Browsing by Author "Ersoy, Zeynep"

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Anaesthesia Management of a Patient with Factor XI Deficiency
(2016) Adibelli, Bilgehan; Araz, Coskun; Ersoy, Zeynep; Kayhan, Zeynep; 0000-0002-4927-6660; 0000-0003-0767-1088; 0000-0003-0579-1115; 27366578; AAJ-4576-2021; AAF-3066-2021; AAJ-4623-2021
Factor XI deficiency is an extremely rare disease presenting no clinical symptoms, unless there is an inducing reason such as trauma or surgery. Normally, factor levels are in the range of 70-150 U dL-1 in healthy subjects. Although no clinical symptoms are seen, only high levels of aPTT can be found. Once a prolongation is detected in aPTT, factor XI deficiency should be suspected and factor levels should be analysed. With careful preoperative preparations in factor-deficient people, preoperative and postoperative complications can be decreased. In this case report, management of anaesthesia during total hip arthroplasty of a patient with factor XI deficiency is presented.
Anesthesia Management of a Deceased Cadaveric-Donor Combined Liver and Kidney Transplant for Primary Hyperoxaluria Type 1: Report of a Case
(2015) Ersoy, Zeynep; Araz, Coskun; Kirnap, Mahir; Zeyneloglu, Pinar; Torgay, Adnan; Arslan, Gulnaz; 0000-0003-2312-9942; 0000-0003-0767-1088; 0000-0002-6829-3300; 0000-0002-4927-6660; 26640925; AAH-9198-2019; C-3736-2018; AAF-3066-2021; AAJ-5221-2021; AAJ-4576-2021
Primary hyperoxaluria type 1 is an autosomal recessive disorder that is responsible for the overproduction of oxalate and has an incidence of 1 in 120 000 live births. Indications for combined liver and kidney transplant are still debated. However, combined liver and kidney transplant is preferred in various conditions, including primary hyperoxaluria, liver-based metabolic abnormalities affecting the kidney, and structural diseases affecting both the liver and the kidney, such as congenital hepatic fibrosis and polycystic kidney disease. When compared with sequential liver and kidney transplant, the rejection rate of both liver and kidney allografts was reported to be lower than with combined liver and kidney transplant. With proper anesthesia management, the probable increased complications with combined liver and kidney transplant can be prevented. In this report, we present the anesthesia care of a 22-year-old patient with primary hyperoxaluria type 1 who had deceased-donor combined liver and kidney transplant.
Anesthetic and Perioperative Management of Nontransplant Surgery in Patients After Liver Transplant
(2017) Ersoy, Zeynep; Ayhan, Asude; Ozdemirkan, Aycan; Polat, Gulsah Gulsi; Zeyneloglu, Pinar; Arslan, Gulnaz; Haberal, Mehmet; 0000-0003-0767-1088; 0000-0003-2312-9942; 0000-0002-3462-7632; 0000-0003-3299-6706; 0000-0001-8285-0372; 28260430; AAF-3066-2021; AAH-7003-2019; C-3736-2018; AAJ-8097-2021; AAJ-2066-2021
Objectives: We aimed to document the anesthetic management and metabolic, hemodynamic, and clinical outcomes of liver-graft recipients who subsequently undergo nontransplant surgical procedures. Materials and Methods: We retrospectively analyzed the data of 96 liver-graft recipients who underwent 144 nontransplant surgeries between October 1998 and April 2016 at Baskent University Hospital. Results: The median patient age at the time of nontransplant surgery was 32 years, and 35% were female (n = 33). The median time between transplant and nontransplant surgery was 1231 days. The most frequent types of nontransplant surgery were abdominal (22%), orthopedic (16%), and urologic (13%). Seventy patients had an American Society of Anesthesiologists status of 2 (49%); the status was 3 in 71 patients (49%) and 4 in 3 patients (2%). Of the 144 procedures, 23 were emergent (16%) and 48% were abdominal. General anesthesia was used in 69%, regional anesthesia in 19%, and sedoanalgesia in 11%. Twenty-five patients required intraoperative blood-product transfusion (17%). Intraoperative hemodynamic instability developed in 17% of patients, and hypoxemia developed in 2%. Eleven patients remained intubated at the end of surgery (8%). Of the 144 procedures, 19 (13%) required transfer to the intensive care unit, 108 (75%) transferred to the ward, and the remaining 17 (12%) were discharged on the same day. Eight patients developed respiratory failure (6%), 7 had renal dysfunction (5%), 4 had coagulation abnormalities (3%), and 10 had infectious complications (7%) in the early postoperative period. The median hospital stay was 4 days, and 5 patients (4%) developed rejection during hospitalization. Five patients died of respiratory or infectious complications (4%). Conclusions: Most liver-graft recipients who undergo nontransplant surgery are given general anesthesia, transferred to the ward after the procedure, and discharged without major complications. We suggest that orthotopic liver transplant recipients may undergo nontransplant surgery without any post operative graft dysfunction.
Bridging Technique of Bile Duct Anastomosis Using An Expanded Polytetrafluoroethylene (Eptfe) Graft in A Porcine Model
(2016) Haberal, Mehmet; Ozdemir, Handan; Bacanli, Didem; Ozcay, Necdet; Ersoy, Zeynep; Torgay, Adnan; https://orcid.org/0000-0002-3462-7632; https://orcid.org/0000-0003-0767-1088; AAJ-8097-2021; AAF-3066-2021
Effect of Graft Weight to Recipient Body Weight Ratio on Hemodynamic and Metabolic Parameters in Pediatric Liver Transplant: A Retrospective Analysis
(2017) Haberal, Mehmet; Ersoy, Zeynep; Kaplan, Serife; Ozdemirkan, Aycan; Torgay, Adnan; Arslan, Gulnaz; Pirat, Arash; 0000-0003-0767-1088; 0000-0002-6829-3300; 0000-0002-3462-7632; 28260433; AAF-3066-2021; AAJ-5221-2021; AAJ-8097-2021; AAH-7003-2019
Objectives: To analyze how graft-weight-to-body-weight ratio in pediatric liver transplant affects intraoperative and early postoperative hemodynamic and metabolic parameters. Materials and Methods: We reviewed data from 130 children who underwent liver transplant between 2005 and 2015. Recipients were divided into 2 groups: those with a graft weight to body weight ratio > 4% (large for size) and those with a ratio <= 4% (normal for size). Data included demographics, preoperative laboratory findings, intraoperative metabolic and hemodynamic parameters, and intensive care follow-up parameters. Results: Patients in the large-graft-for-size group (>4%) received more colloid solution (57.7 +/- 20.1 mL/kg vs 45.1 +/- 21.9 mL/kg; P = .08) and higher doses of furosemide (0.7 +/- 0.6 mg/kg vs 0.4 +/- 0.7 mg/kg; P = .018). They had lower mean pH (7.1 +/- 0.1 vs 7.2 +/- 0.1; P = .004) and PO2 (115.4 +/- 44.6 mm Hg vs 147.6 +/- 49.3 mm Hg; P = .004) values, higher blood glucose values (352.8 +/- 96.9 mg/dL vs 262.8 +/- 88.2 mg/dL; P < .001), and lower mean body temperature (34.8 +/- 0.7 degrees C vs 35.2 +/- 0.6 degrees C; P = .016) during the neohepatic phase. They received more blood transfusions during both the anhepatic (30.3 +/- 24.3 mL/kg vs 18.8 +/- 21.8 mL/kg; P = .013) and neohepatic (17.7 +/- 20.4 mL/kg vs 10.3 +/- 15.5 mL/kg; P = .031) phases and more fresh frozen plasma (13.6 +/- 17.6 mL/kg vs 6.2 +/- 10.2 mL/kg; P = .012) during the neohepatic phase. They also were more likely to be hypotensive (P < .05) and to receive norepinephrine infusion more often (44% vs 22%; P < .05) intra-operatively. More patients in this group were mechanically ventilated in the intensive care unit (56% vs 31%; P = .035). There were no significant differences between the groups in postoperative acute renal dysfunction, graft rejection or loss, infections, length of intensive care stay, and mortality (P > .05). Conclusions: High graft weight-to-body-weight ratio is associated with adverse metabolic and hemodynamic changes during the intraoperative and early postoperative periods. These results emphasize the importance of using an appropriately sized graft in liver transplant.
Evaluation of Coronavirus Diseases (COVID-19) in Terms of Epidemiological and Clinical Features, Comorbidities, Diagnostic Methods, Treatment, and Mortality
(2022) Cekmen, Nedim; Ersoy, Zeynep; Gunay, Yagiz Ilteris; Ghavam, Amir Asian; Tufan, Muhammed Yavuz Selim; Sahin, Ibrahim Mete; 0000-0003-0767-1088; 36177413; AAF-3066-2021
BACKGROUND: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) causes COVID-19. On March 11, 2020, the WHO declared it a pandemic. SARS-CoV-2 indicates that it poses a significant threat to public health and global economy. The aim of the study was to determine (a) patient characteristics, (b) demographic characteristics, (c) comorbidities, diagnostic methods used, treatment, and outcomes, and (d) mortality rates of patients. MATERIALS AND METHODS: This retrospective cohort study included 352 hospitalized adult patients from Baskent University Hospital in Ankara who were confirmed cases of COVID-19 between March 2020 and March 2021. SPSS v. 14.0 was used for statistical analysis. RESULTS: Out of 352 patients, 55 died (males: 37, females: 18), while 297 survived (males: 162, females: 135). The most common comorbidities were hypertension (HT), diabetes mellitus (DM), coronary artery disease (CAD), cancer, Vitamin D deficiency, and chronic obstructive pulmonary disease. Comorbidities associated with mortality rate were obesity (33%) (P = 0.118), Vitamin D deficiency (28%) (P = 0.009), DM (25%) (P = 0.004), CAD (21.2%) (P = 0.142), cancer (20.9%) (P = 0.084), and HT (16.6%) (P = 0.90). Normal ward admission resulted in death in 67.3% and survival in 93.9% (P = 0.001), intensive care unit (ICU) admission resulted in death in 69.1% and survival in 18.5% (P = 0.001), and oxygen therapy was used in 80% death and survival in 39.4% (P = 0.001). CONCLUSIONS: Our study shows that male gender, advanced age, and presence of comorbidities in COVID 19 patients are at higher risk for severe disease, ICU admission, and death. We emphasize that morbidity and mortality can be reduced by early and comprehensive identification of risk factors and the warning systems that will meet the ICU needs of these patients.
Evaluation Of Perioperative Parameters In Patients Undergoing Radical Cystectomy Urinary Diversion Surgery For Bladder Cancer
(2022) Ergenoglu, Pinar; Ersoy, Zeynep; Aribogan, Anis; https://orcid.org/0000-0003-0767-1088; AAF-3066-2021
Purpose: The aim of this study was to evaluate the effect of red blood cell transfusion and/or inotropic/vasopressor agent infusion during intraoperative and postoperative first 24-hour period on 30-day and one-year survival. Materials and Methods: In the final analysis, 133 patients who underwent radical cystectomy and urinary diversion surgery between November 2011 and January 2019 were included in this study. Perioperative anesthesia management early postoperative intensive care patient follow-ups were based on. Results: A statistically significant relationship was found between intraoperative red blood cell transfusion and one-year mortality rates. A statistically significant relationship was found between red blood cell transfusion in the intensive care unit and postoperative 30-day mortality rates. The relationship between vasopressor/inotrope agent infusion in intensive care unit and postoperative 30-day mortality was statistically significant. Conclusion: In radical cystectomy and urinary diversion, intraoperative red blood cell and/or inotrope/vasopressor drug administration, and red blood cell transfusion within first 24 postoperative hours in intensive care unit are associated with lower survival rates in both early and late periods. Future studies should focus on developing and implementing different strategies for perioperative blood management and maintenance of patient hemodynamics that may affect early and late outcomes.
Incidence and Patient Outcomes in Renal Replacement Therapy After Orthotopic Liver Transplant
(2017) Ayhan, Asude; Ersoy, Zeynep; Ulas, Aydin; Zeyneloglu, Pinar; Pirat, Arash; Haberal, Mehmet; 0000-0003-0767-1088; 0000-0003-3299-6706; 0000-0002-3462-7632; 0000-0003-2312-9942; 0000-0002-8130-9901; 28260481; AAF-3066-2021; AAJ-2066-2021; AAJ-8097-2021; AAJ-2057-2021; C-3736-2018
Objectives: Our objective was to evaluate the incidence of renal replacement therapy after orthotopic liver transplant and to evaluate and analyze patient outcomes. Materials and Methods: We performed a retrospective analysis of 177 consecutive patients at a tertiary care unit who underwent orthotopic liver transplant between January 2010 and June 2016. Patients who were admitted to the intensive care unit after orthotopic liver transplant and who required renal replacement therapy were included. Results: A total of 177 (79 adult, 98 pediatric) orthotopic liver transplants were performed during the study period. Of these, 35 patients (19%) required renal replacement therapy during the early posttrans plantation period. After excluding 5 patients with previous chronic renal failure, 30 patients (17%; 20 adult [25%], 10 pediatric [10%]) with acute kidney injury required renal replacement therapy. The mean patient age was 31.1 +/- 20.0 years, with a mean Model for End-stage Liver Disease score of 16.7 +/- 12.3. Of the patients with acute kidney injury who underwent renal replacement therapy, in-hospital mortality was 23.3% (7 of 30 patients), and 40% remained on dialysis. No significant difference was seen in mortality between early versus delayed initiation of renal replacement therapy in patients with stage 3 acute kidney injury (P = .17). Conclusions: Of liver transplant recipients who present with acute kidney injury, 19% require renal replacement therapy, and in-hospital mortality is 20% in the early postoperative period.
Incidence of Acute Kidney Injury Following Liver Transplantation
(2018) Ersoy, Zeynep; Ozdemirkan, Aycan; Zeyneloglu, Pinar; Pirat, Arash; Torgay, Adnan; Haberal, Mehmet; 0000-0003-0767-1088; 0000-0002-6829-3300; 0000-0002-3462-7632; AAF-3066-2021; AAH-7003-2019; AAJ-5221-2021; AAJ-8097-2021
Percutaneous Dilational Tracheotomy in Solid-Organ Transplant Recipients
(2015) Ozdemirkan, Aycan; Ersoy, Zeynep; Zeyneloglu, Pinar; Gedik, Ender; Pirat, Arash; Haberal, Mehmet; 0000-0003-0767-1088; 0000-0002-3462-7632; 0000-0003-2312-9942; 0000-0002-7175-207X; 26640911; AAF-3066-2021; AAH-7003-2019; AAJ-8097-2021; C-3736-2018; ABI-2971-2020
Objectives: Solid-organ transplant recipients may require percutaneous dilational tracheotomy because of prolonged mechanical ventilation or airway issues, but data regarding its safety and effectiveness in solid-organ transplant recipients are scarce. Here, we evaluated the safety, effectiveness, and benefits in terms of lung mechanics, complications, and patient comfort of percutaneous dilational tracheotomy in solid-organ transplant recipients. Materials and Methods: Medical records from 31 solid-organ transplant recipients (median age of 41.0 years [interquartile range, 18.0-53.0 y]) who underwent percutaneous dilational tracheotomy at our hospital between January 2010 and March 2015 were analyzed, including primary diagnosis, comorbidities, duration of orotracheal intubation and mechanical ventilation, length of intensive care unit and hospital stays, the time interval between transplant to percutaneous dilational tracheotomy, Acute Physiology and Chronic Health Evaluation II score, tracheotomy-related complications, and pulmonary compliance and ratio of partial pressure of arterial oxygen to fraction of inspired oxygen. Results: The median Acute Physiology and Chronic Health Evaluation II score on admission was 24.0 (interquartile range, 18.0-29.0). The median interval from transplant to percutaneous dilational tracheotomy was 105.5 days (interquartile range, 13.0-2165.0 d). The only major complication noted was left-sided pneumothorax in 1 patient. There were no significant differences in ratio of partial pressure of arterial oxygen to fraction of inspired oxygen before and after procedure (170.0 [inter quartile range, 102.2-302.0] vs 210.0 [interquartile range, 178.5-345.5]; P=.052). However, pulmonary compliance results preprocedure and postprocedure were significantly different (0.020 L/cm H2O [interquartile range, 0.015-0.030 L/cm H2O] vs 0.030 L/cm H2O [interquartile range, 0.020-0.041 L/cm H2O); P=.001]). Need for sedation significantly decreased after tracheotomy (from 17 patients [54.8%] to 8 patients [25.8%]; P=.004]). Conclusions: Percutaneous dilational tracheotomy with bronchoscopic guidance is an efficacious and safe technique for maintaining airways in solid-organ transplant recipients who require prolonged mechanical ventilation, resulting in possible improvements in ventilatory mechanics and patient comfort.
Perioperative Characteristics of Siblings Undergoing Liver or Kidney Transplant
(2015) Ersoy, Zeynep; Ozdemirkan, Aycan; Pirat, Arash; Torgay, Adnan; Arslan, Gulnaz; Haberal, Mehmet; 0000-0002-3462-7632; 0000-0002-6829-3300; 0000-0003-0767-1088; 26640926; AAJ-8097-2021; AAH-7003-2019; AAJ-5221-2021; AAF-3066-2021
Objectives: Reasons for chronic liver and kidney failure may vary; sometimes more than 1 family member may be affected, and may require a transplant. The aim of this study was to examine the similarities or differences between the peri operative characteristics of siblings undergoing liver or kidney transplant. Materials and Methods: The medical records of 6 pairs of siblings who underwent liver transplant and 4 pairs of siblings who underwent kidney transplant at Baskent University Hospital between 1989 and 2014 were retrospectively analyzed. Collected data included demographic features; comorbidities; reasons for liver and kidney failure; perioperative laboratory values; intraoperative hemodynamic parameters; use and volume of crystalloids, colloids, blood products, cell saver system, and albumin; duration of anesthesia; urine output; and postoperative follow-up data. Results: The mean age of the 6 sibling pairs who underwent liver transplant was 16.3 +/- 12.2 years. All 12 patients had Child-Pugh grade B cirrhosis, with mean disease duration of 7.8 +/- 3.9 years. There were no significant differences between siblings with respect to intraoperative blood product transfusion, crystalloid and colloid fluid replacements, hypotension frequency, blood gas analyses, urinary output, duration of anhepatic phase, inotropic agent administration, post operative laboratory values, need for mechanical ventilation and vasopressors, occurrence of acute renal failure and infections, and duration intensive care unit stay (P>.05). The mean age of the 4 sibling pairs who underwent kidney transplant was 21.3 +/- 6.4 years, with mean duration of renal insufficiency of 2.2 +/- 1.6 years. There were no significant differences between siblings with respect to intraoperative crystalloid and colloid fluid administration, duration of anesthesia, intra operative mannitol and furosemide administration, and postoperative laboratory values (P>.05). Conslusions: In conclusion, the 6 sibling pairs who underwent liver transplant and 4 sibling pairs who underwent kidney transplant in our cohort had similar perioperative characteristics.
PiCCO Monitoring During Liver Transplantation for Pediatric Patients
(2018) Ersoy, Zeynep; Ozdemirkan, Aycan; Zeyneloglu, Pinar; Pirat, Arash; Torgay, Adnan; Kayhan, Zeynep; Haberal, Mehmet; 0000-0003-0767-1088; 0000-0002-6829-3300; 0000-0003-0579-1115; 0000-0002-3462-7632; AAF-3066-2021; AAH-7003-2019; AAJ-5221-2021; AAJ-4623-2021; AAJ-8097-2021
Preliminary Experimental Model for "Ileobladder" and Renal Transplant in Rats and Pigs
(2017) Haberal, Mehmet; Kirnap, Mahir; Gokce, Oruc Numan; Bacanli, Didem; Ersoy, Zeynep; Bayzakov, Mirbek; Torgay, Adnan; Ozdemir, Handan; 0000-0002-3462-7632; 0000-0002-6829-3300; 0000-0003-0767-1088; 0000-0002-6829-3300; 0000-0002-7528-3557; AAJ-8097-2021; AAH-9198-2019; AAJ-5221-2021; AAF-3066-2021; AAJ-5221-2021; X-8540-2019
Prevention of Vascular Stricture By Using An Expanded Polytetrafluoroethylene (Eptfe) Graft in A Porcine Model: Preliminary Study
(2016) Haberal, Mehmet; Ozdemir, Handan; Ozcay, Necdet; Bacanli, Didem; Ersoy, Zeynep; Torgay, Adnan; https://orcid.org/0000-0002-3462-7632; https://orcid.org/0000-0003-0767-1088; https://orcid.org/0000-0002-6829-3300; AAJ-8097-2021; AAF-3066-2021; AAJ-5221-2021
Renal Transplantation for VACTERL Syndrome
(2018) Haberal, Mehmet; Kirnap, Mahir; Sezgin, Atilla; Moray, Gokhan; Yildirim, Sedat; Baskin, Esra; Akdur, Aydincan; Soy, Ebru H. Ayvazoglu; Ersoy, Zeynep; Torgay, Adnan; 0000-0002-3462-7632; 0000-0003-2498-7287; 0000-0002-5735-4315; 0000-0002-8726-3369; 0000-0002-0993-9917; 0000-0003-0767-1088; 0000-0002-6829-3300; AAJ-8097-2021; AAH-9198-2019; AAE-1041-2021; AAF-4610-2019; AAA-3068-2021; AAC-5566-2019; AAF-3066-2021; AAJ-5221-2021
Surgical Complications after Pediatric Kidney Transplantation
(2019) Akdur, Aydincan; Baskin, Esra; Ersoy, Zeynep; Moray, Gokhan; Haberal, Mehmet A.
Surgical complications after pediatric kidney transplantation
(2019) Akdur, Aydincan; Baskin, Esra; Ersoy, Zeynep; Moray, Gokhan; Haberal, Mehmet; 0000-0003-4361-8508; B-5785-2018
SURGICAL COMPLICATIONS AFTER PEDIATRIC KIDNEY TRANSPLANTATION
(2020) Akdur, Aydincan; Baskin, Esra; Ersoy, Zeynep; Moray, Gokhan; Haberal, Mehmet A.
Technique of Ileobladder and Kidney Transplant in Rats and Pigs
(2018) Haberal, Mehmet; Kirnap, Mahir; Gokce, Oruc N.; Bacanli, Didem; Ersoy, Zeynep; Bayzakov, Mirbek; Torgay, Adnan; Ozdemir, Handan; Erdem, Remzi; 0000-0003-0767-1088; 0000-0002-9678-7818; 0000-0002-7528-3557; 0000-0002-6829-3300; 0000-0002-3462-7632; 0000-0002-7537-2170; 29409436; AAF-3066-2021; AAH-9198-2019; AAQ-8259-2021; X-8540-2019; AAJ-5221-2021; AAJ-8097-2021
Objectives: Kidney transplant is the best choice for treatment of patients with advanced chronic renal disease. However, small, poorly compliant, and unstable bladders can result in major problems for patients. Here, we aimed to develop and evaluate a new ileobladder model. Materials and Methods: Fifteen rats (250-300 g) and 5 pigs (similar to 100 kg) were cared for according to institutional and published guidelines. After general anesthesia, laparotomy was done through midline incision. Ileal loops were prepared for ileobladder. After cystectomy (0.5 cm above the trigone in rats, 1 cm above the trigone in pigs), anastomoses were done between antimesenteric sides of ileal loops and bladder remnant with 6/0 Prolene suture. Three other pigs received simultaneous renal transplant. Results: One rat died on day 1 postsurgery from multiorgan hemorrhage. Two rats survived for 5 days, 3 rats for 7 days, and 3 rats for 11 days; 6 rats were killed for pathologic evaluation after 3 months. One pig survived for 22 days and 1 for 9 days. Of the 3 pigs that received a simultaneous renal transplant, 2 pigs were alive and doing well 80 and 72 days after surgery with normal urinary discharge (1 pig was killed for pathologic evaluation after 3 days). When ileobladder was opened, complete recovery of the anastomosis line was observed. Pathologic examination of the anastomosis sites reported a normal healing process with moderate inflammation and the muscular wall of the intestine showed hypertrophia that nearly reached the size of the bladder muscularis propria. Conclusions: Although we had some complications because no draining procedure was used, in terms of technique, our new ileobladder model is promising for providing functional bladder volume. A larger scale series in the clinical setting is planned. This technique can be useful for small bladders and bladder physiology disorders.