Tıp Fakültesi / Faculty of Medicine

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

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Author: search.filters.author.Torgay, AdnanSubject: search.filters.subject.Liver transplantation

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    Treatment of Biliary Complications After Liver Transplant: Results of a Single Center
    (2015) Yildirim, Sedat; Soy, Ebru Hatice Ayvazoglu; Akdur, Aydincan; Kirnap, Mahir; Boyvat, Fatih; Karakayali, Feza; Torgay, Adnan; Moray, Gokhan; Haberal, Mehmet; 0000-0002-8726-3369; 0000-0002-3462-7632; 0000-0002-5735-4315; 0000-0002-0993-9917; 0000-0002-6829-3300; 0000-0002-1874-947X; 0000-0003-2498-7287; 25894131; AAA-3068-2021; F-4230-2011; AAH-9198-2019; AAJ-8097-2021; AAF-4610-2019; AAC-5566-2019; AAJ-5221-2021; AAB-3888-2021; AAE-1041-2021
    Biliary complications are major sources of morbidity after liver transplant due to vulnerable vascularization of the bile ducts. Biliary complications are the "Achilles' heel" of liver transplant with their high incidence, need for repeated and prolonged treatment, and potential effects on graft and patient survival. Although standardization of reconstruction techniques and improvements in immunosuppression and organ preservation have reduced the incidence of biliary complications, in early reports the morbidity rates are 50%, with related mortality rate 25% to 30%. Prophylaxis is a major issue. Although many risk factors (old donor age, marginal graft, prolonged ischemia time, living-donor liver transplant, partial liver transplant, donation after cardiac death, hepatic arterial thrombosis, organ preservation, chronic rejection, and other donor and recipient characteristics) do not directly affect biliary complications, accumulation of the factors mentioned above, should be avoided. However, no accepted standard has been established. Treatment strategy is a subject of debate. Recently, non-operative treatment of biliary complications have been preferred for diagnosis and therapy, because percutaneous or endoscopic treatment may prevent the need for surgical intervention. In this study, we reviewed our treatment of early and late biliary complications after liver transplant.
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    Results of Biliary Reconstruction Using a Polytetrafluoroethylene Graft in Liver Transplant Patients
    (2017) Haberal, Mehmet; Soy, Ebru H. Ayvazoglu; Moray, Gokhan; Caliskan, Kenan; Yildirim, Sedat; Torgay, Adnan; 0000-0003-2498-7287; 0000-0002-5735-4315; 0000-0002-0993-9917; 0000-0002-3462-7632; 0000-0002-8767-5021; 0000-0002-6829-3300; 28260438; AAE-1041-2021; AAF-4610-2019; AAC-5566-2019; AAJ-8097-2021; AAJ-7201-2021; AAJ-5221-2021
    Objectives: Biliary complications after liver transplant are a major concern with their high incidence, the need for repeated and long-term treatment, and their potential effects on graft and patient survival. We report our experience with biliary anastomosis using a spiral polytetrafluoroethylene graft. Materials and Methods: Between December 8, 1988, and July 2016, we performed 538 liver transplant procedures. We used a spiral polytetrafluoroethylene graft for biliary anastomosis in 10 patients: for biliary stricture reconstruction after liver transplant in 4 patients and during the primary liver transplant in 6 patients. Results: Four patients who underwent biliary stricture reconstruction are doing well, with normal liver function. Of the 6 patients who received the graft during primary liver transplant, 2 died from sepsis, although they maintained normal liver function. Of the 4 living patients, 1 had a biliary complication that was reconstructed surgically. The 4 living patients are currently doing well, with normal liver function. Conclusions: Our small series of patients shows that the use of a spiral polytetrafluoroethylene graft is effective at reducing biliary complications in transplant patients.