Browsing by Author "Karakayali, Feza Yarbug"

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Acute Appendicitis During Coronavirus Disease 2019 in Turkiye: Changes in Clinical Approach, Treatment, and Diagnosis Modalities: A Retrospective and Cohort Study
(2022) Ersoz, Siyar; Bozkurt, Mehmet Abdussamet; Kulle, Cemil Burak; Elhan, Atilla Halil; Gulcu, Baris; Tarim, Ismail Alper; Bozbiyik, Osman; Yasar, Necdet Fatih; Atalay, Vafi; Yonder, Huseyin; Yalav, Orcun; Kuzu, Mehmet Ayha; Karakayali, Feza Yarbug; 36453790
BACKGROUND: The novel coronavirus disease 2019 (COVID-19) has resulted in major changes in health-care systems and emergency surgical interventions. Here, we examined patients with acute appendicitis who presented to emergency departments and compared diagnosis, treatment, and post-treatment processes before and during the pandemic period and investigated how the pandemic affected management of acute appendicitis. METHODS: A national, multicenter, and cohort study model was designed that included patients older than 18 years of age diagnosed with acute appendicitis clinically and/or radiologically, with patients compared before (pre-pandemic period: January 1-April 30, 2019) and after (pandemic period: January 1-April 30, 2020) the pandemic. Our investigation included comparisons of pre-operative imaging methods, presence of plastron appendicitis/abscess, conservative/surgical approach, type of anesthesia given, laparoscopic/ open surgical approach, bowel resection rates, drain insertion rates, and presence of post-operative complications RESULTS: For the two study groups, 8972 patients from 69 centers were examined, with 4582 patients operated in the pre-pandemic period and 4234 patients operated in the pandemic period. During the pandemic period, 63.6% of patients underwent open surgery, whereas 34.4% had laparoscopic surgery. Although 60 patients (1.3%) requested non-operative follow-up in the pre-pandemic period, 94 patients (2.2%) requested this in the pandemic period. When conditions of patients were evaluated regardless of their own wishes, 114 patients (2.4%) before and 163 patients (3.8%) during the pandemic received non-operative follow-up. CONCLUSION: Our study did not show the direct correlation between the application of COVID-19-related restrictions and the severity of acute appendicitis. Although non-operative management rates have been increased during the COVID-19 period, the incidences of both complicated and the uncomplicated appendicitis were similar during the COVID-19 crisis period. Given this information non-operative management can be employed for patients diagnosed with appendicitis.
Clinical Outcomes of Liver Transplantation for Patients Over 60 Years Old: a Single-Center Experience
(2022) Akdur, Aydincan; Karakaya, Emre; Soy, Hatice Ebru Ayvazoglu; Karakayali, Feza Yarbug; Moray, Gokhan; Haberal, Mehmet; https://orcid.org/0000-0002-4879-7974; https://orcid.org/0000-0002-3462-7632; 35384805; AAD-5466-2021; AAJ-8097-2021
Objectives: Although advanced age is no longer considered an absolute contraindication for liver transplant, transplant in elderly patients with comorbid diseases remains debatable because of high risks with surgery. Here, we report patient outcomes in this population. Materials and Methods: We retrospectively reviewed medical records of 276 liver transplant recipients, grouped by age. Group 1 (=59 years old) consisted of 247 recipients, and group 2 (=60 years old) consisted of 29 recipients. Reviewed data included age, sex, cause of liver disease, presence of hepatocellular carcinoma, Child-Pugh and Model for End-Stage Liver Disease scores, survival, and posttransplant complications. Results: In both groups,mostpatients (n = 108) required liver transplant for hepatitis B virus. Mean age was 40 +/- 12.3 and 63 +/- 2.3 years in groups 1 and 2, respectively, with more men than women in both group 1 (71.7% vs 28.3%) and group 2 (75.9% vs 24.1%). No significant differences were shown between groups for patient characteristics, except group 1 had significantly higher Model for End-Stage Liver Disease score. Group 1 mean survival time was 10.2 +/- 0.6 years, with patient survival rates at 1, 5, 10, and 15 years of 65.5%, 53%, 46.3%, and 40%, respectively. In group 2, respective results were 10.6 +/- 1.3 years and 75.9%, 68.6%, 61%, and 48.8% (no significant difference vs group 1). Conclusions: Liver transplant recipients >60 years of age had survival rates, acute rejection rates, and complications similar to younger recipients. Liver transplant should not be withheldfromolderrecipients on the basis of age alone. However, comprehensive screening for comorbidities should be performed.
Corner-Saving Renal Artery Anastomosis for Renal Transplantation
(2018) Akdur, Aydincan; Kus, Murat; Moray, Gokhan; Yildirim, Sedat; Karakayali, Feza Yarbug; Caliskan, Kenan; Haberal, Mehmet; 0000-0002-8726-3369; 0000-0001-6529-7579; 0000-0003-2498-7287; 0000-0002-5735-4315; 0000-0002-1874-947X; 0000-0002-8767-5021; 0000-0002-3462-7632; AAA-3068-2021; AAJ-7870-2021; AAE-1041-2021; AAF-4610-2019; AAB-3888-2021; AAJ-7201-2021; AAJ-8097-2021
Deceased-donor transplantation activities at Baskent University
(2019) Haberal, Mehmet; Kirnap, Mahir; Akdur, Aydincan; Moray, Gokhan; Karakayali, Feza Yarbug; Yildirim, Sedat; Caliskan, Kenan; Torgay, Adnan; Arslan, Gulnaz
Deceased-donor transplantation activities in Turkey
(2019) Haberal, Mehmet; Akdur, Aydincan; Moray, Gokhan; Karakayali, Feza Yarbug; Yildirim, Sedat; Caliskan, Kenan; Torgay, Adnan; Arslan, Gulnaz
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
Increased Mortality Among Renal Transplant Patients With Invasive Pulmonary Aspergillus Infection
(2018) Balcan, Baran; Ozcelik, Umit; Ugurlu, Aylin Ozsancakli; Aydin, Mehtap; Nalcaci, Serdar; Karakayali, Feza Yarbug; 0000-0003-1073-2494; 0000-0003-3598-3986; 0000-0003-4044-9366; 0000-0002-1874-947X; 30235978; A-4721-2018; AAG-8651-2021; AAA-2925-2020; HLX-0937-2023; AAB-3888-2021
Introduction: Renal transplantation is the most effective and preferred definite treatment option in patients with end-stage renal disease. Due to long-term immunesuppressive treatment, renal transplant recipients become vulnerable to opportunistic infections, especially to fungal infections. Method: This was a single-center, retrospective observational study of 438 patients who underwent renal transplantation between 2010 and 2016. Results: Thirty-eight renal transplant recipients who had lower respiratory tract infection with median age of 41.5 years were evaluated for invasive pulmonary aspergillus (IPA). Of these, 52.6% were female and 84.2% had living donors. Eleven of 38 lower respiratory patients were found to have IPA infection, 5 with proven infection. Compared to patients who did not have fungal pulmonary infection, patients with invasive aspergillus were older and had high fever, galactomannan levels, and leukocyte counts. Mortality was also higher in those patients. Having fever at the baseline and IPA infection was significantly associated with mortality in univariate analysis and remained related in multivariate model after adjustment for age, gender, and fever. Conclusion: Invasive pulmonary aspergillus infection is highly associated with increased mortality rates in renal transplant patients. Fungal pulmonary infections in immune-suppressed patients should be diagnosed and treated immediately in order to avoid the life-threatening complications and may greatly improve prognosis.
Liver and Kidney Transplant During a 6-Month Period in the COVID-19 Pandemic: A Single-Center Experience
(2020) Akdur, Aydincan; Karakaya, Emre; Soy, Ebru H. Ayvazoglu; Karakayali, Feza Yarbug; Yildirim, Sedat; Torgay, Adnan; Sayin, Cihat Burak; Coskun, Mehmet; Moray, Gokhan; Haberal, Mehmet; 0000-0002-1874-947X; 0000-0002-6829-3300; 0000-0002-8726-3369; 0000-0002-0993-9917; 0000-0002-3462-7632; 0000-0002-5735-4315; 0000-0002-4879-7974; 0000-0003-2498-7287; 0000-0001-5630-022X; 33143601; AAB-3888-2021; AAJ-5221-2021; AAA-3068-2021; AAC-5566-2019; AAJ-8097-2021; AAF-4610-2019; AAD-5466-2021; AAE-1041-2021; AAM-4120-2021
Objectives: With the declaration of COVID-19 as a pandemic, many studies have indicated that elective surgeries should be postponed. However, post-ponement of transplants may cause diseases to get worse and increase the number in wait lists. We believe that, with precautions, transplant does not pose a risk during pandemic. Here, we aimed to evaluate our transplant results, which we safely performed during a 6-month pandemic period. Materials and Methods: Until September 2020, 3140 kidney and 667 liver transplants have been performed in our centers. We evaluated 38 kidney transplants and 9 liver transplants procedures performed during the pandemic (March 1 to September 2, 2020). Recipient and donor candidates were screened for COVID-19 with polymerase chain reaction and thoracic computed tomography. All recipients had routine immunosuppressive protocol. During hospitalization at our COVID-19-free transplant facility, we restricted the interactions during multidisciplinary rounds. Results: During the pandemic, 38 kidney transplants with an average length of hospital stay of 8.1 days were performed. Mean serum creatinine values of recipients were 0.91, 0.86, and 0.74 mg/dL on postoperative days 7, 30, and 90, respectively. During the pandemic, 9 living donor liver transplants (1 adult, 8 pediatric) were performed with an average length of hospital stay of 17.1 days. Mean serum total bilirubin levels were 0.9, 0.5, and 0.4 mg/dL on postoperative days 7, 30, and 90, respectively. Mean serum aspartate aminotransferase levels were 38.1, 28.3, and 22.3 U/L on postoperative days 7, 30, and 90, respectively. All recipients and donors were successfully discharged. Only 1 liver recipient died (on day 55 after discharge as a result of oxalosis-induced heart failure). Conclusions: According to our results, when precautions are taken, transplant does not pose a risk to patients during the pandemic period. We attribute the safety and success shown to our newly developed protocol in response to the COVID-19 pandemic.
LIVER TRANSPLANTATION AT BASKENT UNIVERSITY
(2020) Akdur, Aydincan; Karakaya, Emre; Karakayali, Feza Yarbug; Moray, Gokhan; Torgay, Adnan; Habera, Mehmet A.
Long-term and Perioperative Outcomes of Laparoscopic and Open Surgery for Rectal Cancer
(2018) Aydin, Huseyin Onur; Ekici, Yahya; Karakayali, Feza Yarbug; Tezcaner, Tugan; Ozgun, Gonca; Yildirim, Sedat; Moray, Gokhan
Objectives: The necessity of comparing oncologic results with the use of minimally invasive surgery in rectal cancer has arisen. The aim of the present study was to evaluate the treatment approach in rectal cancer and to compare the outcomes of laparoscopic and open surgery. Methods: Patients who underwent surgery for rectal carcinoma between January 2006 and January 2016 in our institution were evaluated. The results were compared between the two groups according to open or laparoscopic surgery. Clinical characteristics, preoperative and postoperative results, pathological examination results, and disease-free survival rates were compared after the surgical procedure. Results: A total of 121 patients were included in the study. Of the patients, 50 underwent open, and 71 underwent laparoscopic surgery. The median follow-up times were 56.75 months in the open surgery group and 55.2 months in the laparoscopic surgery group. Pathological examination revealed similar numbers of lymph nodes in both groups (p>0.05). The duration of hospital stay was statistically significantly lower in the open surgery group than in the laparoscopic group (p<0.05). The rates of disease-free survival were 74% in the open surgery group and 82.5% in the laparoscopic group, and no statistically significant difference was found (p>0.05). Conclusion: There was no significant difference in complication and recurrence between laparoscopic and open surgery for rectal cancer in our study. The duration of hospital stay of patients was statistically significantly lower in the laparoscopic group than in the open surgery group. Laparoscopic or open surgical options could be preferred according to the clinical suitability of the patient, experience of the surgeon, and resources of the center in rectal cancer treatment.
LONG-TERM RESULTS OF LIVING DONOR KIDNEY TRANSPLANTATION
(2020) Akdur, Aydincan; Karakayali, Feza Yarbug; Caliskan, Kenan; Moray, Gokhan; Arslan, Gulnaz; Haberal, Mehmet A.
MANAGEMENT OF PORTAL VENOUS COMPLICATIONS AFTER LIVER TRANSPLANT
(2020) Karakaya, Emre; Akdur, Aydincan; Bovyat, Fatih; Karakayali, Feza Yarbug; Moray, Gokhan; Haberal, Mehmet A.
Our Experience with Paired Kidney Exchange Transplantation
(2018) Haberal, Mehmet; Akdur, Aydincan; Karakayali, Feza Yarbug; Ozcelik, Umit; Moray, Gokhan; Kulah, Eyyup; Inal, Ali; Torgay, Adnan; Arslan, Gulnaz; 0000-0002-3462-7632; 0000-0002-8726-3369; 0000-0002-1874-947X; 0000-0003-1073-2494; 0000-0003-2498-7287; 0000-0001-6041-4254; 0000-0002-0690-2529; 0000-0002-6829-3300; AAJ-8097-2021; AAA-3068-2021; AAB-3888-2021; AAG-8651-2021; AAE-1041-2021; AAJ-5764-2021; J-8056-2012; AAJ-5221-2021
The Outcomes of Ultralow Anterior Resection or an Abdominoperineal Pull-Through Resection and Coloanal Anastomosis for Radiation-Induced Recto-Vaginal Fistula Patients
(2016) Karakayali, Feza Yarbug; Tezcaner, Tugan; Ozcelik, Umit; Moray, Gokhan; https://orcid.org/0000-0002-1874-947X; https://orcid.org/0000-0002-3641-8674; https://orcid.org/0000-0003-1073-2494; https://orcid.org/0000-0003-2498-7287; 26628070; AAB-3888-2021; AAD-9865-2021; AAG-8651-2021; AAE-1041-2021
The purpose of this study was to evaluate the outcomes of patients who underwent colorectal resections and coloanal anastomosis for radiation-induced recto-vaginal fistulas (RVFs). The effect of the surgical treatment technique on bowel function, fecal continence, and quality of life of patients was also evaluated. Twenty-one female patients, who received adjuvant chemotherapy and external beam pelvic radiation for cervix carcinoma after radical hysterectomy + pelvic/paraaortic lymph node dissection, having RVF but without tumor recurrence, were included. All patients underwent an ultralow anterior resection (n = 11) or an abdominoperineal pull-through resection and straight coloanal anastomosis (n = 10). A bowel functions questionnaire and a Fecal Incontinence Quality of Life (FIQLI) questionnaire were applied to patients pre-operatively and also 6 months after the ileostomy closure procedures. No recurrent RVF was observed in a mean follow-up period of 20 months after ostomy reversal procedures. The FIQLI depression, lifestyle, and embarrassment scores were significantly improved on the follow-up questionnaire. The mean pre- and post-operative incontinence scores were not significantly different. The spontaneous closure rate after a simple diverting stoma is quite low and local repair procedures usually result in failure. In selected patients, performing a nearly total rectum resection and maintaining the intestinal continuity with a coloanal anastomosis may be accepted as a safe and curative option. Recurrence-free outcome and the improvement of the quality of life of the patients represent the efficiency of this treatment modality.
Results of BK Virus Screening in Renal Transplant Recipients
(2016) Ozcelik, Umit; Bircan, Huseyin Yuce; Aydin, Mehtap; Kulah, Eyyup; Karakayali, Feza Yarbug; Haberal, Mehmet; https://orcid.org/0000-0003-1073-2494; https://orcid.org/0000-0003-4044-9366; https://orcid.org/0000-0002-1874-947X; https://orcid.org/0000-0002-3462-7632; AAG-8651-2021; R-6394-2019; HLX-0937-2023; AAB-3881-2021; AAB-3888-2021; AAJ-8097-2021
Results of Liver Transplant in Elderly Patients: A Single Center Experience
(2015) Akdur, Aydincan; Fidan, Cihan; Soy, Ebru Ayvazoglu; Kirnap, Mahir; Karakayali, Feza Yarbug; Torgay, Adnan; Yildirim, Sedat; Moray, Gokhan; Haberal, Mehmet; 0000-0002-5735-4315; 0000-0002-9093-1524; 0000-0002-8726-3369; 0000-0002-3462-7632; 0000-0002-1874-947X; 0000-0002-0993-9917; 0000-0003-2498-7287; 0000-0002-6829-3300; 25894140; AAF-4610-2019; AAH-9198-2019; F-5830-2019; AAA-3068-2021; AAJ-8097-2021; AAB-3888-2021; AAC-5566-2019; AAE-1041-2021; AAJ-5221-2021
Objectives: With the increased life span, the need for liver transplant for elderly patients also increased in the world. In this study, we reviewed our experience to determine the outcomes and problems of patients aged > 60 years who had liver transplants. Materials and Methods: Data of recipients aged > 60 years were reviewed retrospectively. We analyzed 16 elderly patients who had liver transplant for chronic liver disease between 2001 and 2014 in our center. Results: In our series, there were 5 women and 11 men between age 60 and 65 years. The mean Child-Pugh score was 7.9 +/- 1.7 and Model for End-Stage Liver Disease score was 14.1 +/- 5.1. Primary liver disease was hepatitis B in 9 patients (34.5%), most of them with hepatocellular carcinoma. The other causes of liver failure were hepatitis C (n = 4), alcoholic cirrhosis (n = 2), and cryptogenic cirrhosis (n = 2); 1 patient had both hepatitis B and hepatitis C virus, and 1 patient had both hepatitis B virus and alcoholic cirrhosis. There were 9 patients who had hepatocellular carcinoma. Mortality was observed in 4 patients. The reasons for mortality were sepsis (n=3) and hepatocellular carcinoma (n=1). Conclusions: Liver transplant can be safely performed and has acceptable long-term outcomes in low-risk elderly recipients. Age alone should not be a contraindication for liver transplant in elderly patients.
Surgical Complications After Kidney Transplantation
(2016) Haberal, Mehmet; Boyvat, Fatih; Akdur, Aydincan; Kirnap, Mahir; Ozcelik, Umit; Karakayali, Feza Yarbug; 0000-0002-3462-7632; 0000-0002-8726-3369; 0000-0003-1073-2494; 0000-0002-1874-947X; 27934557; AAJ-8097-2021; F-4230-2011; AAA-3068-2021; AAH-9198-2019; AAG-8651-2021; AAB-3888-2021
Since the first successful organ transplant conducted between twins in 1954, kidney transplant has evolved considerably over the past 50 years. Kidney transplant plays an important role in the treatment of end-stage kidney disease to improve the quality of life and prolong the life of patients. Despite significant advances, postoperative medical and surgical complications still represent important causes of morbidity and mortality. Many problems can be avoided through prophylactic correction of abnormalities detected during the preoperative evaluation; however, it is critical that technical mishaps at all stages of the transplant process (donor nephrectomy, benchwork preparation, and implant) be prevented and that careful postoperative monitoring be carried out, including thorough examination by attending physicians. However, despite these advances, surgical complications still present serious problems in kidney transplant recipients.
Surgical Treatment for Ureteral Obstruction After Kidney Transplantation
(2018) Haberal, Mehmet; Boyvat, Fatih; Akdur, Aydincan; Kirnap, Mahir; Ozcelik, Umit; Karakayali, Feza Yarbug; 0000-0002-3462-7632; 0000-0002-8726-3369; 0000-0003-1073-2494; 0000-0002-1874-947X; AAJ-8097-2021; F-4230-2011; AAA-3068-2021; AAH-9198-2019; AAG-8651-2021; AAB-3888-2021
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.