Browsing by Author "Yildirim, Sedat"

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An Alternative Abdominal Closure Technique After Pediatric Liver Transplant: Bogota-Bag Technique
(2022) Karakaya, Emre; Akdur, Aydincan; Soy, Hatice Ebru Ayvazoglu; Moray, Gokhan; Yildirim, Sedat; Haberal, Mehmet; 0000-0002-4879-7974; 0000-0002-3462-7632; 0000-0003-2817-1920; AAD-5466-2021; AAJ-8097-2021
Analysis of Quality of Life, Depression, and Sexual Function in Patients on the Liver Transplant List
(2021) Fidan, Cihan; Akdur, Aydincan; Kirnap, Mahir; Selcuk, Haldun; Yildirim, Sedat; Moray, Gokhan; Haberal, Mehmet; 0000-0002-3462-7632; 0000-0002-8726-3369; 34609310; AAJ-8097-2021; AAA-3068-2021
Background: I he only treatment in patients developing liver failure is liver transplantation. According to the Ministry of Health, the number of patients waiting for a liver transplantation is 2141, the average waiting period for liver transplantation is approximately 5 years, and 15-18% of these patients lose their life while waiting for transplantation. In these patients, limitations in daily activities and depression-anxiety are commonly found. The aim of this study was to analyze life quality, depression symptoms, and existence of sexual functional disorders of patients waiting for liver transplantation. Methods: A total of 74 patients, who were registered in Baskent University Hospital between 2015 and 2018, were included into the study. Short Form-36, Beck Depression Inventory, and Arizona Sexual Experiences Scale were applied to 56 patients who approved study. Results: Most of the patients were male (64.3%), and the mean age was 46 (18-64). Short Form-36 scores were low in all patients. The mean Beck Depression Inventory score of patients was found as 18.4 +/- 11.3, and they were suffering from moderate depressive symptoms. According to Arizona Sexual Experiences Scale, total mean scores of males was found as 16.3 +/- 5.5, and for females, it was 19.5 +/- 5.3 with a statistically significant difference (P < .05). It was found that sexual dysfunction mostly had moderate to mild. Conclusion: Depression and sexual dysfunction are common in patients with chronic liver diseases, and their life qualities deteriorate significantly. It is anticipated that evaluation of these patients in terms of psychological issues and sexual dysfunction will increase their quality of life during the organ waiting period and affect their well-being post-transplant.
Application of Ileobladder for Clinical Kidney Transplantation: Two Case Reports
(2018) Haberal, Mehmet; Kirnap, Mahir; Akdur, Aydincan; Soy, Ebru H. Ayvazoglu; Yildirim, Sedat; Moray, Gokhan; Kayhan, Zeynep; Torgay, Adnan; 0000-0002-3462-7632; 0000-0002-8726-3369; 0000-0002-0993-9917; 0000-0002-5735-4315; 0000-0003-2498-7287; 0000-0003-0579-1115; 0000-0002-6829-3300; AAJ-8097-2021; AAH-9198-2019; AAA-3068-2021; AAC-5566-2019; AAF-4610-2019; AAE-1041-2021; AAJ-4623-2021; AAJ-5221-2021
Association Between Panel Reactive Antibody and Antiendothelial Cell Antibody Positivity in Kidney Transplant Patients
(2015) Basturk, Bilkay; Kantaroglu, Bircan; Noyan, Z. Aytul; Yildirim, Sedat; Sariturk, Cagla; 0000-0002-8784-1974; 0000-0002-5735-4315; 0000-0002-4130-1059; 25894170; AAD-6918-2021; AAF-4610-2019; AAS-7129-2021
Objectives: Endothelium is the major tissue for hyperacute and acute rejection. Binding of antibody to endothelium activates several immunologic mechanisms. Antiendothelial cell antibodies are a group of nonhuman leukocyte antigen antibodies that may play a role in the induction of an immunologic reaction that triggers inflammation. The aim of this study was to investigate whether there was an association between antiendothelial cell antibody positivity and panel reactive antibody positivity in renal transplant patients. Materials and Methods: In this study, we investigated the association between antiendothelial cell antibodies and panel reactive antibody Class I class II crossmatch positivity in patients, and compared these results with results from 100 healthy volunteers. All serum samples were analyzed by bead-based technology for calculated panel reactive antibody positivity; in addition, slides were used, each containing human umbilical vein endothelial cells and capillary-rich tissue for antiendothelial cell antibody positivity. Results: Antiendothelial cell antibodies was positive in 48 of 89 patients (panel reactive antibody Class I class II negative), 22 of 35 patients (class l-positive), 25 of 39 patients (class II-positive), 26 of 40 (class I-class II positive), and 37 of 57 serologic and flow cytometry crossmatch-positive patients (P <= .016), and ultimately, in 122 of 205 patients and 25 of 100 volunteers (P <= .001). Antiendothelial cell antibody positivity was more frequent in panel reactive antibody-positive than negative patients and the control group. Conclusions: Binding of antiendothelial cell antibodies to endothelial cells may activate complement by the classical pathway and cause up-regulation of adhesion molecules. This study questioned the antigenic specificity of antiendothelial cell antibodies. Our study results showed that antiendothelial cell antibodies may play an important role for graft destruction, independent of panel reactive antibody and crossmatch positivity.
Cardiac Function in Children After Kidney Transplantation
(2018) Arslan, Alev; Parmaksiz, Gonul; Noyan, Aytul; Caliskan, Kenan; Yildirim, Sedat; Haberal, Mehmet; 0000-0003-4444-0027; 0000-0003-2373-1837; 0000-0002-8767-5021; 0000-0002-5735-4315; 0000-0002-3462-7632; V-1112-2019; AAM-2935-2021; AAD-5713-2021; AAJ-7201-2021; AAF-4610-2019; AAJ-8097-2021
A Comparative Study of Conservative versus Surgical Treatment Protocols for 77 Patients with Idiopathic Granulomatous Mastitis
(2015) Yabanoglu, Hakan; Colakoglu, Tamer; Belli, Sedat; Aytac, Huseyin Ozgur; Bolat, Filiz Aka; Pourbagher, Aysin; Tezcaner, Tugan; Yildirim, Sedat; Haberal, Mehmet; 0000-0003-2031-7374; 0000-0002-3462-7632; 0000-0002-5735-4315; 0000-0002-3641-8674; 0000-0002-3583-9282; 0000-0002-1161-3369; 25858348; HJZ-1654-2023; AAJ-8097-2021; AAF-4610-2019; AAD-9865-2021; AAJ-7913-2021; AAJ-7865-2021
The purpose of this study was to analyze the clinical features and demographic data of patients with idiopathic granulomatous mastitis (IGM) and to compare the results of conservative versus surgical treatment protocols. The demographic data, clinical findings, microbiological and pathologic features, scanning and treatment methods, recurrence, and recovery rates of 77 patients were analyzed retrospectively. The patients were divided into two groups based on the type of treatment received. Core biopsies were used to diagnose 37 patients: 26 using incisional biopsies and 14 using excisional biopsies. Of the patient population with IGM, 31 were treated with surgical excision, one with a simple mastectomy, and one with a subcutaneous mastectomy combined with a breast implant, whereas 44 were treated with steroids. The recovery rates of the 44 patients who were treated conservatively were 6 (1-15) months while for the 33 patients who were treated surgically, it was 1 (1-5) month (p=0.001). Nine patients from the conservative treatment group experienced a recurrence while there were no recurrences in the surgically treated group (p=0.009). Among all patients, the recurrence rate was 11.7% (9/77) while the average follow-up period was 16.57 +/- 18.57months. As a comparative study between conservative treatment protocols and surgical ones for patients with idiopathic granulomatous mastitis (IGM), this study is the largest to date. A wide surgical excision is the preferred approach for treating patients with IGM because of the low recurrence rate.
Comparison of Mortality Rates in Patients Waiting for Liver Transplant and Patients With Colorectal Metastatic Tumors
(2022) Erkent, Murathan; Aydin, H. Onur; Tezcaner, Tugan; Avci, Tevfik; Kavasoglu, Lara; Soy, Ebru H. Ayvazoglu; Yildirim, Sedat; Haberal, Mehmet; 0000-0002-3592-5092; 0000-0002-0664-5147; 0000-0002-0993-9917; 0000-0002-3462-7632; 35352633; CAA-2756-2022; AAJ-8219-2021; AAC-5566-2019; AAJ-8097-2021
Objectives: We aimed to identify outcomes of liver surgery in patients with hepatocellular carcinoma and colorectal cancer, which result in primary and secondary liver tumors. Materials and Methods: Our study included 51 patients with colorectal cancer and liver metastases and 63 patients with hepatocellular carcinoma who were prepared for liver transplant due to cirrhosis who underwent hepatic resection or local ablation treatments; patients were seen between January 2011 and December 2021. Results: Most patients with colorectal cancer were men (58.8%). Mean age was 65.76 +/- 13.818 years (range, 27-88 y). Most patients had planned, elective surgery (86.3%). Neoadjuvant chemotherapy was administered to 58.8% of patients. The most common location of metastasis in the liver was in the right lobe (43.1%), and the most common surgery was low anterior resection (17 patients). During simultaneous liver surgery, 31 patients required metastasectomy and 7 patients required radiofrequency ablation plus metastasectomy. No deaths occurred in the early posttransplant period, and cumulative survival was 82.624 +/- 7.962 months. Disease-free survival was 45.2 +/- 7.495 months. Most patients with hepatocellular carcinoma were men (82.5%). Mean age was 58.73 +/- 17.428 years. Hepatocellular carcinoma lesions were mostly located in both the right and left lobes (23.8%). In the hepatocellular cancer group, 60.3% had transarterial chemoembolization and 42.9% had radiofrequency ablation. The primary surgical resection was metastasectomy (17.9%) because of multiple localized lesions. Median follow-up was 22 months (range, 1-126 mo). Overall survival was 101.898 +/- 7.169 months, with 10-year overall survival of 38%. Disease-free survival was 74.081 +/- 8.732 months, with 1-year and 5-year disease-free survival of 90.5% and 54%. Conclusions: Better survival was shown in patients with hepatocellular carcinoma than in patients with colorectal cancer. Therefore, more aggressive treatment options, as used in hepatocellular carcinoma, including liver transplant, may be options for patients with colorectal cancer.
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
(2020) Soy, Ebru H. Ayvazoglu; Akdur, Aydincan; Karakayali, Feza; Moray, Gokhan; Yildirim, Sedat; Haberal, Mehmet A.
Deceased-donor transplantation activities in Turkey
(2019) Haberal, Mehmet; Akdur, Aydincan; Moray, Gokhan; Karakayali, Feza Yarbug; Yildirim, Sedat; Caliskan, Kenan; Torgay, Adnan; Arslan, Gulnaz
Diagnosis and Management of Retained Foreign Objects
(2015) Yildirim, Tulin; Parlakgumus, Alper; Yildirim, Sedat; 0000-0001-7788-9416; 0000-0002-5735-4315; 26008665; AAQ-7559-2021; AAF-4610-2019
Retained surgical foreign objects (RFO) include surgical sponges, instruments, tools or devices that are left behind following a surgical procedure unintentionally. It can cause serious morbidity as well as even mortality. It is frequently misdiagnosed. It should be considered in the differential diagnosis of any postoperative case with unresolved or unusual problems. Risk factors for RFOs include emergency procedures, unplanned change in operation, and body mass index and are clarified as being more frequent approximately 1 in 700 emergent cases. Although human errors cannot be completely prevented, medical training and consistency to rules seem to reduce the incidence to a minimum. It is a legal issue and potentially dangerous medical error. The definition, types, incidence, risk factors, complications and prevention strategies from RFOs are reviewed, from the comprehensive series until the year 2014.
Early Infections in Renal Transplant Recipients: Incidence, Risk Factors, and Causative Microorganisms
(2015) Yabanoglu, Hakan; Aliskan, Hikmet Eda; Caliskan, Kenan; Arer, Ilker; Akdur, Aydincan; Yildirim, Sedat; Moray, Gokhan; Haberal, Mehmet; 0000-0002-1161-3369; 0000-0002-8726-3369; 0000-0002-5735-4315; 0000-0001-9060-3195; 0000-0002-8767-5021; 0000-0002-3462-7632; 0000-0003-0268-8999; 0000-0003-2498-7287; 26640902; AAJ-7865-2021; AAA-3068-2021; AAF-4610-2019; AAE-2282-2021; AAJ-7201-2021; AAJ-8097-2021; AAK-2011-2021; AAE-1041-2021
Objectives: This study aimed to compare renal transplant recipients with and without infection with respect to demographic and clinical characteristics as well as risk factors; to determine the incidence of posttransplant infections; and to study the antibiotic resistance patterns of bacterial species identified as the causative organisms in posttransplant infections. Materials and Methods: This study included a total of 136 patients undergoing renal transplant in a 4-year period. The patients were categorized into 2 groups. The 2 groups were compared with each other with respect to general clinical and demographic variables and the number and frequency of infectious attacks within a 1-year follow-up, infection type, and antibiotic resistance patterns. Results: Ninety-two (67.6%) of the subjects were male and 44 (32.4%) were female. A total of 57 (41.9%) patients developed 128 infectious attacks. Urinary tract infections were the most common infections (42.1%). There was a significant correlation between a clinically relevant urinary culture proliferation and postoperative infection rate (P =.002). There was a significant correlation between antimicrobial resistance and the number of infectious attacks (P =.023). There was a significant correlation between the proliferation of Extended Spectrum Beta Lactamase-positive Enterobactericeae species and the number of infectious attacks (P =.000). Conclusions: Presence of a clinically relevant proliferation in the preoperative urinary culture, which was identified as a risk factor for infection, increased the number of infectious attacks. Moreover, Extended Spectrum Beta Lactamase-positive Enterobactericeae species increased the number of infections. These 2 principle results should be taken into account in patient management.
Early Postoperative Infections After Liver Transplant
(2018) Soy, Ebru H. Ayvazoglu; Akdur, Aydincan; Yildirim, Sedat; Arslan, Hande; Haberal, Mehmet; 0000-0002-0993-9917; 0000-0002-8726-3369; 0000-0002-5735-4315; 0000-0002-5708-7915; 0000-0002-3462-7632; 29528013; AAC-5566-2019; AAA-3068-2021; AAF-4610-2019; ABG-7034-2021; AAJ-8097-2021
Objectives: Despite surgical advances and effective prophylactic strategies in liver transplant, infection is still a major cause of morbidity and mortality. Up to 80% of liver recipients will develop at least 1 infection during the first year after liver transplant. The spectrum and manifestations of these infections are broad and variable. Their diagnosis and treatment are often delayed because immunosuppressive therapy diminishes inflammatory responses. However, if an infection is not identified early enough and treated properly, it can have devastating consequences. In addition, prophylactic approaches remain controversial. Our aim was to review our early postoperative infection management after liver transplant. Materials and Methods: We retrospectively evaluated infections that occurred during the first hospital stay of transplant patients. Infections were grouped as surgical site and nonsurgical site infections. Consequences and treatment protocols of infections were stratified according to the Clavien scale. Results: Between December 1988 and January 2017, we performed 561 liver transplants at our center (patient age range, 6 months to 64 years), which included 401 living-donor (72%) and 160 deceased-donor (28%) liver transplants. Early postoperative infections were detected in 131 patients (23.3%), comprising 67 surgical site (51%), 56 nonsurgical site (43%), and 8 combined surgical and nonsurgical site infections (6%). Although no mortalities occurred in patients with single nonsurgical or surgical site infections, there were 4 mortalities in patients with combined surgical and nonsurgical site infections. In the 4 other patients with combined infections, 3 patients required endoscopic or radiologic intervention and 1 recovered from single-organ dysfunction. Conclusions: Initiation of appropriate prophylactic and therapeutic protocols at the right time decreases morbidity and mortality due to infection in liver transplant recipients. Increased understanding and effective approaches to prevent infection are essential to improving both graft and recipient survival.
Effect of Adipose-Derived Stem Cells on Colonic Anastomosis in Immunosuppressed Rats with Everolimus: An Experimental Study
(2019) Karakaya, Emre; Akdur, Aydincan; Tezcaner, Tugan; Atilgan, Alev Ok; Uysal, Cagri; Ozer, Eda Ozturan; Yildirim, Sedat; Haberal, Mehmet A.
Effect of Adipose-Derived Stem Cells on Colonic Anastomosis in Rats Immunosuppressed With Everolimus: An Experimental Study
(2021) Karakaya, Emre; Akdur, Aydincan; Atilgan, Alev Ok; Uysal, Ahmet Cagri; Ozer, Huriye Eda Ozturan; Yildirim, Sedat; Haberal, Mehmet; 0000-0002-3462-7632; 0000-0002-8726-3369; 34269651; AAJ-8097-2021; AAA-3068-2021
Objectives: Immunosuppressed patients sometimes require colorectal surgery. We investigated whether adipose tissue-derived stem cells contributed to anastomosis healing in rats immunosuppressed with the mTOR inhibitor everolimus. Materials and Methods: Sixty male Sprague-Dawley rats were randomly divided into 4 groups of 14 each, with all groups undergoing descending colon anastomosis; the 4 remaining rats were used for stem cell retrieval. Group 1 (control) underwent surgery only, group 2 received stem cell injection, group 3 received everolimus only, and group 4 received everolimus plus stem cell injection. After treatment, each group was randomly divided into 2 equal subgroups according to the day of euthanasia (posttreatment day 4 or day 7). We measured anastomosis bursting pressure and tissue hydroxyproline level and performed histopathological evaluation. Results: At both posttreatment days 4 and 7, median weight loss in group 3 was higher than in group 1, group 3 had higher severity of intraabdominal adhesion than group 4, and group 2 had mean hydroxyproline level higher than the other groups. At posttreatment day 4, mean bursting pressure was significantly different in group 1 versus groups 2 and 4 (P = .002) and group 2 versus groups 3 and 4 (P < .001). No significant differences were shown in pathological analysis except for vascular proliferation on day 7 (P = .003). Conclusions: Injection of adipose tissue-derived stem cells in the anastomosis site prevented anastomosis leakage by contributing to healing. Injection of adipose tissue-derived stem cells in the anastomosis region, especially in the early period after solid-organ transplant in recipients and after gastrointestinal surgery in immunosuppressed patients, may help reduce mortality and morbidity.
Effects of Adipose-Induced Stem Cell Application on Everolimus Immunosuppressed Rats on Colon Anastomosis: An Experimental Study
(2018) Karakaya, Emre; Akdur, Aydincan; Atilgan, Alev Ok; Ozer, Huriye Eda Ozturan; Uysal, Cagri; Yildirim, Sedat; Haberal, Mehmet; 0000-0002-4879-7974; 0000-0002-8726-3369; 0000-0001-8595-8880; 0000-0002-5735-4315; 0000-0002-3462-7632; AAD-5466-2021; AAA-3068-2021; AAK-3333-2021; AAF-4610-2019; AAJ-8097-2021
Effects of Adipose-Induced Stem Cell Application on Everolimus Immunosuppressed Rats on Colon Anastomosis: An Experimental Study
(2018) Karakaya, Emre; Akdur, Aydincan; Atilgan, Alev Ok; Ozer, Huriye Eda Ozturan; Uysal, Cagri; Yildirim, Sedat; Haberal, Mehmet; https://orcid.org/0000-0002-4879-7974; https://orcid.org/0000-0002-8726-3369; https://orcid.org/0000-0001-8595-8880; https://orcid.org/0000-0002-5735-4315; https://orcid.org/0000-0002-3462-7632; AAD-5466-2021; AAA-3068-2021; AAK-3333-2021; AAF-4610-2019; AAJ-8097-2021
The Effects of Graft Weight on Allograft Outcomes in Pediatric Patients
(2018) Gulleroglu, Kaan; Baskin, Esra; Soy, Ebru H. Ayvazoglu; Akdur, Aydincan; Yildirim, Sedat; Moray, Gokhan; Haberal, Mehmet; 0000-0003-1434-3824; 0000-0003-4361-8508; 0000-0002-0993-9917; 0000-0002-8726-3369; 0000-0002-5735-4315; 0000-0003-2498-7287; 0000-0002-3462-7632; AAJ-8833-2021; B-5785-2018; AAC-5566-2019; AAA-3068-2021; AAF-4610-2019; AAE-1041-2021; AAJ-8097-2021
EFFECTS OF LOWER GASTROINTESTINAL TRACT SURGERY ON SURVIVAL IN ELDERLY AND OCTOGENARIAN PATIENTS
(2018) Aydin, Huseyin Onur; Avci, Tevfik; Tezcaner, Tugan; Karagulle, Erdal; Yildirim, Sedat; 0000-0003-3795-5794; 0000-0002-8522-4956; 0000-0002-3641-8674; 0000-0001-5225-959X; 0000-0002-5735-4315; S-8185-2018; C-6247-2017; AAD-9865-2021; AAF-1698-2021; AAF-4610-2019
Introduction: Life expectancy has significantly increased in the last decade. The decision to perform surgery has always been challenging in elderly patients. We aimed to evaluate outcomes in patients who underwent surgery for lower gastrointestinal tract diseases and investigate factors influencing morbidity and mortality, particularly in octogenarian patients, and the effects of age on prognosis and survival in the postoperative period. Materials and Method: This study included patients aged >= 70 years who underwent lower gastrointestinal tract surgery; patients were divided into three groups as 70-75 years, 75-79 years, and >= 80 years. Age, gender, type of surgery, ASA score, length of hospital stay, morbidity, 30-day mortality, and overall survival were evaluated. Results: The surgery was performed to 598 patients due to lower gastrointestinal tract diseases. There was a significant increase in the ASA score with increasing age (Chi-square=35.472; p<0.001). The survival rate was significantly higher in patients with malignancies than in those with benign diseases, and in patients who underwent elective surgery than in those who underwent emergency surgery (p<0.001). When patients were examined according to age groups, the overall survival was similar across groups (p=0.217). Conclusion: There was no significant difference between octogenarian and younger patients for complications and survival. Thus, planned surgical interventions in elderly patients will not negatively affect survival and surgical interventions and can be safely performed in these patients.