Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item Early Pulmonary Complications of Liver Transplant(2014) Dogrul, Mustafa Ilgaz; Akcay, Sule; Bozbas, Serife Savas; Dedekarginoglu, Balam Er; Eyuboglu, Fusun Oner; Moray, Gokhan; Haberal, Mehmet; https://orcid.org/0000-0002-7230-202X; https://orcid.org/0000-0002-5525-8207; https://orcid.org/0000-0003-2498-7287; https://orcid.org/0000-0002-3462-7632; 24635815; AAI-8064-2021; AAR-4338-2020; AAE-1041-2021; AAJ-8097-2021Objectives: Pulmonary complications are a leading problem after a liver transplant. This study sought to predict postoperative early complications by a chest radiograph performed after a transplant among adult orthotopic liver transplant recipients. Materials and Methods: One hundred thirty-five patients (43 women, 92 men; mean age, 40 y; range, 16-66 y) were included and their medical data reviewed retrospectively. A postoperative chest radiograph of each patient was evaluated to check for pulmonary complications. Results: Smoking history was noted in 61 patients (45.2%). Postoperative first chest radiograph evaluation showed normal findings in 56 patients (41.5%). Right pleural effusion was found in 25 patients (18.5%), and atelectasis was found in 25 (18.5%). Bilateral pleural effusion was the second most-frequent finding on postoperative radiograph (14.8%). Effusion accompanied by atelectasis was found in 3 patients (2.2%). Other postoperative chest radiograph findings were consolidation (n=2, 1.5%), left pleural effusion (n=2, 1.5%), and bronchiectasis (n=2, 1.5%). Conclusions: We investigated the reflection of the first chest radiograph after liver transplant on postoperative early complications. Postoperative first chest radiograph can be an inexpensive and accessible diagnostic tool for predicting postoperative problems.Item Perioperative Venoarterial Extracorporeal Membrane Oxygenation Support During Heart Transplant(2017) Gedik, Ender; Atar, Funda; Ozdemirkan, Aycan; Firat, Aynur Camkiran; Zeyneloglu, Pinar; Sezgin, Atilla; Pirat, Arash; 0000-0002-7175-207X; 0000-0003-2312-9942; 0000-0003-1470-7501; 28260473; AAH-7003-2019; ABI-2971-2020; C-3736-2018Objectives: Heart transplant is the only definitive treatment of end-stage heart failure. Venoarterial extracorporeal membrane oxygenation may be used as a bridge to heart transplant. This technique may be used after heart transplant for conditions refractory to medical treatment like primary graft failure. Previously, we reported our experience with patients who received extracorporeal support as a bridge to emergency heart transplant. In this study, we present our perioperative experience with heart transplants in which extracorporeal support was used. Materials and Methods: We retrospectively screened the data of 31 patients who were seen at our center between January 2014 and June 2016. We screened for patients who were admitted to the intensive care unit before transplant and who required venoarterial extracorporeal membrane oxygenation for circulatory support and postoperative patients who required extracorporeal support. Patient demographics and characteristics, clinical data, and extracorporeal support data were collected from our electronic database and patient medical records. Results: There were 14 patients who required peri operative extracorporeal support. Preoperative sup port was performed in 3 patients before transplant, and postoperative support was performed in 11 patients after transplant. The mean age was 37.7 years in patients within the preoperative group and 29.7 years in patients within the postoperative group. One patient with preoperative support and 5 with postoperative support were pediatric patients. The main indication for transplant was dilated cardiomyopathy in both groups (100% and 63.7%). Overall mortality rates were 33% in the preoperative group and 63.7% in the postoperative group. Conclusions: For patients on heart transplant wait lists who are worsening despite optimal medical therapy, venoarterial extracorporeal membrane oxygenation support is a safe and viable last resort. In addition, extracorporeal support can be used during the posttransplant period as salvage therapy in heart recipients with hemodynamic deterioration. In our experience, preoperative extracorporeal support had lower mortality rates compared with postoperative support.Item Postoperative Pleural Effusions After Orthotopic Heart Transplant: Cause, Clinical Manifestations, and Course(2016) Ulubay, Gaye; Kupeli, Elif; Dedekarginoglu, Balam Er; Bozbas, Serife Savas; Alekberov, Mahal; Sever, Ozlem Salman; Sezgin, Atilla; 0000-0003-2478-9985; 0000-0002-5826-1997; 0000-0002-7230-202X; 27805531; AAB-5064-2021; AAB-5345-2021; AAI-8064-2021Objectives: Postoperative pleural effusions are common in patients who undergo cardiac surgery and orthotopic heart transplant. Postoperative pleural effusions may also occur as postcardiac injury syndrome. Most of these effusions are nonspecific and develop as a harmless complication of the surgical procedure itself and generally have a benign course. Here, we investigated the cause and clinical and laboratory features of postoperative early and late pleural effusions in orthotopic heart transplant patients. Materials and Methods: We retrospectively reviewed the medical records of 50 patients who underwent orthotopic heart transplant between 2004 and 2015 at Baskent University. Patient demographics and clinical and laboratory data, including cause of heart failure, presence of pleural effusions at chest radiography in the first year after transplant, timing of onset, microbiologic and biochemical analyses of pleural effusions, and treatment strategies were noted. Results: Mean age of patients was 39.22 +/- 13.83 years (39 men, 11 women). Reason for heart failure was dilated cardiomyopathy in most patients (76%). Nineteen patients (38%) had postoperative pleural effusions, with 15 patients (78.9%) with pleural effusion during the first week after transplant. Of these, 4 patients had recurrent pleural effusion. A diagnostic thoracentesis was performed in 10 patients, with 4 showing transudative effusion and 6 showing exudative effusion secondary to infection (2 patients), postcardiac injury syndrome (1 patient), and hemo thorax (3 patients). Aspergillus fumigatus was detected by quantitative culture from pleural effusion in 1 patient. Tube thoracoscopy drainage was performed in 10 patients (25%), and 2 patients received antibiotic therapy. Conclusions: Pleural effusions are frequent after cardiac transplant. Complications may occur in a small portion of patients, with most effusions being nonspecific and having a benign course with spontaneous resolution. Early diagnostic thoracentesis could improve post operative outcomes in these patients.Item Return to outdoor walking, car driving, and sexual activity following elective inguinal hernia repair: surgeons' perspective versus patients' reality(2020) Kulacoglu, H.; Celasin, H.; Karaca, A. S.; 0000-0001-6456-1868; 32592152; AAK-5337-2021Purpose To determine the time to resumption of outdoor walking, car driving, sports, and sexual activity following elective inguinal hernia repair, and to reveal if there are differences between surgeons' recommendations and patients' real return times. Methods A questionnaire including questions about recommendations to hernia patients for times to resume outdoor walking ability without assistance, driving and sexual intercourse after an elective inguinal hernia repair was sent to surgeons. Also, a short questionnaire was sent to patients who had undergone elective inguinal hernia repair to search the exact times for resuming these physical activities. Results Surgeons' thoughts and recommendations to their patients varied significantly. The range of recommendations were same day to 20 days for outdoor walking, and same day to 3 months both for driving and sexual intercourse. Patients' actual resumption of postoperative activities were 1-14 days for outdoor walking, 1 day to 3 months for driving, and 1 day to 2 months for sexual intercourse. When the answers from the two questionnaires were compared, it was observed that the mean times for resumption of outdoor walking and sexual intercourse were significantly longer in the patients' lives than recommended by the surgeons. Patients >= 60 years were able to walk outside, drive, and participate in sexual activity earlier than the younger patients. Bilateral and recurrent hernia repairs caused slower resumption of different activities in comparison to primary hernias. Conclusions Patients reported that times for resumption of outdoor walking, driving, and sexual activity were significantly longer than those recommended by surgeons. Age, BMI, bilateral repair, and recurrent hernias were found to be factors affecting return time to different activitie