Tıp Fakültesi / Faculty of Medicine

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

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Author: search.filters.author.Sayin, Buraksearch.filters.applied.f.rights: search.filters.rights.info:eu-repo/semantics/openAccess

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    Sensitization Status of Patients on the Deceased Donor Kidney Transplant Waiting List: A Single-Center Experience
    (2022) Erdogmus, Siyar; Celebi, Zeynep Kendi; Turgut, Didem; Sayin, Burak; Ozdemir, Fatma Nurhan; Colak, Turan; Haberal, Mehmet; 0000-0002-3462-7632; AAJ-8097-2021
    Objectives: This study aimed to analyze the features of patients on the deceased donor kidney transplant waiting list and risk factors associated with sensitization that affect panel reactive antibody status in our center. Methods: Patients' data were collected retrospectively. Panel reactive antibody screening and definition tests were studied for class I (A, B, and C) and class II (DR, DP, DQ) antigens with Luminex every 6 months. Patients with panel reactive antibody >5% and antibody strength >1000 median fluorescence intensity were considered panel reactive antibody-positive. Based on the panel reactive antibody status, the patients were divided into 2 groups: the panel reactive antibody-positive group and -negative group. Results: A total of 338 patients (60% male, mean age: 52.6 +/- 14.6 years) were included in the analysis. Panel reactive antibody positivity was detected in 117 (34.6) patients on the waiting list. Compared with the panel reactive antibody-negative patient group, the panel reactive antibody-positive patient group had higher rate of women and lower age (P <.001 and P <.001, respectively). The patients in the panel reactive antibody-positive group also had longer dialysis vintage (P =.027), higher rate of blood transfusion history (P <.001), organ transplant (P <.001), and higher number of blood transfusion (P <.001). Female gender (odd ratio:4.094, 95% CI:2.275-7.368, P <.001), history of blood transfusion (odds ratio:2.027, 95% CI:1.131-3.633, P =.018), and organ transplant (odds ratio:16.894, 95% CI:7.212-39.578, P <.001) were independent risk factors associated with panel reactive antibody positivity. Conclusion: Updates of the organ allocation system to consider sensitized patients and new strategies to expand the donor pool and donation rates are needed in Turkiye.
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    Tacrolimus intrapatient variability in BK virus nephropathy and chronic calcineurin toxicity in kidney transplantation
    (2021) Turgut, Didem; Sayin, Burak; Soy, Ebru Ayvazoglu; Topcu, Deniz İlhan; Ozdemir, Binnaz Handan; Haberal, Mehmet; 0000-0002-3462-7632; 0000-0002-0993-9917; 35017328; AAJ-8097-2021; AAC-5566-2019
    Intrapatient variability (IPV) in tacrolimus has been increasingly acknowledged as a risk factor for poor graft survival after kidney transplantation. Although past studies have mainly accounted for IPV in acute or chronic rejection states as due to underimmunosuppression, this is not yet clear. So far, tacrolimus IPV for BK virus-associated nephropathy (BKVN) and chronic calcineurin inhibitor toxicity (CNIT) has not been investigated. Here, we evaluated IPV in tacrolimus for BKVN and chronic CNIT, which are mainly considered as overimmunosuppression states. In this caseucontrol study, kidney allograft biopsies conducted between 1998 and 2018 were included, with patients grouped by biopsy results as BKVN alone group, CNIT alone group, and normal graft function (control group). IPV was estimated as mean absolute deviation. Our study groups included 25 kidney transplant recipients with BKVN alone, 91 patients with CNIT alone, and 60 patients with normal 5-year graft survival (control group). In analyses of IPV in tacrolimus six months before graft biopsy, IPV was highest in the BKVN group (P = 0.001). The BKVN group also had the highest IPV in tacrolimus at 12 months after biopsy (P = 0.001), with all pairwise comparisons statistically different between groups. At 12 months after biopsy, five patients (20%) in the BKVN group and 10 patients (10.9%) in the CNIT group had graft loss. Among other risk factors, BKVN and chronic CNIT are consequences related to high IPV. Quantification of IVP for tacrolimus in clinical practice would help to optimize kidney transplant outcomes.
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