine, Atatürk University, Erzurum, Turkey
| | - Bulent Aydinli
- Department of General Surgery, Faculty of Medicine, Ataturk University, 25040 Erzurum, Turkey
| |
Collapse
|
35
|
Abstract
BACKGROUND AND OBJECTIVES Sigmoid gangrene develops in 6.1% to 93.4% of sigmoid volvulus (SV) cases, and increases the mortality rate from 0% to 40% without bowel gangrene to 3.7% to 80%. This study aimed to investigate factors that induce bowel gangrene development in SV patients. DESIGN AND SETTINGS Retrospective study from a single center. PATIENTS AND METHODS We determined whether there was any correlation between sigmoid gangrene and the following factors: age, gender, a previous history of a volvulus, previous history of abdominal surgery, pregnancy, major comorbidities, shock, duration of symptoms, direction and degree of rotation of volvulus, and ileosigmoid knotting. RESULTS Of 442 patients, 271 (61.3%) had sigmoid gangrene. The presence of pregnancy was negatively cor.related with sigmoid gangrene development (P < .05), while comorbid diseases (P < .01), associated shock (P < .01), prolonged symptom duration (P < .05), overrotation (P < .05), and associated ileosigmoid knotting (P < .01) were positively correlated with bowel gangrene. However, no correlation was observed between sigmoid gangrene and the other studied factors. CONCLUSION An inverse correlation between pregnancy and sigmoid gangrene was observed. On the other hand, a positive correlation was noted between bowel gangrene and comorbid diseases, shock, prolonged duration of symptoms, overrotation, and associated ileosigmoid knotting.
Collapse
Affiliation(s)
- Sabri Selcuk Atamanalp
- Faculty of Medicine, Department of General Surgery, Ataturk University, Erzurum 25070, Turkey.
| | | | | |
Collapse
|
36
|
Kisaoglu A, Borekci B, Yapca OE, Bilen H, Suleyman H. Tissue damage and oxidant/antioxidant balance. Eurasian J Med 2013; 45:47-9. [PMID: 25610248 PMCID: PMC4261508 DOI: 10.5152/eajm.2013.08] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Accepted: 12/08/2012] [Indexed: 01/26/2023] Open
Abstract
The oxidant/antioxidant balance in healthy tissues is maintained with a predominance of antioxidants. Various factors that can lead to tissue damage disrupt the oxidant/antioxidant balance in favor of oxidants. In this study, disruptions of the oxidant/antioxidant balance in favor of oxidants were found to be a consequence of the over-consumption of antioxidants. For this reason, antioxidants are considered to be of importance in the prevention and treatment of various types of tissue damage that are aggravated by stress.
Collapse
Affiliation(s)
- Abdullah Kisaoglu
- Department of General Surgery, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Bunyamin Borekci
- Department of Obstetrics and Gynecology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - O. Erkan Yapca
- Department of Obstetrics and Gynecology, Sorgun State Hospital, Yozgat, Turkey
| | - Habib Bilen
- Department of Endocrinology and Metabolism, Ataturk University Faculty of Medicine, Erzurum, Turkey
| | - Halis Suleyman
- Department of Pharmacology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| |
Collapse
|
37
|
Ozogul B, Kisaoglu A, Atamanalp SS, Ozturk G, Aydinli B, Yıldırgan Mİ, Kantarcı AM. Splenic Hydatid Cysts: 17 Cases. Indian J Surg 2013; 77:257-60. [PMID: 26730005 DOI: 10.1007/s12262-012-0788-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Accepted: 11/21/2012] [Indexed: 10/27/2022] Open
Abstract
Hydatid cyst disease, which is endemically observed and an important health problem in our country, involves the spleen at a frequency ranking third following the liver and the lungs. In this study, we aimed to evaluate the efficacy and results of management in splenic hydatid cysts. The demographic data, localization, diagnosis, treatment methods, and the length of postoperative hospital stay of patients with splenic hydatid cysts in a 12-year period were evaluated retrospectively. Seventeen cases were evaluated. Among these, 13 were females and four were males. Seven had solitary splenic involvement, eight had involvement of both the spleen and the liver, and two had multiple organ involvement. Ten had undergone splenectomy, one had undergone distal splenectomy, and the remaining cases had undergone different surgical procedures. The patients had received albendazole treatment in the pre- and postoperative period. One patient had died secondary to hypernatremia on the first postoperative day. The clinical picture in splenic hydatid cysts, which is seen rarely, is usually asymptomatic. The diagnosis is established by ultrasonography and abdominal CT. Although splenectomy is the standard mode of treatment, spleen-preserving methods may be used.
Collapse
Affiliation(s)
- Bunyami Ozogul
- Department of General Surgery, Faculty of Medicine, Ataturk University, 25040 Erzurum, Turkey
| | - Abdullah Kisaoglu
- Department of General Surgery, Faculty of Medicine, Ataturk University, 25040 Erzurum, Turkey
| | - Sabri Selcuk Atamanalp
- Department of General Surgery, Faculty of Medicine, Ataturk University, 25040 Erzurum, Turkey
| | - Gurkan Ozturk
- Department of General Surgery, Faculty of Medicine, Ataturk University, 25040 Erzurum, Turkey
| | - Bulent Aydinli
- Department of General Surgery, Faculty of Medicine, Ataturk University, 25040 Erzurum, Turkey
| | - Mehmet İlhan Yıldırgan
- Department of General Surgery, Faculty of Medicine, Ataturk University, 25040 Erzurum, Turkey
| | - A Mecit Kantarcı
- Department of Radiology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| |
Collapse
|
38
|
Ozogul B, Kisaoglu A, Ibrahim Turan M, Altuner D, Sener E, Cetin N, Ozturk C. The effect of mirtazapine on methotrexate-induced toxicity in rat liver. ScienceAsia 2013. [DOI: 10.2306/scienceasia1513-1874.2013.39.356] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
|
39
|
Donmez R, Oren D, Ozturk G, Kisaoglu A, Ozogul B, Atamanalp SS. The combined effects of glutamine and growth hormone on intestinal anastomosis in the rat intra-abdominal sepsis model. J Surg Res 2012; 182:142-5. [PMID: 23474304 DOI: 10.1016/j.jss.2012.08.033] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2012] [Revised: 07/15/2012] [Accepted: 08/17/2012] [Indexed: 12/17/2022]
Abstract
AIM Intestinal anastomoses are always risky in patients who develop intra-abdominal sepsis. In this study, the effects of combined glutamine and growth hormone (GH) on healing of intestinal anastomosis following intestinal repair in the rat intra-abdominal sepsis was induced. MATERIAL AND METHODS Forty Sprague Dawley Albino rats at 10 weeks weighing between 180 and 240 g were included in the study. All the animals were divided into five groups comprising eight rats each. In the control group, no treatment was given in addition to the routine oral nutrition before and after surgery. In the other groups, following surgery, oral glutamine was given at a dose of 1 mg/kg/d in the glutamine group, subcutaneous GH was given at a dose of 1 mg/kg/d in the GH group, and combined glutamine and GH were administered at the same doses in the glutamine + GH group. In rats, a clinical model mimicking intestinal fistula was generated and fistula repair was performed, and the bursting pressure of the repair area and tissue hydroxyproline level of the repair area were calculated. RESULTS Compared with the control group, glutamine, GH, and combined groups displayed significantly higher mean bursting pressures and tissue hydroxyproline levels. CONCLUSION In order to decrease the risks originating from impaired mechanisms due to intra-abdominal sepsis, and to make anastomosis safer, combined use of glutamine and GH increases the bursting pressure of anastomosis. While the use of either of these two substances alone is effective, combined use makes this effect more prominent.
Collapse
Affiliation(s)
- Ramazan Donmez
- Department of General Surgery, Memorial Atasehir Hospital, Istanbul, Turkey
| | | | | | | | | | | |
Collapse
|
40
|
Atamanalp SS, Ozogul B, Kisaoglu A. Cecal volvulus: a rare cause of intestinal obstruction. Eurasian J Med 2012; 44:115-6. [PMID: 25610220 PMCID: PMC4261296 DOI: 10.5152/eajm.2012.25] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2012] [Accepted: 06/16/2012] [Indexed: 11/22/2022] Open
Abstract
Cecal volvulus is a rare cause of intestinal obstruction. In this report, we present a 41 year-old patient with cecal volvulus, and we discuss this very rare entity.
Collapse
Affiliation(s)
- S. Selcuk Atamanalp
- Department of General Surgery, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Bunyami Ozogul
- Department of General Surgery, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Abdullah Kisaoglu
- Department of General Surgery, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| |
Collapse
|
41
|
Kisaoglu A, Ozogul B, Cetyn N, Suleyman B, Atamanalp S, Akcay F, Suleyman H. The Role of Alpha-2 Adrenergic Receptors in the Anti-ulcerative Activity of Famotidine and Omeprazole in Rats and its Relationship with Oxidant-antioxidant Parameters. INT J PHARMACOL 2011. [DOI: 10.3923/ijp.2011.682.689] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|