Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
Browse
8 results
Search Results
Item Late Intensive Care Unit Admission in Liver Transplant Recipients: 10-Year Experience(2015) Atar, Funda; Gedik, Ender; Kaplan, Serife; Zeyneloglu, Pinar; Pirat, Arash; Haberal, Mehmet; 0000-0002-3462-7632; 0000-0002-7175-207X; 0000-0003-2312-9942; 0000-0001-6762-895X; 26640903; AAJ-8097-2021; ABI-2971-2020; C-3736-2018; GLV-1652-2022Objectives: We evaluated late intensive care unit admission in liver transplant recipients to identify incidences and causes of acute respiratory failure in the postoperative period and to compare these results with results in patients who did not have acute respiratory failure. Materials and Methods: We retrospectively screened the data of 173 consecutive adult liver transplant recipients from January 2005 through March 2015 to identify patients with late admission (> 30 d posttransplant) to an intensive care unit. Patients were divided into 2 groups: patients with and without acute respiratory failure. Acute respiratory failure was defined as severe dyspnea, respiratory distress, decreased oxygen saturation, hypoxemia or hypercapnia on room air, or need for noninvasive or invasive mechanical ventilation. Demographic, laboratory, clinical, and respiratory data were collected. Model for End-Stage Liver Disease, Acute Physiology and Chronic Health Evaluation II, and Sequential Organ Failure Assessment scores; lengths of intensive care unit and hospital stays; and hospital mortality were assessed. Results: Among 173 patients, 37 (21.4%) were admitted to an intensive care unit, including 22 (59.5%) with acute respiratory failure. The leading cause of acute respiratory failure was pneumonia (n = 19, 86.4%). Patients with acute respiratory failure had significantly lower levels of albumin before intensive care unit admission (P =.003). In patients with acute respiratory failure, severe sepsis and septic shock were more frequently observed and tracheotomy was more frequently performed (P=.041). Conclusions: Acute respiratory failure developed in 59.5% of liver transplant recipients with late intensive care unit admission. The leading cause was pneumonia, with this group of patients having higher requirements for invasive mechanical ventilation and tracheotomy, longer stays in an intensive care unit, and higher mortality.Item Aneurysmal Bone Cyst in a Renal Transplant Patient(2022) Sahinturk, Fikret; Sonmez, Erkin; Altinors, Nur; Terzi, Aysen; Haberal, Mehmet; 0000-0002-3462-7632; 0000-0002-0471-3177; 31324137; AAJ-8097-2021; AAI-7972-2021Aneurysmal bone cysts constitute 1% to 2% of all primary bone tumors. They are rapidly growing benign bone tumors. Nearly 80% of aneurysmal bone cysts occur in the first 20 years of life, and most are primary tumors. Aneurysmal bone cysts are mostly benign, locally aggressive, and highly vascularized tumors. Generally, the period required for postoperative recovery and new bone formation is long. The relapse rate can be up to 50%. Although computed tomography and magnetic resonance imaging scans are the preferred diagnostic methods, biopsy is the most necessary prerequisite to confirm diagnosis, as aspects of these cysts can show similarity to many other bone lesions. Correct histopathologic diagnosis is important since malignancies may be seen in transplant recipients.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 Smoking Behaviors of Renal Transplant Recipients: An Analysis of 113 Patients(2016) Sozen, Fisun; Aydemir, Sinem; Erdal, Rengin; Haberal, Mehmet; 0000-0002-1951-2693; 0000-0002-7329-7576; 0000-0002-3462-7632; 27805523; AAC-1823-2021; AAK-2334-2021; AAJ-8097-2021Objectives: Smoking is the most important remediable risk factor for the progression of renal diseases. Smoking has serious adverse effects, such as cardiovascular disease, kidney function impairment, and cancer in kidney transplant recipients who are already at high risk for these diseases. In this study, our objective was to evaluate descriptive characteristics and smoking status of renal transplant recipients. Materials and Methods: We evaluated 113 patients who underwent renal transplant at Baskent University Hospital between 1990 and 2015. The medical records of all patients were retrospectively reviewed. Patient demographics, cause of renal diseases, mortality status, smoking status, and amount of smoking were recorded. Results: In our study, 82 patients (72.7%) were male and 31 were female. The mean age was 38.50 +/- 12.94 years. Causes of renal failure were as follows: 15.9% from hypertension, 12.4% from diabetes mellitus (all types), 8% from glomerulonephritis, 8% from vesicoureteral reflux, 6.2% from polycystic kidney disease, 17.6% other, and 31.9% unknown. Comorbid systemic disease was found in 57.6% of the patients. Fifty patients (44.2%) were current smokers, and 63 patients (55.8%) were nonsmokers. Mean age of smokers was 44.68 +/- 10.60 years, with most being male patients (92.0%). There was a statistically significant difference between smoking status and sex (P < .001). The presence of comorbid diseases was significantly different between smokers and nonsmokers (P = .001). The smoking status of patients with hypertension (28.2%) was significantly different (P = .032) than others. Conclusions: Smoking cessation is associated with substantial health benefits for all smokers. For kidney transplant recipients, cigarette smoking has many adverse effects, causing cardiovascular disease and other comorbid diseases. Therefore, every attempt should be made to encourage kidney transplant candidates to stop smoking.Item Skin Cancer Risk Awareness and Sun-Protective Behavior Among Solid-Organ Transplant Recipients(2018) Vural, Ayse Tuncer; Togral, Arzu Karatas; Kirnap, Mahir; Gulec, A. Tulin; Haberal, Mehmet; 0000-0001-8770-5721; 0000-0002-3462-7632; 29528028; AAQ-4123-2021; AAH-9198-2019; AAJ-8097-2021Objectives: Solid-organ transplant recipients are at an increased risk of developing skin cancer; this risk is due to long-term graft-preserving immunosuppressive therapy, and excessive sun exposure is a major contributing factor to this process. The aim of this study was to evaluate the skin cancer awareness and sun-protective behavior of solid-organ transplant recipients. Materials and Methods: In all, 70 consecutive solid-organ transplant recipients were evaluated regarding knowledge of their increased skin cancer risk and regarding the influence of this knowledge on their sun-protective practices, by applying a questionnaire during their routine check-up visits. Results: Of 70 solid-organ transplant recipients, 38 (54.3%) stated knowledge of hazardous consequences of sun exposure; however, only 28 (40%) had the knowledge of causal relationship between sun and skin cancer development. There were 31 patients (44.3%) who were unable to recall anybody giving any information to them about sun protection, and 40 patients (57.1%) had never visited a dermatology clinic. The 10 solid-organ transplant recipients (14.3%) who used sunscreen creams daily had been undergoing regular dermatologic examination. Regarding sun-protective clothing, only 8 patients (11.4%) had been wearing a suitable hat, long sleeves, and sunglasses when outdoors. There was a statistically significant difference between the groups who had visited a dermatology clinic versus those who had not regarding knowledge of sun protection, the causal relationship between sun exposure and skin cancer, the use of sunscreens, and use of sun-protective clothing (P < .05). Conclusions: Our data showed that dermatologic examination and education of patients about skin cancer development and sunscreen measures improved the sun-protective habits of solid-organ transplant recipients. Therefore, orderly visits once or twice a year should be strongly advised for this patient population by their medical care providers.Item Nonmelanoma Skin Cancers in Solid-Organ Transplant Recipients: A Single Center Experience(2018) Albayati, Abbas; Ozkan, Burak; Eyuboglu, Atilla Adnan; Uysal, Ahmet Cagri; Ertas, Nilgun Markal; Haberal, Mehmet; 0000-0003-2806-3006; 0000-0003-3093-8369; 0000-0002-9805-9830; 0000-0001-6236-0050; 0000-0002-3462-7632; 29528001; AAC-3344-2021; AAI-5063-2020; AIC-3493-2022; AAJ-2949-2021; AAJ-8097-2021Objectives: Skin cancers are one of the most common malignancies in solid-organ transplant recipients. Increased age and immunosuppressive drug use are risk factors for posttransplant skin malignancies. We evaluated nonmelanocytic skin cancer incidence and development time in transplant patients. Materials and Methods: We reviewed 1833 patients who received kidney, liver, and heart grafts between 1996 and 2016 at Baskent University. We excluded melanocytic skin cancers, premalignant lesions, and benign skin tumors. Results: Of 1833 patients, 1253 were male (68.4%) and 580 were female (31.6%), composed of 1133 kidney (61.8%), 512 liver (27.9%), and 120 heart recipients (6.5%). Of these, 22 patients (18 kidney/3 liver/1 heart) developed 23 different types of skin cancer. Prevalence of skin cancer was 1.20%. Mean age at presentation was 55.8 years (range, 37-71 y). Average time from transplant to skin malignancy was 6.1 years (range, 1-13 y), with the most common being basal cell carcinoma (43%, 10 cases), followed by squamous cell carcinoma (39%, 9 cases) and Kaposi sarcoma (13%, 3 cases). Tumor sites included head and neck (15 case), trunk (2 cases), lower extremity (2 cases), and upper extremity (2 cases). Neither local recurrence nor distant metastasis was shown. Conclusions: Skin cancer risk is increased in solid-organ transplant recipients versus the general population. Although squamous cell carcinoma is the most common tumor in this patient population, followed by basal cell carcinoma, we found this reversed in our patients. The low prevalence of skin malignancy (1.20%) may be associated with close clinical follow- up to detect premalignant skin lesions and the low-dose immunosuppressive drug regimen. We believe that local recurrence and distant metastasis were absent because we use a wide surgical margin of excision and provide strict follow-up. Routine dermatologic follow-up visits of transplant recipients are recommended to detect and treat early skin cancer and premalignant lesions and thus lower morbidity and mortality.Item 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-8097-2021Objectives: 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.Item Cervical Spinal Ependymoma With Hemorrhage in a Renal Transplant Patient(2022) Sahinturk, Fikret; Dere, Umit Akin; Kirnap, Mahir; Sonmez, Erkin; Altinors, Nur; Ozen, Ozlem; Haberal, Mehmet; https://orcid.org/0000-0002-0471-3177; https://orcid.org/0000-0002-6678-6224; 30251937; AAI-7972-2021; N-1435-2014Ependymomas are the most common intramedullary spinal tumors in adults and constitute around 20% of all spinal tumors in adults. There are 3 subgroups of ependymomas according to World Health Organization classification: subependymoma or myxopapillary (grade 1), ependymoma (grade 2), and anaplastic (grade 3). Therapy for patients is aimed at safe and total surgical removal and, in selected cases, postoperative radiotherapy. Bleeding from a spinal ependymoma, with subsequent urgent surgery, is extremely rare. Here, we present a case of a renal transplant patient who had a cervical ependymoma. Although a considerable volume of peritumoral blood was observed during surgery, the patient had no neurologic deficits and no signs of deterioration.