Browsing by Author "Atar, Funda"

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Acute Respiratory Distress Syndrome in Solid Organ Transplant Recipients
(2016) Zeyneloglu, Pinar; Ozdemirkan, Aycan; Komurcu, Ozgur; Ulas, Aydin; Atar, Funda; Gedik, Ender; Pirat, Arash; https://orcid.org/0000-0002-7175-207X; AAH-7003-2019; ABI-2971-2020
The Incidence and Risk Factors of Acute Kidney Injury After Left Ventricular Assist Device Implantation
(2023) Atar, Funda; Sahinturk, Helin; Zeyneloglu, Pinar; Ozdemirkan, Aycan; 0000-0003-0159-4771; AAJ-1419-2021
Objective: Left ventricular assist device surgery (LVAD) associated acute kidney injury (AKI) is a severe complication of cardiac surgery with 15-45% incidence. The study evaluated AKI in the early postoperative period after LVAD surgery using the Kidney Disease: Improving Global Outcomes (KDIGO) criteria and compare patients with and without AKI to determine the incidence, risk factors, and clinical outcomes. Materials and Methods: In this retrospective cohort study, the medical records of all patients aged between 18 and 75 years who underwent LVAD implantation from January 2011 to December 2016 were reviewed. Patients were divided into two groups based on the development of AKI to analyze demographic features and perioperative variables. AKI was defined according to the KDIGO criteria. Results: Out of 57 patients, 10 (18%) were female, and the cohort's mean age was 44.6 +/- 16.1 years. Thirty-six patients (63%) developed AKI following LVAD implantation. Logistic regression analysis revealed the duration of cardiopulmonary bypass (CPB), mean arterial pressure, and cumulative fluid balance on the first postoperative day as independent risk factors for AKI [odds ratio (OR): 1.013, confidence interval (CI) 95% 1.000-1.025, p=0.05; OR: 0.929, CI 95% 0.873-0.989, p=0.02; OR: 1.001, CI 95% 1.000-1.001, p=0.04 respectively]. Hospital mortality (58% vs. 24%, p=0.01) and 30-day mortality (39% vs. 5%, p=0.01) were significantly higher in patients who had AKI. Conclusion: Risk factors for the occurrence of AKI include a longer duration of CPB, lower mean arterial pressures, and higher cumulative fluid balance on the first postoperative day. Therefore, AKI is one of the most important causes of morbidity and mortality after LVAD.
Late Intensive Care Unit Admission in Liver Transplant Recipients: 10-Year Experience
(2015) Atar, Funda; Gedik, Ender; Kaplan, Serife; Zeyneloglu, Pinar; Pirat, Arash; Haberal, Mehmet; 0000-0002-3462-7632; 0000-0002-7175-207X; 0000-0003-2312-9942; 0000-0001-6762-895X; 26640903; AAJ-8097-2021; ABI-2971-2020; C-3736-2018; GLV-1652-2022
Objectives: We evaluated late intensive care unit admission in liver transplant recipients to identify incidences and causes of acute respiratory failure in the postoperative period and to compare these results with results in patients who did not have acute respiratory failure. Materials and Methods: We retrospectively screened the data of 173 consecutive adult liver transplant recipients from January 2005 through March 2015 to identify patients with late admission (> 30 d posttransplant) to an intensive care unit. Patients were divided into 2 groups: patients with and without acute respiratory failure. Acute respiratory failure was defined as severe dyspnea, respiratory distress, decreased oxygen saturation, hypoxemia or hypercapnia on room air, or need for noninvasive or invasive mechanical ventilation. Demographic, laboratory, clinical, and respiratory data were collected. Model for End-Stage Liver Disease, Acute Physiology and Chronic Health Evaluation II, and Sequential Organ Failure Assessment scores; lengths of intensive care unit and hospital stays; and hospital mortality were assessed. Results: Among 173 patients, 37 (21.4%) were admitted to an intensive care unit, including 22 (59.5%) with acute respiratory failure. The leading cause of acute respiratory failure was pneumonia (n = 19, 86.4%). Patients with acute respiratory failure had significantly lower levels of albumin before intensive care unit admission (P =.003). In patients with acute respiratory failure, severe sepsis and septic shock were more frequently observed and tracheotomy was more frequently performed (P=.041). Conclusions: Acute respiratory failure developed in 59.5% of liver transplant recipients with late intensive care unit admission. The leading cause was pneumonia, with this group of patients having higher requirements for invasive mechanical ventilation and tracheotomy, longer stays in an intensive care unit, and higher mortality.
Perioperative Venoarterial Extracorporeal Membrane Oxygenation Support During Heart Transplant
(2017) Gedik, Ender; Atar, Funda; Ozdemirkan, Aycan; Firat, Aynur Camkiran; Zeyneloglu, Pinar; Sezgin, Atilla; Pirat, Arash; 0000-0002-7175-207X; 0000-0003-2312-9942; 0000-0003-1470-7501; 28260473; AAH-7003-2019; ABI-2971-2020; C-3736-2018
Objectives: Heart transplant is the only definitive treatment of end-stage heart failure. Venoarterial extracorporeal membrane oxygenation may be used as a bridge to heart transplant. This technique may be used after heart transplant for conditions refractory to medical treatment like primary graft failure. Previously, we reported our experience with patients who received extracorporeal support as a bridge to emergency heart transplant. In this study, we present our perioperative experience with heart transplants in which extracorporeal support was used. Materials and Methods: We retrospectively screened the data of 31 patients who were seen at our center between January 2014 and June 2016. We screened for patients who were admitted to the intensive care unit before transplant and who required venoarterial extracorporeal membrane oxygenation for circulatory support and postoperative patients who required extracorporeal support. Patient demographics and characteristics, clinical data, and extracorporeal support data were collected from our electronic database and patient medical records. Results: There were 14 patients who required peri operative extracorporeal support. Preoperative sup port was performed in 3 patients before transplant, and postoperative support was performed in 11 patients after transplant. The mean age was 37.7 years in patients within the preoperative group and 29.7 years in patients within the postoperative group. One patient with preoperative support and 5 with postoperative support were pediatric patients. The main indication for transplant was dilated cardiomyopathy in both groups (100% and 63.7%). Overall mortality rates were 33% in the preoperative group and 63.7% in the postoperative group. Conclusions: For patients on heart transplant wait lists who are worsening despite optimal medical therapy, venoarterial extracorporeal membrane oxygenation support is a safe and viable last resort. In addition, extracorporeal support can be used during the posttransplant period as salvage therapy in heart recipients with hemodynamic deterioration. In our experience, preoperative extracorporeal support had lower mortality rates compared with postoperative support.
Venoarterial Extracorporeal Membrane Oxygenation Support as a Bridge to Heart Transplant: Report of 3 Cases
(2016) Gedik, Ender; Ulas, Aydin; Ersoy, Ozgur; Atar, Funda; Firat, Aynur Camkiran; Pirat, Arash; 0000-0002-7175-207X; 0000-0002-8130-9901; 0000-0003-1470-7501; 27805530; ABI-2971-2020
Heart transplant is the only definitive treatment of end-stage heart failure. Venoarterial extracorporeal membrane oxygenation may be used as a bridge to heart transplant. Among 31 patients who underwent heart transplant between January 2014 and June 2016, we present our experiences with 3 patients who received venoarterial extracorporeal support as a bridge to heart transplant. The first patient was a 51-year-old male with ischemic dilated cardio myopathy. Transplant was performed after 6 days of extracorporeal support, and the patient was discharged and alive at follow-up. Patient 2 was a 12-year-old girl with dilated cardiomyopathy who presented with cardiac arrest. Extracorporeal support was initiated during cardiopulmonary resuscitation. She had full neurologic recovery and remained on the wait list. She received a transplant 22 days after resuscitation. She survived and was alive at day 220 posttransplant. The third patient was a 50-year-old male with ischemic dilated cardiomyopathy requiring venoarterial extracorporeal support. Percutaneous balloon atrial septostomy was performed for left ventricle venting. He underwent transplant on day 28 after intensive care unit admission. He died 29 days after release from the hospital. Regarding patients on heart transplant wait lists who are worsening despite optimal medical therapy, venoarterial extracorporeal membrane oxygenation support is a safe and viable last resort.
Venoarterial Extracorporeal Membrane Oxygenation Support As A Bridge To Heart Transplantation: Report of Three Cases
(2016) Gedik, Ender; Ulas, Aydin; Ersoy, Ozgur; Atar, Funda; Firat, Aynur Camkiran; Zeyneloglu, Pinar; Sezgin, Atilla; Pirat, Arash; https://orcid.org/0000-0002-7175-207X; ABI-2971-2020