Browsing by Author "Soy, Ebru Ayvazoglu"

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BK Polyomavirus Infection and Risk Factors in Pediatric Patients Undergoing Kidney Transplant
(2022) Avci, Begum; Baskin, Esra; Gulleroglu, Kaan; Ecevit, Zafer; Soy, Ebru Ayvazoglu; Moray, Gokhan; Haberal, Mehmet; 35570612
Objectives: BK polyomavirus infection is a critical complication affecting graft survival after kidney transplant. We aimed to determine the frequency, the effect on graft function, and the risk factors of BK polyomavirus infection in pediatric kidney transplant patients. Materials and Methods: We retrospectively reviewed data of 144 pediatric patients (female/male: 67/77; 0-18 years of age) who received kidney transplants in the past 10 years at our center. Demographic/laboratory data, kidney failure etiologies, donor types, and immunosuppressive treatments were recorded. Patients were grouped as those with and without BKV infection, with groups compared in terms of transplant age, sex, kidney failure etiology, donor type, immunosuppressive treatments, presence of ureteral stents, acute rejection episodes, accompanying viral infections, glomerular filtration rate, and graft loss rate. Results: Twelve patients (8.3%) had BK polyomavirus infection. All 12 patients had viruria (8.3%), 8 (5.5%) had viremia, and 4 (2.8%) had BK polyomavirus nephropathy. Two patients (1.4%) had graft loss because of BK polyomavirus nephropathy. When patients with and without infection were compared, no significant differences were found in terms of sex, transplant age, donor type, presence of a ureteral stent, acute rejection, graft loss, or immunosuppressive treatment (P > .05). Rates of congenital anomalies of the kidney and urinary tract were 30.3% and 66.6% in those without and with BK polyomavirus infection, respectively (P < .05). The group positive for BK polyomavirus had a significantly higher incidence of cytomegalovirus infection versus the group without infection (P < .05). Glomerular filtration rate values at years 1 and 3 were similar between groups (P > .05). Conclusions: Frequency of BK polyomavirus nephropathy in pediatric patients undergoing kidney transplant in our center was consistent with data from other centers. Graft loss can be prevented by early detection and treatment through close periodic control and adequate evaluation of risk factors.
Differences in Antibody Responses Between an Inactivated SARS-CoV-2 Vaccine and the BNT162b2 mRNA Vaccine in Solid-Organ Transplant Recipients
(2021) Erol, Cigdem; Yalcin, Tugba Yanik; Sari, Nuran; Bayraktar, Nilufer; Soy, Ebru Ayvazoglu; Colak, Meric Yavuz; Azap, Ozlem; Arslan, Hande; Haberal, Mehmet; 0000-0002-3462-7632; 0000-0002-2535-2534; 0000-0002-0993-9917; 0000-0002-5708-7915; 0000-0001-5996-8639; 0000-0002-3165-4520; 34951350; AAJ-1219-2021; AAC-5566-2019; AAJ-8097-2021; ABG-7034-2021; AAA-4708-2022
Objectives: Vaccination against SARS-CoV-2 may reduce COVID-19 mortality and complications in solidorgan transplant recipients, and we evaluated the associated antibody responses and adverse effects in this high-risk population. Materials and Methods: This prospective observational study (April-June 2021) included 10 liver and 38 kidney transplant recipients who received 2 vaccine doses (Sinovac, n = 31; or BioNTech, n = 17) and 56 healthy adults (Sinovac), all of whom provided 3 blood samples (prevaccination, 4 weeks after first dose, and 4-6 weeks after second dose) for quantitative tests (Abbott Quant assay for immunoglobulin G antibodies against SARS-CoV-2 spike protein). Type I error was alpha = .05 in all statistical analyses (SPSS, version 25). Results: We analyzed demographic data, antibody responses, and adverse events after 2 doses of SARS-CoV-2 vaccine, compared immune responses from solidorgan transplant recipients (median age, 36.5 years) versus healthy patients (median age, 37.5 years), and observed significantly higher seropositivity in healthy versus transplant patients after Sinovac vaccination (100% vs 67.5%; P = .001). However, we observed no significant seropositive differences for Sinovac versus BioNTech second doses in transplant recipients. Median SARS-CoV-2 immunoglobulin G level after second dose was significantly higher in BioNTech (1388.6 AU/mL) versus Sinovac patients (136.6 AU/mL) (P = .012). The seropositivity difference between the 2 vaccines was significant in participants 24 to 44 years old (P = .040). The rate of at least 1 side effect was 82.4% (n = 14) for BioNTech vaccine and 32.3% (n = 10) for Sinovac vaccine, and the difference was statistically significant. The most common side effect was arm pain (significantly higher in BioNTech group). Conclusions: Solid-organ transplant recipients demonstrated inadequate vaccine responses (higher risk of complications and mortality) versus healthy patients. Furthermore, immune responses may differ between vaccines. Therefore, additional vaccine doses and strict control measures remain crucial.
Effect of Post-Transplant Cardiac Angiographic Procedures on Post-Transplant Renal Function
(2022) Keskin, Suzan; Ciftci, Orcun; Soy, Ebru Ayvazoglu; Muderrisoglu, Haldun; Haberal, Mehmet; 0000-0002-0993-9917; 0000-0002-3462-7632; 35918191; AAC-5566-2019; AAJ-8097-2021
Background. Cardiac interventions often are performed before and after renal transplant for coronary artery disease. The aim of this study was to investigate whether post-transplant cardiac coronary procedures affect post-transplant renal function. Method. We retrospectively included renal transplant recipients who underwent renal transplant procedures at Baskent University between April 28, 1997 and January 20, 2020. We analyzed the effect of cardiac catheterization in renal transplant recipients between 6 and 12 months post-transplant with post-transplant renal function assessed by glomerular filtration rate (GFR). We compared the effect of the type of coronary intervention on GFR change in group 1, whereby group 1 was divided into 2 subgroups (coronary artery bypass grafting [CABG] and stenting). Group 1 included patients who underwent cardiac intervention, whereas group 2 included those who had not undergone cardiac intervention. Results. In all, 108 patients underwent coronary angiography; 45 (41.7%) had normal coronaries or minimal coronary artery disease (CAD); 37 (34.3%) underwent stent implantation; 26 (24.1%) underwent CABG. The mean post- transplantation GFR of all patients after cardiac catheterization was 84.26+25.91 (mL/min/1.73 m(2)). The final, after 12 months mean GFR of all patients was 69.55+27.05. The final GFR was significantly lower than the initial post-renal GFR value in patients who underwent cardiac intervention but not in non-intervened patients. Conclusion. Invasive cardiac revascularization procedures showed a negative effect on posttransplant renal function in renal transplant recipients. All renal transplant recipients who underwent cardiac intervention survived the intervention, and there was no mortality. The reason for this outcome was assumed to be because of the short follow-up period.
Effect of Subcutaneous Topical Ozone Therapy on Second-Degree Burn Wounds in Rats: An Experimental Study
(2021) Karakaya, Emre; Akdur, Aydincan; Soy, Ebru Ayvazoglu; Araz, Coskun; Atilgan, Alev Ok; Ozer, Eda Ozturan; Sencelikel, Tugce; Haberal, Mehmet; 0000-0002-3462-7632; 0000-0002-0993-9917; 0000-0002-8726-3369; AAJ-8097-2021; AAC-5566-2019; AAA-3068-2021
Burns are one of the most severe traumas, causing coagulative destruction of the skin. The use of various products that accelerate wound healing in patients with burns may affect rates of patient survival and reduce complications. We studied the effects of subcutaneous ozone injection on second-degree burn wounds in an animal model. For this study, 72 Sprague-Dawley male rats were divided randomly into the following three groups: control group, silver sulfadiazine group, and ozone group; each group was then divided randomly into two subgroups (day 7 or day 14 examination and euthanized). Superficial partial-thickness burns were created on the lower back. In the control group, subcutaneous 0.9% serum saline was injected daily into the burn area. In the silver sulfadiazine group, burns were dressed daily with silver sulfadiazine. In the ozone group, subcutaneous ozone was injected daily into the burn area. We performed tissue hydroxyproline level measurements and histopathological evaluations. When groups were compared in terms of weight change, no significant difference was found between day 7 and day 14. With regard to tissue hydroxyproline levels, the ozone group had significantly higher levels on both days 7 and 14 (P < .001). In histopathological evaluations, we determined that wound healing in the ozone group was significantly higher than in the other groups. We found that subcutaneous ozone therapy was more effective than silver sulfadiazine in the healing process of second-degree burn wounds and could be safely used in the treatment of burn wounds.
Liver TNF - ALPHA Expression Predicts Acute Allograft Rejection and Graft Survival
(2017) Ozdemir, B. Handan; Ozgun, Gonca; Soy, Ebru Ayvazoglu; Ozcay, Figen; Haberal, Mehmet; 0000-0002-7528-3557; 0000-0002-0993-9917; 0000-0002-5214-516X; 0000-0002-3462-7632; X-8540-2019; AAC-5566-2019; ABG-5684-2020; AAJ-8097-2021
A model for acute kidney injury in severe burn patients
(2022) Karakaya, Emre; Akdur, Aydincan; Aydogan, Cem; Turk, Emin; Sayin, Cihat Burak; Soy, Ebru Ayvazoglu; Yucebas, Sait Can; Alshalabi, Omar; Haberal, Mehmet; 0000-0002-4879-7974; 0000-0002-8726-3369; 0000-0002-8726-3369; 0000-0002-0993-9917; 0000-0002-3462-7632; 33879373; AAD-5466-2021; AAA-3068-2021; AAA-3068-2021; AAC-5566-2019; AAJ-8097-2021
Introduction: In patients with severe burns, morbidity and mortality are high. One factor related to poor prognosis is acute kidney injury. According to the AKIN criteria, acute kidney injury has 3 stages based on urine output, serum creatinine level, and renal replacement therapy. In this study, we aimed to create a decision tree for estimating risk of acute kidney injury in patients with severe burn injuries. Methods: We retrospectively evaluated 437 adult patients with >20% total burn surface area injury who were treated at the Baskent University Ankara and Konya Burn Centers from January 2000 to March 2020. Patients who had high-voltage burn and previous history of kidney disease were excluded. Patient demographics, medical history, mechanism of injury, presence of inhalation injury, depth of burn, laboratory values, presence of oliguria, need for renal replacement therapy, central venous pressure, and prognosis were evaluated. These data were used in a "decision tree method" to create the Baskent University model to estimate risk of acute kidney injury in severe burn patients. Results: Our model provided an accuracy of 71.09% for risk estimation. Of 172 patients, 78 (45%) had different degrees of acute kidney injury, with 26 of these (15.1%) receiving renal replacement therapy. Our model showed that total burn surface area was the most important factor for estimation of acute kidney injury occurrence. Other important factors included serum creatinine value, burn injury severity score, hemoglobin value, neutrophil-tolymphocyte ratio, and platelet count. Conclusion: The Baskent University model for acute kidney injury may be helpful to determine risk of acute kidney injury in burn patients. This determination would allow appropriate treatment to be given to high-risk patients in the early period, reducing the incidence of acute kidney injury. (c) 2021 Published by Elsevier Ltd.
De Novo Thrombotic Microangiopathy in Renal Transplant Patients
(2018) Ozdemir, B. Handan; Atilgan, Alev Ok; Akcay, Eda Yilmaz; Ozdemir, Gokce; Soy, Ebru Ayvazoglu; Akdur, Aydincan; Haberal, Mehmet; 0000-0002-7528-3557; 0000-0001-8595-8880; 0000-0001-6831-9585; 0000-0003-2545-0078; 0000-0002-0993-9917; 0000-0002-8726-3369; 0000-0002-3462-7632; 29528010; X-8540-2019; AAK-3333-2021; AAK-1960-2021; AAL-4282-2020; AAC-5566-2019; AAA-3068-2021; AAJ-8097-2021
Objectives: Thrombotic microangiopathy is a form of renal capillary injury possibly associated with calcineurin inhibitor toxicity, acute humoral rejection, infections, and recurrent diseases. Here, we examined its incidence in patients diagnosed with acute and chronic active humoral rejection, polyomavirus nephropathy, acute cellular rejection, and immunoglobulin A recurrence. Materials and Methods: In total, 272 renal allograft recipients who met the inclusion criteria were reevaluated for presence of renal thrombotic microangiopathy. Thrombotic microangiopathy diagnosis was established by clinical, laboratory, and histologic features. C4d expression in peritubular capillaries was determined. Clinical data were collected from medical records. Results: Of 272 patients (mean age of 42.8 +/- 12.7 years), only 74 patients (27.2%) had de novo thrombotic microangiopathy, which was found in 30/90 patients (33.3%) with acute humoral rejection, 9/51 (17.6%) with acute cellular rejection, 22/53 (41.5%) with chronic active humoral rejection, 10/55 (18.2%) with polyomavirus nephropathy, and 3/23 (13%) with immunoglobulin A nephropathy. Significant differences were shown between therapy type and thrombotic microangiopathy development (P= .02). Patients who received cyclosporine (38.5%) tended to show higher incidence of thrombotic microangiopathy than patients who received tacrolimus (20.7%) or sirolimus (7.7%). Patients with C4d-positive acute humoral (97.6% vs 2.4%) and chronic active humoral rejection (68.2% vs 31.8%) had greater incidence of thrombotic microangiopathy versus those who were C4d-negative. Graft loss was significantly higher in C4d-positive than in C4d-negative thrombotic microangiopathy groups (P < .001). Overall 1-, 3-, and 5-year graft survival was 94%, 85%, and 85% versus 83%, 51%, and 51% in thrombotic microangiopathy-negative versus thrombotic microangiopathy-positive patients (P < .001). Conclusions: Acute humoral rejection and chronic active humoral rejection were the most common and therefore most important causes of de novo thrombotic microangiopathy in renal transplant patients. Its presence in the renal allograft biopsy should arouse suspicion for underlying acute or chronic active humoral rejection.
Pediatric Liver Transplant For Hepatoblastoma: A Single-Center Experience
(2017) Kirnap, Mahir; Soy, Ebru Ayvazoglu; Ozcay, Figen; Moray, Gokhan; Ozdemir, Binnaz Handan; Haberal, Mehmet; 0000-0002-3462-7632; 0000-0002-5214-516X; 0000-0003-2498-7287; 0000-0002-0993-9917; 0000-0002-7528-3557; 28260432; AAJ-8097-2021; ABG-5684-2020; AAH-9198-2019; AAE-1041-2021; AAC-5566-2019; X-8540-2019
Portal Venous Flow Alterations in Hepatic Artery Thrombosis Following Liver Transplant
(2022) Tezcan, Sehnaz; Ozturk, Ozturk, Funda Ulu; Soy, Ebru Ayvazoglu; Uslu, Nihal; Haberal, Mehmet; https://orcid.org/0000-0001-7204-3008; https://orcid.org/0000-0002-0993-9917; https://orcid.org/0000-0002-3462-7632; 30702049; AAC-5566-2019; AAJ-8097-2021
Objectives: The hepatic vasculature is a unique system due to a dual supply that includes the hepatic artery and portal vein, which interact when the liver vascular supply is decreased. Hepatic artery buffer response, an intrinsic regulatory mechanism that compensates for blood supply, maintains increased hepatic artery flow and caliber in response to portal vein failure. Previous studies revealed that portal vein flow showed no alterations to establish adequate blood supply in response to hepatic artery occlusion. Here, we analyzed portal vein flow changes in patients with hepatic artery thrombosis after liver transplant. Materials and Methods: From December 1988 to October 2017, our center performed 580 liver trans plant procedures. Those diagnosed with hepatic artery thrombosis (19 females, 24 males) by Doppler ultrasonography during postoperative week 1 were analyzed. Patients received either surgery or endovascular treatment for hepatic artery thrombosis, with patency confirmed by Doppler ultrasonography. We compared portal vein flow velocity and caliber before and after treatment using Wilcoxon signed rank and Mann Whitney U tests. Results: Mean patient age was 18.9 +/- 21.4 years. Portal vein flow velocity pretreatment (median of 70 cm/s) was significantly higher than posttreatment (median of 52 cm/s) in all patients (P < .001). Median flow velocity decreased significantly after treatment when subgroups were compared, including age (adult vs child), transplant type (orthotopic transplant vs living donor), and treatment (surgery vs endovascular). However, portal vein flow velocity showed a significantly higher decrease in the surgery subgroup than in the endovascular treatment subgroup (P = .018). There was no significant relationship between portal vein calibers before and after treatment (P = .36). Conclusions: The significant decrease in portal vein flow velocity after successful treatment of hepatic artery thrombosis may represent a compensatory flow change of the portal vein in response to diminished hepatic artery flow.
Posttransplant Malignancies in Adult Renal and Hepatic Transplant Patients
(2020) Rahatli, Samed; Altundag, Ozden; Soy, Ebru Ayvazoglu; Moray, Gokhan; Haberal, Mehmet; 0000-0003-2498-7287; 0000-0002-3462-7632; 0000-0002-0993-9917; 0000-0003-3163-7429; 30119617; AAE-1041-2021; AAJ-8097-2021; AAC-5566-2019; AAJ-3047-2021
Objectives: The risk of some cancer types increases after organ transplant compared with that shown in the general population; this has been well documented in clinical studies. With patients having longer survival and with the higher number of transplant procedures, cancer is an increasing health concern at high-volume transplant centers. Malignancy has an important effect on short- and long-term graft and patient survival. In this study, we evaluated cancer frequency during transplant patient follow-up. Materials and Methods: This single-center retrospective study included patients who underwent solid-organ transplant at the Baskent University Medical Faculty Hospital from 1997 to 2017. Renal and hepatic transplant patients older than 16 years at the time of transplant and diagnosed with cancer after transplant were included the study. In total, 1176 of 2018 renal transplant recipients and 274 of 548 hepatic transplant recipients met the inclusion criteria. Results: We determined that 52 of 1176 renal transplant (4.5%) and 9 of 274 hepatic transplant patients (3.3%) developed posttransplant cancer during followup. Of 61 total patients with cancer posttransplant, 44 were males (72.1%) and 17 were females (27.9%), with median age at transplant of 39.2 years. Overall, the incidence of cancer in transplant recipients was 4.2%. The most frequent cancers were basal and squamous skin cancers, which were seen in 18 patients (29%), and Kaposi sarcoma, which was seen in 11 patients (18%). Of the 61 patients who developed cancer, 43 (70%) were still alive at the time of this study. Conclusions: Despite recent positive developments in the use of immunosuppressive drugs, posttransplant malignancy is still a health problem. Fortunately, most cancers in this patient group have good prognosis and can be cured by surgical resection. Transplant physicians should aim for early detection of these diseases.
Results of Biliary Reconstruction with Ptfe Graft in Liver Transplantation
(2017) Haberal, Mehmet; Soy, Ebru Ayvazoglu; Moray, Gokhan; Torgay, Adnan; Ozdemir, Handan; 0000-0002-3462-7632; 0000-0002-0993-9917; 0000-0003-2498-7287; 0000-0002-6829-3300; 0000-0002-7528-3557; AAJ-8097-2021; AAC-5566-2019; AAE-1041-2021; AAJ-5221-2021; X-8540-2019
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.
Success Rate of Grafts With Multiple Renal Vessels in 3136 Kidney Transplants
(2021) Karakaya, Emre; Akdur, Aydincan; Soy, Ebru Ayvazoglu; Moray, Gokhan; Haberal, Mehmet; https://orcid.org/0000-0002-4879-7974; https://orcid.org/0000-0002-8726-3369; https://orcid.org/0000-0002-0993-9917; https://orcid.org/0000-0003-2498-7287; https://orcid.org/0000-0002-3462-7632; 32967599; AAD-5466-2021; AAA-3068-2021; AAC-5566-2019; AAE-1041-2021; AAJ-8097-2021
Objectives: Multiple renal vessels are often detected in living and deceased organ donors. In the past, transplant with multiple renal vessel grafts has been a contraindication because of high vascular and urological complication rates. However, improvements in vascular reconstruction and anastomosis techniques have allowed graft function to be maintained for many years. Here, we retrospectively evaluated transplant of multiple renal vessel grafts and graft survival and postoperative vascular and urological complications. Materials and Methods: From November 1975 to July 2020, there were 3136 renal transplants (716 deceased donors, 2420 living donors) performed in our center. There were 2167 living donors and 643 deceased donors with single renal vessel grafts and 253 living donors and 73 deceased donors with multiple renal vessel grafts. For anastomoses, external iliac, internal iliac, common iliac, and inferior epigastric arteries and external iliac veins were used. Cold ischemia time, anastomosis time, postoperative vascular and urological complications, acute tubular necrosis, creatinine clearance, serum creatinine levels, graft rejection episodes, and graft and patient survival rates were evaluated. Results: With regard to creatinine clearance, cold ischemia and anastomosis time, acute tubular necrosis, rejection episodes, and 1-, 2-, and 5-year posttransplant serum creatinine levels, there were no significant differences between the groups. Graft survival rates in the single renal vessel group were 92.9% at 1 year posttransplant and 78.3% at 5 years posttransplant; rates in the multiple renal vessel group were 93.1% at 1 year and 79.7% at 5 years. The corresponding patient survival rates were 95.5% (1 year) and 92.9% (5 years) for the single renal vessel group and 96.9% (1 year) and 87.2% (5 years) for the multiple renal vessel group. Conclusions: Improved anastomosis and reconstruction techniques have allowed the safe transplant of multiple renal vessel grafts that may remain functional for many years.
Tacrolimus intrapatient variability in BK virus nephropathy and chronic calcineurin toxicity in kidney transplantation
(2021) Turgut, Didem; Sayin, Burak; Soy, Ebru Ayvazoglu; Topcu, Deniz İlhan; Ozdemir, Binnaz Handan; Haberal, Mehmet; 0000-0002-3462-7632; 0000-0002-0993-9917; 35017328; AAJ-8097-2021; AAC-5566-2019
Intrapatient variability (IPV) in tacrolimus has been increasingly acknowledged as a risk factor for poor graft survival after kidney transplantation. Although past studies have mainly accounted for IPV in acute or chronic rejection states as due to underimmunosuppression, this is not yet clear. So far, tacrolimus IPV for BK virus-associated nephropathy (BKVN) and chronic calcineurin inhibitor toxicity (CNIT) has not been investigated. Here, we evaluated IPV in tacrolimus for BKVN and chronic CNIT, which are mainly considered as overimmunosuppression states. In this caseucontrol study, kidney allograft biopsies conducted between 1998 and 2018 were included, with patients grouped by biopsy results as BKVN alone group, CNIT alone group, and normal graft function (control group). IPV was estimated as mean absolute deviation. Our study groups included 25 kidney transplant recipients with BKVN alone, 91 patients with CNIT alone, and 60 patients with normal 5-year graft survival (control group). In analyses of IPV in tacrolimus six months before graft biopsy, IPV was highest in the BKVN group (P = 0.001). The BKVN group also had the highest IPV in tacrolimus at 12 months after biopsy (P = 0.001), with all pairwise comparisons statistically different between groups. At 12 months after biopsy, five patients (20%) in the BKVN group and 10 patients (10.9%) in the CNIT group had graft loss. Among other risk factors, BKVN and chronic CNIT are consequences related to high IPV. Quantification of IVP for tacrolimus in clinical practice would help to optimize kidney transplant outcomes.
Treatment of Posttransplant Hepatocellular Carcinoma Recurrence
(2022) Haberal, Mehmet; Karakaya, Emre; Akdur, Aydincan; Soy, Ebru Ayvazoglu; https://orcid.org/0000-0002-3462-7632; https://orcid.org/0000-0002-8726-3369; https://orcid.org/0000-0002-0993-9917; 35060449; AAJ-8097-2021; AAA-3068-2021; AAC-5566-2019
Objectives: In patients who receive liver transplant to treat hepatocellular carcinoma, 10% to 15% posttransplant recurrence is observed. In the present study, we evaluated the long-term outcomes of patients who had received liver transplant for treatment of hepatocellular carcinoma. Materials and Methods: Of the 683 liver transplants that we performed, 72 were in response to hepatocellular carcinoma. The physical examination and laboratory and imaging results of the patients were retrospectively analyzed and recorded. The recipients were evaluated according to the Baskent criteria and divided into 2 groups: early diagnosis and late diagnosis. Results: Among 72 total patients in our study, 19 (26.3%) were pediatric recipients. Hepatocellular carcinoma recurred in 7 patients (9.7%; 5 adult, 2 pediatric). Except for one patient, all were in the late diagnosis group.The mean survival time of all patients was 137.45 +/- 10 months.The mean survival in the early diagnosis group was longer than in the late diagnosis group. During follow-up, 11 patients died from recurrence and distant metastasis. Conclusions: In patients with hepatocellular carcinoma who received liver transplant, we found that postoperative recurrence of hepatocellular carcinoma and distant metastasis can be treated with surgery and/or with interventional radiology methods, which may improve patient survival after liver transplant.
Ultrasonography Findings of Urinary Tract Infection After Kidney Transplant: A Case Report
(2018) Tezcan, Sehnaz; Soy, Ebru Ayvazoglu; Uslu, Nihal; Haberal, Mehmet; 0000-0001-7204-3008; 0000-0002-0993-9917; 0000-0002-6733-8669; 0000-0002-3462-7632; 29528007; AAC-5566-2019; ABC-5258-2020; AAJ-8097-2021
Urinary tract infection is the most common complication after kidney transplant and often is associated with graft loss and mortality. Ultrasonography is the most widely applied imaging modality for diagnosis of complications after kidney transplant. Here, we report a case of a 52-year-old male patient who underwent renal transplant 1 month earlier and who presented with fever, leukocytosis, and leukocyturia. Klebsiella pneumoniae was found in the urine and blood cultures. Ultrasonography revealed multiple, ill-defined margined, hypoechoic areas and cysts within the cortex. Both clinical findings and ultrasonography findings were resolved after antimicrobial therapy. One month later, the patient presented again with fatigue, leukocytosis, and leukocyturia. Blood and urine culture results were consistent with Klebsiella pneumoniae. Ultrasonography revealed large hypoechoic mass, including multiple cysts in the upper pole of the transplanted kidney. Doppler ultrasonography showed increased vascularity within the hypoechoic mass and surrounding parenchyma. Renal parenchymal echogenicity was also increased in the upper pole. Ultrasonography-guided percutaneous drainage was performed. Clinical, laboratory, and ultrasonography findings were resolved after antimicrobial therapy. Ultrasonography plays an important role in the diagnosis and evaluation of the treatment response of urinary tract infections after kidney transplant.
Utility of Mean Platelet Volume to Diagnose Pneumonia in Patients With Solid-Organ Transplant
(2018) Ulubay, Gaye; Soy, Ebru Ayvazoglu; Serifoglu, Irem; Sozen, Fisun; Moray, Gokhan; Haberal, Mehmet; 0000-0003-2478-9985; 0000-0002-0993-9917; 0000-0002-1951-2693; 0000-0003-2498-7287; 0000-0002-3462-7632; 29528024; AAB-5064-2021; AAC-5566-2019; AAS-6628-2021; AAC-1823-2021; AAE-1041-2021; AAJ-8097-2021
Objectives: Despite improved success with solid-organ transplant procedures, recipients remain at risk for infections, including pneumonia, due to their immunosuppressive regimens. In solid-organ transplant patients, clinical findings of pneumonia can be nonspecific, and diagnosis of pneumonia may be difficult as several conditions (drug lung, hypervolemia, infections, hemorrhage) can led to pulmonary infiltrates, mimicking pneumonia in these patients. The role of mean platelet volume, a predictor of inflammatory disease, with elevated values inversely correlated with inflammatory problems, in the diagnosis of pneumonia has not yet been investigated in solid-organ transplant patients. Here, we retrospectively investigated mean platelet volume in diagnosis of pneumonia in transplant patients. Materials and Methods: Medical records of solid-organ transplant patients from 2011 to 2016 were reviewed for demographic, clinical, radiographic, laboratory, and microbiology data. Transplant type, immunosuppressive drugs, and clinical outcomes were noted. Pneumonia diagnosis was based on clinical respiratory symptoms and signs, imaging findings, positive microbiological tests, pathologic findings, laboratory findings, or effective clinical treatment trials. Results: Our study included 70 patients (47 male/23 female; mean age of 46 +/- 14 years), comprising 26 liver and 44 renal transplant recipients. Pneumonia was diagnosed radiologically in 30 patients (42.9%), with procalcitonin positive in 11 patients (36.7%), C-reactive protein elevated in 29 patients (96.7%), and leukocytes increased in 6 patients (20%). When laboratory measurements were compared with mean platelet volume, mean platelet volume values were significantly lower in patients with pneumonia who had elevated procalcitonin levels (P=.038). Conclusions: We found that mean platelet volume for diagnosis of pneumonia in solid-organ transplant patients was not a promising tool. Considering the difficulties in caring for transplant patients with pulmonary infiltrates, clinical decisions should be based on clinical, laboratory, microbiological, and radiologic findings.