Browsing by Author "Gemici, Atilla"

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Bilateral Native Kidney Papillary Renal Cell Carcinomas in a 11-Year-Old Renal Transplant Patient
(2022) Durakbasa, Cigdem Ulukaya; Ugurlu, Deniz; Bozbeyoglu, Sabriye Gulcin; Aydoner, Sinem; Seneldir, Hatice; Candir, Mehmet Onur; Candan, Cengiz; Gemici, Atilla; 36474523
Renal cell carcinomas (RCCs) are the most common renal tumors in adults and are usually sporadic and unilateral. Renal transplant recipients have an increased risk of developing RCC. RCC development after kidney transplantation is very rarely reported in children. We present a 11-year-old boy who had cadaveric kidney transplantation for kidney failure 2 years ago. He was under immunosuppressive therapy and presented with microscopic hematuria. An ultrasound (US) revealed bilateral solid renal masses. Further cross-sectional imaging showed a 60 x 70 x 60-mm right renal mass with claw sign and a 5 x 6 x 6-mm mass in the left renal lower pole. A bilateral radical nephroureterectomy of native kidneys was performed. The pathology revealed bilateral papillary RCC without TFE3 upregulation. The patient was kept on low-dose immunosuppressive therapy in the perioperative period. He received no chemotherapy but a close radiological surveillance was undertaken. He is tumor-free 2 years after the operation. RCC is a rare tumor for children and bilateralism is even rarer. The child had a history of chronic kidney disease, peritoneal dialysis, and immunosuppressive therapy. As there are no standardized protocols regarding imaging in transplanted kidneys routine surveillance, US follow-up should also focus on detecting malignancy.
Eculizumab Therapy for Late Antibody-Mediated Rejection in Pediatric Kidney Transplant Patients
(2022) Siddiqui, Meraj Alam; Baskin, Esra; Karakayali, Feza Yarbug; Gemici, Atilla; Gulleroglu, Kaan; Yilmaz, Aysun Caltik; Moray, Gokhan; Haberal, Mehmet; 0000-0003-1434-3824; 0000-0002-3462-7632; AAJ-8833-2021; AAJ-8097-2021
Use of Eculizumab in Pediatric Patients with Late Antibody-Mediated Rejection After Kidney Transplantation
(2022) Siddiqui, Meraj Alam; Baskin, Esra; Karakayali, Feza Yarbug; Gemici, Atilla; Gulleroglu, Kaan; Yilmaz, Aysun Caltik; Moray, Gokhan; Haberal, Mehmet; 0000-0002-3462-7632; 0000-0003-0774-4419; 0000-0003-1434-3824; 0000-0002-5739-6590; 35570600; AAJ-8097-2021; AAD-1877-2021; AAJ-8833-2021; ABF-7609-2022
Late antibody-mediated rejection triggered by donor-specific antibodies is a leading cause of kidney allograft failure. Effective treatment options for late antibody-mediated rejection are limited in renal transplant recipients. Here, we report 2 pediatric cases of severe late antibody-mediated rejection resistant to conventional immunosuppressive therapy who were successfully treated with eculizumab. Two patients who fulfilled the late antibody-mediated rejection diagnostic criteria (positive donor-specific antibodies, elevated mean fluorescence index, acute and/or chronic morphological lesions in the microvasculature, and abnormal kidney function test) were included in this study. Both patients were previously unsensitized with negative panel-reactive antibody. Case 1 was a 12-year-old male patient with kidney failure secondary to vesicoureteral reflux who underwent related-living donor kidney transplantation 2 years ago. Eleven months later, he was diagnosed with late antibody-mediated rejection. Despite an aggressive conventional immunosuppressive regimen, signs of rejection persisted. After the patient was treated with 2 doses of eculizumab, his mean fluorescence index dropped and serum creatinine decreased from 3.8 to 1.5 mg/dL. Case 2 was an unsensitized 16-year-old male patient with kidney failure secondary posterior urethral valve who underwent related-living donor kidney transplantation 4 years ago. Two years later, he was diagnosed with late antibody-mediated rejection. Despite an aggressive conventional immunosuppressive regimen, signs of rejection persisted. After treatment with 2 doses of eculizumab, his mean fluorescence index dropped and serum creatinine decreased from 2.1 to 1.01 mg/dL. In both patients, eculizumab therapy effectively reduced the markers of late antibody-mediated rejection and improved the kidney function.