Browsing by Author "Soy, Ebru Hatice Ayvazoglu"

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Causes of Hemoptysis in Renal Transplant Patients
(2018) Serifoglu, Irem; Dedekarginoglu, Balam Er; Soy, Ebru Hatice Ayvazoglu; Ulubay, Gaye; Haberal, Mehmet; 0000-0002-0993-9917; 0000-0003-2478-9985; 0000-0002-3462-7632; 29527996; AAS-6628-2021; AAC-5566-2019; AAJ-8097-2021
Objectives: Hemoptysis is a symptom that can be caused by airway disease, pulmonary parenchymal disease, or pulmonary vascular disease, or it can be idiopathic. Infection is the most common cause of hemoptysis, accounting for 60% to 70% of cases. Hemoptysis is also an initial symptom of diffuse alveolar hemorrhage syndrome, although it may be absent at presentation in one-third of patients. Diffuse alveolar hemorrhage is characterized by disruption of the alveolar-capillary basement membranes because of either injury or inflammation of the arterioles, venules, or capillaries, resulting in bleeding in alveolar spaces. To date, no study in the literature has investigated the cause of hemoptysis in renal transplant patients. In this retrospective study, we aimed to investigate the causes of hemoptysis in renal recipients. Materials and Methods: The data included in this study were obtained from 352 renal transplant patients who were consulted by the pulmonology department regarding hemoptysis between 2011 and 2017 at Baskent University. Patient medical records were reviewed for demographic, clinical, radiographic, bronchoscopic features, and microbiology data. Immunosuppressive drugs and clinical outcome data were also noted. Results: This study included 352 renal transplant patients (139 male patients with mean age of 34.9 +/- 7 years and 113 female patients with mean age of 31.1 +/- 5 years). Hemoptysis was detected in 17 patients (4.8%),with 3 (0.85%) having massive hemoptysis as a result of diffuse alveolar hemorrhage syndrome. Fourteen of our patient group (4%) had pneumonia, and Aspergillus species was detected in 5 patients (1.4%). The only reason for diffuse alveolar hemorrhage was immunosuppressive agents, including sirolimus and mycophenolate mofetil. Conclusions: Hemoptysis is an important respiratory symptom in renal transplant patients. Although community- or hospital-acquired pneumonia may result in hemoptysis, drug-induced diffuse alveolar hemorrhage and Aspergillus infection should be considered for causes in renal transplant patients.
Dermal Tophus: A Complication of Gout in a Kidney Transplant Recipient
(2015) Soy, Ebru Hatice Ayvazoglu; Karakaya, Emre; Togral, Arzu Karatas; Akdur, Aydincan; Moray, Gokhan; Haberal, Mehmet; 0000-0002-4879-7974; 0000-0002-8726-3369; 0000-0002-0993-9917; 0000-0003-2498-7287; 0000-0002-3462-7632; 25894172; AAD-5466-2021; AAA-3068-2021; AAC-5566-2019; AAE-1041-2021; AAJ-8097-2021
Gout is a chronic metabolic disease caused by disturbance of purine metabolism that leads to hyperuricemia. Hyperuricemia prevalence after renal transplant is reported as 19% to 84% in different studies. Tophaceous gout in renal transplant recipients is a consequence of increased hyperuricemia. Although tophus formation in skin and soft tissues is an indicator of chronic gout (also referred to as tophaceous gout), tophi may be the first sign of gout. In this study, we report a case of a 62-year-old male renal transplant recipient who had tophi as the first clinical sign of gout. After confirming gout diagnosis, cyclosporine was changed to sirolimus, and allopurinol was added to therapy to decrease uric acid levels. In conclusion, hyperuricemia is a common complication in renal transplant recipients. Presentation might be atypical, and diagnosis can be challenging.
Effect Of Meal Intake For Evaluating Hepatic Artery By Doppler Ultrasonography In Liver Transplants: Does Fasting Matter For Screening Hepatic Artery Due To Hemodynamic Changes In Splanchnic Circulation?
(2022) Ozturk, Funda Ulu; Tezcan, Sehnaz; Soy, Ebru Hatice Ayvazoglu; Uslu, Nihal; Haberal, Mehmet; https://orcid.org/0000-0003-2782-2824; https://orcid.org/0000-0001-7204-3008; https://orcid.org/0000-0002-0993-9917; https://orcid.org/0000-0002-3462-7632; 35419884; AAC-5566-2019; AAJ-8097-2021
Purpose The aim of this study is to assess the utility of fasting on Doppler ultrasonography findings of hepatic artery in liver transplants. Methods Liver transplant patients without vascular abnormalities were prospectively evaluated between December 2017 and January 2020. Doppler sonography was used to describe hemodynamic changes in response to a standard meal. The diameter, peak systolic velocity, blood flow, resistive index (RI) of the main hepatic artery and portal vein peak velocity were measured. Results The mean hepatic arterial diameter of 44 patients was higher in the fasting group (4.5 mm) than in the postprandial group (3.3 mm) (p < .05). The mean hepatic arterial blood flow decreased (from .276 to .127 L/min) and hepatic arterial RI increased (from .66 to .71) following meal ingestion (p < .05). Hepatic arterial velocity was significantly lower and portal venous velocity was higher after oral intake. Conclusion Meal ingestion has an important effect on hepatic artery Doppler features in liver transplants. Therefore, Doppler ultrasound evaluation should be considered after appropriate fasting due to postprandial responses of liver transplant.
Predisposing Risk Factors for Isolated Bile Leakage After Pancreaticoduodenectomy
(2023) Aydin, Huseyin Onur; Soy, Ebru Hatice Ayvazoglu; Kirnap, Mahir; Moray, Gokhan; 38131350
AIM: Isolated bile leakage (IBL) from hepaticojejunostomy, following pancreaticoduodenectomy, is a serious complication that increases morbidity and mortality. We aimed to assess the frequency of IBL development after pancreaticoduodenectomy and its underlying factors. MATERIALS AND METHODS: Patients who underwent pancreaticoduodenectomy for pancreatic diseases between January 2005 and January 2016 were retrospectively evaluated. Patients were dichotomized according to those with and without postoperative IBL. RESULTS: In the 111 patients who underwent pancreaticoduodenectomy during our study period, 8 patients (7.2%; 5 men/3 women) developed IBL. Risk of IBL development was significantly elevated among male patients, those with pre-operative serum albumin < 3.5 g/dL, and those with previous cholangitis (P < 0.05). DISCUSSION: Male sex, preoperatively low levels of serum albumin, and preoperative history of cholangitis can be listed as risk factors for IBL development. Physicians should pay attention to the risk of postoperative IBL development in such patients.
Relationship Between Exercise Perception With Physical Activity Level, Body Awareness, and Illness Cognition in Renal Transplant Patients: A Pilot Study
(2019) Tigli, Ayca; Soy, Ebru Hatice Ayvazoglu; Aytar, Aydan; Moray, Gokhan; Haberal, Mehmet; https://orcid.org/0000-0002-0993-9917; https://orcid.org/0000-0003-2498-7287; https://orcid.org/0000-0002-3462-7632; 30777573; AAC-5566-2019; HIR-3735-2022; AAE-1041-2021; AAJ-8097-2021
Objectives: Transplantation offers better quality of life and long-term survival benefits. Further knowledge is needed regarding exercise in daily life of transplant recipients. Here, we investigated the relationship between exercise perception and physical activity level, body awareness, and illness cognition in renal transplant patients. Materials and Methods: Our study included 53 renal transplant recipients (Standardized Mini-Mental Test score = 26.35 +/- 1.36; age = 41.11 +/- 13.52 year, body mass index = 25.96 +/- 5.26 kg/m(2), elapsed time after transplant = 3.68 +/- 1.53 year). Perceived benefits and barriers to exercise, physical activity level, body awareness, and illness cognition were assessed with the Exercise Benefits/Barriers Scale, International Physical Activity Questionnaire, Body Awareness Questionnaire, and Patient Illness Perception Questionnaire, respectively. Correlations were established with Spearman test for nonparametric data, with regression analysis used to find determinants of physical activity levels. Results: We observed correlations between physical activity level and perceived benefits and barriers to exercise. There was a positive relationship between body awareness and perceived benefits and barriers to exercise and also illness cognition, with significant correlation between perceived benefits and barriers to exercise and illness cognition (P < .05). Perceived benefits and barriers to exercise (P = .006, R = 0.373, R2 = 0.139, beta = 0.373, t = 2.867, F = 8.22) were determining factors for physical activity level. Conclusions: Psychologic and physical factors, including negative emotions and body dissatisfaction, are risk factors for poor quality of life. Although it is important to increase quality of life, tools to enhance body awareness and to develop strategies to alter motor behaviors in daily living activities are needed. Treatment and assessment strategies on body awareness and illness perception should be considered, with emphasis on the importance of physical activity posttransplant.
Retroperitoneal cystic lesion mimicking malign sarcoma as a complication of lost gallstones during laparoscopic cholecystectomy
(2018) Aydin, Huseyin Onur; Soy, Ebru Hatice Ayvazoglu; Avci, Tevfik; Yildirim, Sedat
Role of Interventional Radiology in the Management of Early Vascular Complications After Liver Transplant
(2022) Igus, Behlul; Boyvat, Fatih; Ozen, Ozgur; Soy, Ebru Hatice Ayvazoglu; Karakaya, Emre; Haberal, Mehmet; 0000-0002-3462-7632; 0000-0001-7122-4130; 0000-0002-4879-7974; 0000-0003-4874-8141; 36718007; AAJ-8097-2021; AAN-1681-2021; AAD-5466-2021; AAN-1040-2021
Objectives: A hepatic vascular complication after liver transplant is a critical situation, often resulting in graft failure and potentially leading to patient death. Early diagnosis and treatment of vascular complications can provide prolonged graft survival and prohibit further complications. This study presents our experiences with endovascular treatment during the first week after liver transplant. Materials and Methods: Between January 2012 and February 2021, 240 liver transplants were performed, with 43 patients having early endovascular treatment (37 men; mean age 27 +/- 2.9 years) at a single center. Early endovascular interventions were carried out 1 to 7 days (mean +/- SD of 2.7 +/- 0.24 days) after transplant. Patients with vascular complications were grouped by arterial, venous, and portal complications. In addition, arterial complications were subgrouped by occlusive (hepatic artery thrombosis) and nonocclusive (hepatic artery stenosis/splenic artery steal syndrome) complications. Patients had median follow- up of 47 +/- 4 months. Results: In the first week after liver transplant, vascular complications included splenic artery steal syndrome in 27 patients (62.7%), hepatic complications in 10 patients (23.2%) (7 with hepatic artery thrombosis, 3 with hepatic artery stenosis), hepatic venous outflow complications in 4 patients (9.3%), and portal vein complications in 2 patients (4.6%). Only 1 patient required revision surgery because of excessive arterial kinking; the remaining patients with arterial complications were successfully managed with multiple endovascular treatment attempts. Patients with splenic artery steal syndrome were treated by selective arterial embolization with coil devices. Resistivity index, peak systolic velocity of hepatic arteries, and portal vein maximal velocity significantly improved (P <.001). Patients with hepatic venous outflow and portal vein complications who had endovascular treatments and vascular structures maintained good results over follow-up. Conclusions: Early endovascular intervention is feasible and safe for hepatic vascular complications following liver transplant, with high success treatment rates with advances in interventional radiology.
Stereotactic Ablative Body Radiotherapy as a Bridge to Liver Transplant for Hepatocellular Carcinoma: Preliminary Results of Baskent University Experience
(2022) Yavas, Guler; Soy, Ebru Hatice Ayvazoglu; Coskun, Mehmet; Onal, Cem; Boyvat, Fatih; Haberal, Mehmet; https://orcid.org/0000-0002-3462-7632; 35384806; HOC-5611-2023; AAJ-8097-2021
Objectives: Hepatocellular carcinoma is the most common primary liver tumor, with curative treatment options being liver transplant and resection. However, approximately 20% to 30% of patients have substantial disease progression while awaiting transplant. Here, we report our initial experience on stereotactic ablative body radiotherapy as a bridge to liver transplant for patients with hepatocellular carcinoma. Materials and Methods: Seven patients with 9 lesions received stereotactic ablative body radiotherapy as a bridge treatment to transplant. All patients underwent radiofrequency ablation, transcatheter arterial chemoembolization, or hepatic resection before stereotactic ablative body radiotherapy. Magnetic resonance imaging was used to evaluate radiographic responses 1 month later. Results: Median age of patients was 65 years (range, 63-71 years), median stereotactic ablative body radiotherapy dose was 45 Gy (range, 30-54 Gy; delivered in 3-5 fractions), and median tumor diameter was 17 mm (range, 12-30 mm). Before stereotactic ablative body radiotherapy, all patients underwent liver-directed therapies, including transcatheter arterial chemoembolization for 3 lesions, transcatheter arterial chemoembolization and radiofrequency ablation for 4 lesions, surgical resection for 1 lesion, and surgical resection plus transcatheter arterial chemoembolization for the remaining lesion. Patients showed no evidence of gastrointestinal toxicity or radiation-induced liver disease. Acute toxicity was negligible; all patients completed the treatment course. One month after stereotactic ablative body radiotherapy administration, response rates were assessed with magnetic resonance imaging, with complete responses obtained in 5 lesions (55.5%), partial responses for 2 lesions, and stable disease for 2 lesions. No disease progression was shown following stereotactic ablative body radiotherapy application. Conclusions: Stereotactic ablative body radiotherapy is an effective, safe, and tolerable bridging therapy option. Although we observed an early response after treatment, exact response rates will not be known for at least 3 months following stereotactic ablative body radiotherapy. Thus, our findings should be confirmed through additional prospective studies with longer follow-up.
Treatment of Biliary Complications After Liver Transplant: Results of a Single Center
(2015) Yildirim, Sedat; Soy, Ebru Hatice Ayvazoglu; Akdur, Aydincan; Kirnap, Mahir; Boyvat, Fatih; Karakayali, Feza; Torgay, Adnan; Moray, Gokhan; Haberal, Mehmet; 0000-0002-8726-3369; 0000-0002-3462-7632; 0000-0002-5735-4315; 0000-0002-0993-9917; 0000-0002-6829-3300; 0000-0002-1874-947X; 0000-0003-2498-7287; 25894131; AAA-3068-2021; F-4230-2011; AAH-9198-2019; AAJ-8097-2021; AAF-4610-2019; AAC-5566-2019; AAJ-5221-2021; AAB-3888-2021; AAE-1041-2021
Biliary complications are major sources of morbidity after liver transplant due to vulnerable vascularization of the bile ducts. Biliary complications are the "Achilles' heel" of liver transplant with their high incidence, need for repeated and prolonged treatment, and potential effects on graft and patient survival. Although standardization of reconstruction techniques and improvements in immunosuppression and organ preservation have reduced the incidence of biliary complications, in early reports the morbidity rates are 50%, with related mortality rate 25% to 30%. Prophylaxis is a major issue. Although many risk factors (old donor age, marginal graft, prolonged ischemia time, living-donor liver transplant, partial liver transplant, donation after cardiac death, hepatic arterial thrombosis, organ preservation, chronic rejection, and other donor and recipient characteristics) do not directly affect biliary complications, accumulation of the factors mentioned above, should be avoided. However, no accepted standard has been established. Treatment strategy is a subject of debate. Recently, non-operative treatment of biliary complications have been preferred for diagnosis and therapy, because percutaneous or endoscopic treatment may prevent the need for surgical intervention. In this study, we reviewed our treatment of early and late biliary complications after liver transplant.