Tıp Fakültesi / Faculty of Medicine

Permanent URI for this collectionhttps://hdl.handle.net/11727/1403

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2015 - 20173

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Author: search.filters.author.Haberal, MehmetSubject: search.filters.subject.Kidney

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    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.
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    Lung Biopsy Findings of Patients Who Have Undergone a Liver and Kidney Transplant
    (2016) Ozgun, Gonca; Tepeoglu, Merih; Ozdemir, Binnaz Handan; Akcay, Eda Yilmaz; Ayva, Ebru Sebnem; Deniz, Emine Ebru; Haberal, Mehmet; 0000-0002-9894-8005; 0000-0002-7528-3557; 0000-0001-6831-9585; 0000-0002-2280-8778; 0000-0002-3462-7632; 27805533; AAK-5222-2021; X-8540-2019; AAK-1960-2021; AAK-1967-2021; AAJ-8097-2021
    Objectives: Our objective was to analyze the incidence of pulmonary disorders in solid-organ transplant recipients and report on outcomes in these patients. Materials and Methods: Seventy liver and kidney transplant patients, who underwent lung biopsy because of pulmonary symptoms between January 2000 and December 2015, were enrolled in the study. We examined and evaluated histopathologic findings of these patients based on clinical data recorded in patients' files. Results: Patients' mean age was 44.5 +/- 16.4 years. Of 70 patients, 25 underwent liver transplant and 45 patients underwent kidney transplant. Forty-six patients received organs from living donors and 24 from deceased donors. Biopsy results of all patients included nonspecific findings (28), organized pneumonia (2), tuberculosis (6), fungal infections (11), tumors (5), amyloidosis (1), diffuse alveolar damage (4), mixed bacterial infection (1), and bronchopneumonia (12). Forty-two patients (60%) died within 54.1 +/- 53.3 months after transplant and 24.6 +/- 41.9 months after lung biopsy. Autopsies were performed on 14 patients. The causes of fatal lung diseases included fungal infections (8), malignant tumors (4), amyloidosis (1), diffuse alveolar damage (4), and mixed bacterial infection (1). Aspergillosis was the most frequently implicated lung infection, occurring in 54.5% of patients with fungal infections. Conclusions: Pulmonary diseases remain an important cause of morbidity and mortality in solid-organ transplant recipients. Fungal infection, especially aspergillosis, was the leading cause of early death in these patients.
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    Culture-Positive Pulmonary Aspergillosis Infection: Clinical and Laboratory Features of Solid-Organ Transplant Recipient
    (2017) Dedekarginoglu, Balam Er; Bozbas, Serife Savas; Ulubay, Gaye; Eyuboglu, Fusun Oner; Haberal, Mehmet; https://orcid.org/0000-0002-7230-202X; https://orcid.org/0000-0003-2478-9985; https://orcid.org/0000-0002-5525-8207; https://orcid.org/0000-0002-3462-7632; 28260471; AAI-8064-2021; AAB-5064-2021; AAR-4338-2020; AAJ-8097-2021
    Objectives: Aspergillosis is a common fungal infection among solid-organ transplant recipients. Even after awareness of this infection occurs, there are still gaps in nonculture diagnostic tests, which can delay treatment initiation. Here, we aimed to define the common traits of pulmonary aspergillosis infection among solid-organ transplant recipients, thus shedding light on prevention and early diagnosis. Materials and Methods: We conducted a database search of patients at Baskent University who had a positive aspergillosis culture between January 2010 and March 2016. Among 20 patients identified, 15 (mean age of 50.93 +/- 11.17 y, 2 female and 13 male patients) with solid-organ transplant were included in the study. Results: Of the 15 study patients, 7 were heart transplant, 6 were kidney transplant, and 2 were liver transplant recipients. Three patients had positive aspergillosis cultures from extrapulmonary specimens (1 brain biopsy and 2 wound swap cultures). Other patients with positive cultures were from broncho alveolar lavage (6 patients), sputum (4 patients), both bronchoalveolar lavage and sputum (1 patient), and deep tracheal aspiration specimen (1 patient). Aspergillus fumigatus was the most common species. Mean hospitalization duration was 31.53 days (range, 2-135 d). Although all patients had positive culture results, 7 patients (46.7%) had negative galacto mannan test results at the time of culture specimen collection. Positive galactomannan test results were statistically higher in 6 heart transplant patients (P = .045). All patients had fever at presentation, and 13 patients had been referred to the pulmonary disease department before positive culture results were obtained. Conclusions: Risk factors for pulmonary aspergillosis and its clinical presentation in solid-organ transplant recipients are still unclear. Although the expected time for aspergillosis infection in solid-organ transplant recipients is 6 months after transplant, clinicians must remember the nonspecific presentation of infections in these patients and be aware of the reliability of diagnostic tools.