Tıp Fakültesi / Faculty of Medicine

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Author: search.filters.author.Kirnap, MahirSubject: search.filters.subject.Renal transplant

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    Incidence of Urinary Complications With Double J Stents in Kidney Transplantation
    (2019) Kirnap, Mahir; Boyvat, Fatih; Torgay, Adnan; Moray, Gokhan; Yildirim, Sedat; Haberal, Mehmet; https://orcid.org/0000-0002-6829-3300; https://orcid.org/0000-0003-2498-7287; https://orcid.org/0000-0002-5735-4315; https://orcid.org/0000-0002-3462-7632; 30777542; AAH-9198-2019; F-4230-2011; AAJ-5221-2021; AAE-1041-2021; AAF-4610-2019; AAJ-8097-2021
    Objectives: Ureteral complications remain a major source of morbidity and occasional mortality in renal transplant. Among all ureteral complications, leaks are the most frequently encountered in the early posttransplant period. The routine use of a double-J ureteric stent remains controversial, with reported increased incidence of urinary tract infection. Here, we retrospectively compared the efficacy of a double J stent in kidney transplant patients to investigate ureteral complication incidence in our center. Materials and Methods: Our study included 382 kidney transplant patients. At 5 weeks after transplant, the double J stent was removed under sedation. Patients were divided into 2 groups: 125 patients with double J stent placement (group 1) and 257 patients without double J stent placement (group 2). Results: We observed no significant demographic differences between the 2 groups with regard to patient age (median patient age of 30 y [range, 2-73 y] for group 1; median patient age of 33 y [range, 4-69 y] for group 2), patient sex (30.2% females in group 1, 32.4% females in group 2), and body mass index (median of 25.1 vs 24.9 kg/m 2 in groups 1 and 2, respectively). Cold and warm ischemia time for donor organ, delayed graft function, and episodes of acute rejection did not differ significantly between the groups. Urinary tract infection was observed in 25/125 (20.4%) and 50/257 patients (19.2%) in groups 1 and 2, respectively. Urinary leak was present in 8/125 group 1 (6.4%) and 6/257 group 2 patients (2.3%). Conclusions: A double J stent in ureteral anastomosis was not likely to decrease the frequency of leakage but is likely to reduce the gravity of the complication and the need for reoperation. In addition, the use of a double J stent was not associated with increased urinary tract infections in renal transplant recipients.
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    Timing for Removal of Peritoneal Dialysis Catheters in Pediatric Renal Transplant Patients
    (2016) Melek, Engin; Baskin, Esra; Gulleroglu, Kaan Savas; Kirnap, Mahir; Moray, Gokhan; Haberal, Mehmet; 0000-0003-4361-8508; 0000-0003-1434-3824; 0000-0003-2498-7287; 0000-0002-3462-7632; 27805518; B-5785-2018; AAJ-8833-2021; AAH-9198-2019; AAE-1041-2021; AAJ-8097-2021
    Objectives: Peritoneal dialysis, the preferred long-term renal replacement modality in the pediatric population, can also be used during the post transplant period. Although it is well known that peritonitis or other complications may occur related to the peritoneal dialysis catheter, less is known about complications related to the peritoneal dialysis during the post transplant period. Our objective was to evaluate the complications related to use of a peritoneal dialysis catheter during the posttransplant period and to determine the optimum time for removal of the peritoneal dialysis catheter. Material and Methods: We retrospectively analyzed 33 chronic peritoneal dialysis patients. Pretransplant and posttransplant demographics and clinical and laboratory data for each patient were recorded, including incidence of peritonitis and incidence of peritoneal dialysis catheter requirement after transplant. Results: Mean age of patients at transplant was 12.8 +/- 4.0 years (range, 3.5-18.0 y). Mean catheter removal time was 81.1 +/- 36.2 days (range, 22.0-152.0 d). The peritoneal dialysis catheter was used in 6 of 33 patients (18.2%); none of these patients developed peritonitis. In contrast, 2 of the 27 patients who did not use the peritoneal dialysis catheter developed peritonitis. Our data suggest that the need for catheter use occurs predominantly during the first month, and infectious complications usually happen later. Conclusions: Previously, the trend was to not remove the peritoneal dialysis catheter at the time of transplant. However, in light of recent literature and our present study, we recommend that the time of catheter removal should be modified and decided for each patient on an individual basis.