Tıp Fakültesi / Faculty of Medicine

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Author: search.filters.author.Soy, Ebru H. AyvazogluSubject: search.filters.subject.Kidney transplant

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    Long-Term Follow-up of Over 600 Living Related Kidney Donors: Single-Center Experience
    (2022) Sayin, Burak; Akdur, Aydincan; Karakaya, Emre; Soy, Ebru H. Ayvazoglu; Haberal, Mehmet; https://orcid.org/0000-0002-4879-7974; https://orcid.org/0000-0002-3462-7632; 35384802; AAD-5466-2021; AAJ-8097-2021
    Objectives: Kidney transplant is the treatment of choice in patients with end-stage renal disease because it offers improved survival and better quality of life. Although most epidemiologic studies have suggested that living kidney donors have a minimal lifetime risk of developing end-stage renal disease, long-term complications and physiologic and psychologic sequelae resulting from donation remain unclear. Here, we examined the long-term results of living-related kidney donors who donated kidneys at the Baskent University Ankara Hospital over the past 25 years. Materials and Methods: We were able to examine 607 kidney transplant donors (mean age of 52.03 +/- 11.54 years) who were seen at our center from 1986 to 2021 and who agreed to a general health evaluation. Collected data included donor age, sex, blood type, body mass index, duration after donation, blood pressure measurements, biochemical parameters, abdominal ultrasonograph for size, structure, and renal blood flow of the solitary kidney, comorbid conditions, chronic drug use, and surgical procedures after donation. Results: Mean time after donation was 10.4 +/- 3.2 years. Twenty-four donors (3.9%) were diagnosed with diabetes and 21 (3.4%) with thyroid disease, 64 (10.5%) developed hypertension, and 48 (8.8%) developed atherosclerotic cardiovascular disease. Obesity was found to be an increasing problem in our donor population, with 174 (28.6%) developing mild to moderate obesity (body mass index >25 kg/m2). Older age, obesity, smoking, and hyperlipidemia were found to be the major and independent risk factors of both hypertension and atherosclerotic cardiovascular disease in donors. None of our donors developed endstage renal disease. Conclusions: Obesity and hypertension were the most common comorbidities that developed in our kidney donor population. Our principle is to avoid unrelated and nondirected donors because of the possible long-term complications. Unrelated donors may be desperate if a family member needs donation in the future.
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    Ultrasonography Findings of Acute Tubulointerstitial Nephritis and Multiple Abscesses Following Renal Transplant: A Case Report
    (2017) Tezcan, Sehnaz; Uslu, Nihal; Soy, Ebru H. Ayvazoglu; Haberal, Mehmet; https://orcid.org/0000-0001-7204-3008; https://orcid.org/0000-0002-6733-8669; https://orcid.org/0000-0002-0993-9917; https://orcid.org/0000-0002-3462-7632; 28260478; ABC-5258-2020; AAC-5566-2019; AAJ-8097-2021
    Urinary tract infection is the most common complication after kidney transplant that can cause graft loss. An early diagnosis of urinary infections decreases morbidity and mortality. Besides clinical and laboratory examinations, ultrasonography is considered as the primary imaging modality for the diagnosis of urinary tract infections. Here, we report a 53-year-old woman who presented with fever and pain at surgical site. Ultrasonography examination showed multiple, ill-defined or irregularly margined hypoechoic areas within the cortex. Ultrasonography-guided percutaneous renal biopsy was performed. Histopathologic findings were compatible with acute tubulointerstitial nephritis and multiple abscesses. Ultrasonography is the most widely applied imaging modality for diagnoses of complications after renal transplant. Although ultrasonography findings of infections are generally nonspecific, it still plays an important role in the diagnosis of urinary infections after renal transplant.
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    Pretransplant Renal Arterial Vasculopathy of Donor Predicts Poor Renal Allograft Survival
    (2018) Ozdemir, B. Handan; Ozdemir, F. Nurhan; Borcek, Pelin; Sercan, Cigdem; Ozdemir, Gokce; Soy, Ebru H. Ayvazoglu; Haberal, Mehmet; 0000-0002-7528-3557; 0000-0002-5682-0943; 0000-0003-2545-0078; 0000-0002-0993-9917; 0000-0002-3462-7632; 29527990; X-8540-2019; AAK-1697-2021; AAL-4282-2020; AAC-5566-2019; AAJ-8097-2021
    Objectives: Transplant vasculopathy is a significant predictor of poor outcome. We investigated whether age or pretransplant renal arterial vasculopathy of grafted kidneys affected allograft survival. Materials and Methods: This study included 148 recipients and their donors. All donors underwent pretransplant renal arterial biopsy, with renal artery vascular score determined for each artery. Chronic rejection and graft loss were noted for all patients. Results: Variable grades of pretransplant renal arterial lesions were noted in 103 donors (69.6%). A positive correlation was found between donor age and renal artery score (r = 0.650, P < .001), and chronic rejection and graft loss were found to increase with increasing score (P < .001). Recipient and donor age was significantly associated with graft loss and chronic rejection. With either younger or older donors, recipients had similar and best results regarding chronic rejection and graft loss if donors had renal artery scores of 0 or 1, but worse effects if donors had scores of 2 or 3. Five-year allograft survival rates for scores of 0, 1, 2, and 3 were 91%, 68%, 46%, and 33%. Univariate analyses showed that acute rejection episode (relative risk: 2.729, 95% confidence interval, 1.496-4.977; P= .001), older (>= 50 y) donor age (relative risk: 1.970, 95% confidence interval, 1.038-3.736; P = .04), and donor renal artery score (relative risk: 2.466, 95% confidence interval, 1.382-4.401; P = .002) were associated with decreased allograft survival. Multivariate Cox analysis showed that only acute rejection episode (relative risk: 3.585, 95% confidence interval, 1.781-7.217; P < .001) and renal artery score (relative risk: 2.642; 95% confidence interval, 1.355-5.150; P = .004) were independent predictors of allograft survival. Conclusions: Pretransplant vasculopathy in donor renal artery implies a poor prognosis for renal allograft survival and is independent of other risk factors. Pretransplant renal artery biopsy is recommended for both deceased and living donors, and therapeutic interventions to modify transplant vasculopathy progression should start early posttransplant in recipients with affected renal arteries.