Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Use of Biological Prosthesis in a Patient With Kidney and Pancreas Transplant and a Giant Incisional Hernia: Case Report(2015) Ozcelik, Umit; Cevik, Halime; Bircan, Huseyin Yuce; Demirag, Alp; 0000-0003-1073-2494; 0000-0001-7276-3240; 25894161; AAG-8651-2021; R-6394-2019; JWP-7324-2024Objectives: The use of synthetic mesh in transplant patients is controversial. Recent studies have shown that biological prostheses have a greater ability to integrate into tissues, resist bacterial colonization, and reduce cytotoxic or allergic reactions, and provide similar functional results, compared with synthetic prostheses. Biological prostheses do not require any reduction or discontinuation of immunosuppressive therapy. We present the case of a kidney and pancreas transplant recipient who had a giant incisional hernia that was treated successfully with a biological prosthesis. Case Report: A 40-year-old male kidney and pancreas transplant recipient was admitted to our hospital with a giant incisional hernia, 2 years after transplant. The defect on the abdominal wall was 40 x 30 cm. We used 2 biological prostheses (40 x 20 cm and 30 x 20 cm) to close the abdominal wall. The patient was discharged on postoperative day 5 without complications. An abdominal magnetic resonance imaging scan showed complete integrity of the biological prostheses at 1 year after surgery. Conclusions: Transplant recipients have higher risks with use of synthetic prostheses because of being immunosuppressed, compared with other patients. Recent studies show that biological prostheses provided similar functional results without complications compared with synthetic prostheses. These prostheses are versatile and do not require any changes in immunosuppressive therapy. Therefore, they seem to be a better option than synthetic prostheses. In our opinion, biological prostheses are more safe, effective, and reliable than synthetic prostheses, especially for large incisional hernias in transplant recipients. We believe that further larger studies can support our opinion.Item Multiple Brain Abscesses Due to Phialemonium in a Renal Transplant Recipient: First Case Report in the Literature(2015) Aydin, Mehtap; Ozcelik, Umit; Cevik, Halime; Cinar, Ozlem; Evren, Ebru; Demirag, Alp; 0000-0003-1073-2494; 0000-0003-4044-9366; 26640919; AAG-8651-2021; HLX-0937-2023; JAZ-1759-2023Fungal brain abscesses are a rare but serious complication in transplant recipients. Phialemonium organisms are rare causes of invasive mold infections. Here, we present the first case of a renal transplant recipient with multiple brain abscesses caused by Phialemonium infection A. A 51-year-old female kidney transplant recipient was admitted with pneumonia of an unknown cause and treated with empiric intravenous antibiotics. Her treatment was uneventful, and she was discharged 1010 days later. After 5 days, she was readmitted with fever, cerebral palsy, and speech disorder. The patient had undergone living-donor renal transplant 7 months earlier. A cranial computed tomography and magnetic resonance imaging were performed for a possible cerebro vascular pathology. The magnetic resonance imaging scan showed multiple brain abscesses located at the left parietal, frontal and occipital lobes; right parietal and occipital lobes; right basal ganglia; and left cerebellum. The patient received meropenem, linezolid, sulfamethoxazole and trimethoprim, and AmBisome for probable pathogenic infection, and immunosuppressive agents dosage was reduced increasingly immuno suppressed. We identified Phialemonium in cerebrospinal fluid culture. The patient received voriconazole 200 mg twice daily. Lesions could not be drained due to lack of capsula formation. The patient died on the 30th day of antifungal therapy. Phialemonium organisms, although a rare cause of fungal infections, are associated with a high mortality rate in immunocompromised patients. To our knowledge, this is the first case report in the literature describing multiple brain abscesses due to Phialemonium in a transplant recipient. Clinicians recipient should be alert about these rare opportunistic fungi in the differential diagnosis of brain abscess, and bronchoscopy and broncho alveolar lavage are recommended for transplant patients when they are admitted with pneumonia exclude fungal infections.Item Influence of Various Living Donor Kidney Measurements in Relation to Recipient Body Measurements on Posttransplant Allograft Functional Outcomes(2018) Kulah, Eyup; Ozcelik, Umit; Isiklar, Iclal; Cevik, Halime; Bircan, Huseyin Yuce; Karakayali, Feza Y.; Haberal, Mehmet; https://orcid.org/0000-0001-6041-4254; https://orcid.org/0000-0003-1073-2494; https://orcid.org/0000-0002-1874-947X; https://orcid.org/0000-0002-3462-7632; 27356006; AAJ-5764-2021; AAG-8651-2021; R-6394-2019; AAB-3888-2021; AAJ-8097-2021Objectives: Donor kidney measurements may affect outcomes of transplanted allografts. We tested allograft and recipient measurements on kidney allograft outcomes. In this study, we compared the effects of kidney allograft volumes, which were measured using computed tomographic angiography before transplant, and allograft weight, which was measured during surgery, in relation to the recipient's body weight and body mass index on kidney function at 6 and 12 months after transplant. Material and Methods: We included 74 patients (40 female and 34 male patients, mean age of 50.42 +/- 9.75 y) in this study. Results: Intraoperative allograft weight was 182.68 +/- 40.33 g (range, 104-266 g). The allograft volume measured using computed tomographic angiography scanning was 123.34 +/- 24.26 ml (range, 78-181 ml). The estimated glomerular filtration rates of the recipients at 6 and 12 months after transplant correlated negatively with age and recipient body mass index but correlated positively with allograft volume/recipient body weight, allograft volume/recipient body mass index, allograft weight, allograft weight/recipient body weight, and allograft weight/recipient body mass index values, as concluded by univariate analyses. From multivariate analyses, we found variables of interest presumed to significantly affect the 12-month estimated glomerular filtration rates, including recipient age, allograft volume/recipient body weight, allograft volume/recipient body mass index, allograft weight, allograft weight/recipient body weight, and allograft weight/recipient body mass index. Conclusions: Transplanted allograft and recipient body values may be used as predictors of estimated glomerular filtration rates 6 and 12 months after transplant.Item Renal Stiffness on Patients with Gestational Diabetes(2017) Yilmaz, Birnur; Cevik, Halime; Bildaci, Tevfik Berk; Ozdogan, SerdincIntroduction: Gestational diabetes is defined as glucose intolerance first recognized in pregnancy. Oral glucose tolerance testing is the cornerstone in diagnosing gestational diabetes. In this study, we aimed to find a new method of diagnosis in addition to conventional diagnosed by 75 gr oral glucose tolerance testing. Material and methods: 121 pregnant woman were included part in this study, forming two groups as gestational diabetic patients (51 patients) and control group (70 pregnant woman). Both kidneys are evaluated with B Mode Ultrasound and Colour Doppler Ultrasound mode by measuring resistive index for depiction of other renal pathologies. Stiffness of renal tissue determined by Acoustic Radiation Force Impulse (ARFI) technology utilized by two blinded radiology specialists. Results: We were not able to find any correlation between gestational diabetes mellitus and resistivity index measurements (p > 0.05). But a correlation between second hour glucose levels in oral glucose tolerance test and bilateral renal stiffness was found (p < 0,05). Conclusion: ARFI ultrasound may be a non-invasive technique in determining the course of the disease.