Tıp Fakültesi / Faculty of Medicine
Permanent URI for this collectionhttps://hdl.handle.net/11727/1403
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Item 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-8097-2021Objectives: 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.Item Immediate Tracheal Extubation After Pediatric Liver Transplantation(2021) Sahinturk, Helin; Ozdemirkan, Aycan; Yilmaz, Olcay; Zeyneloglu, Pinar; Torgay, Adnan; Pirat, Arash; Haberal, Mehmet; 0000-0002-3462-7632; 0000-0003-0159-4771; 30346263; AAJ-8097-2021; AAJ-1419-2021Objectives: We examined whether immediate tracheal extubation among pediatric liver transplant recipients was safe and feasible. Materials and Methods: We retrospectively analyzed medical records of pediatric liver transplant recipients at Baskent University Hospital from January 2012 to December 2017. We grouped children who were extubated in the operating room versus those extubated in the intensive care unit. Results: In our study group of 81 pediatric patients, median age was 4 years (range, 4 mo to 16 y) and 44 (54%) were male. Immediate tracheal extubation in the operating room was performed in 39 patients (48%). Children who remained intubated (n = 42) had more frequent massive hemorrhage (14% vs 0%; P = .015), received larger amounts of packed red blood cells (19.3 vs 10.2 mL/kg; P < .001), and had higher serum lactate levels (9.0 vs 6.9 mmol/L; P = .001) intraoperatively. All children with open abdomens postoperatively remained intubated (n = 7). Patients extubated in the operating room received less vasopressors (1 [3%] vs 12 [29%]; P = .002) and antibiotics (11 [28%] vs 22 [52%]; P = 0.041) and developed infections less frequently postoperatively (3.0 [8%] vs 15.0 [36%]; P = .003). Children extubated in the operating room had shorter mean stay in the intensive care unit (2.0 vs 4.5 days; P < .001). Hospital mortality was higher in children who remained intubated (12% vs 0%; P = .026). Conclusions: Immediate tracheal extubation was well tolerated in almost half of our patients and did not compromise their outcomes. Patients who remained intubated had longer intensive care unit stays and higher hospital mortalities. Therefore, we recommend immediate tracheal extubation in the operating room after pediatric liver transplant among those children without intraoperative requirements for massive blood transfusion, high-dose vasopressors, high serum lactate levels, and open abdomen.Item An analysis of 635 consequetive laparoscopic hysterectomy patients in a tertiary referral hospital(2020) Yuksel, Seda; Serbetcioglu, Gonca Coban; Alemdaroglu, Songul; Yetkinel, Selcuk; Durdag, Gulsen Dogan; Simsek, Erhan; Celik, Husnu; 0000-0002-5064-5267; 0000-0002-3285-5519; 0000-0003-4335-6659; 0000-0002-2165-9168; 31610294; AAK-7016-2021; AAI-9594-2021; AAI-9974-2021; AAI-8400-2021; AAL-1530-2021Objective: The objective of this retrospective observational study is to analyse the properties of laparoscopic hysterectomy cases that are performed for benign indications and also endometrial cancer indications. Operation time, postoperative complicaton rate, blood transfusion need, and hospitalization time are compared according to benign and malign indications and also body mass index of the patients. Material and methods: Patients who were operated between September 2012 and December 2017 are included in this study. Patients' age, body mass index, medical histories, operation indications, operation time, pathology reports, pre and postoperative hemoglobine values and postoperative complications are obtained from medical records.Body mass index is classified as underweight for <19 ; normal for 19-25 ; overweight for 25-30 and obese for >= 30. Results: Operation and hospitalization times were significantly higher for high BMI and malign gynecologic indication groups than lower BMI and benign gynecologic indication groups (p:0.0001). Complication rates and transfusion needs were similar in between malign and benign gynecologic disease groups (p :0.443; P:0.670 respectively) and also in between high and lower BMI groups (P:0.813 ; P:0.468 respectively). Conclusion: Laparoscopic approach for hysterectomy operations in high BMI patients and endometrial cancer patients seem to be safe in terms of postoperative complication and bleeding that necessitate transfusion. (C) 2019 Elsevier Masson SAS. All rights reserved.Item Evaluation of Blood Transfusion Applications in Newborn Intensive Care Unit; Single Center Experience(2019) Turhan, AliINTRODUCTION: The frequency of transfusion is high in infants admitted to neonatal intensive care unit (NICU). There is a higher risk of transfusion complications compared to other age groups, and there are many special considerations for transfusion in neonates. The aim of this study was to investigate the records of infants who had blood product transfusions in NICU, to investigate which patient groups were transfused, the characteristics of the blood products used and the current transfusion practices. MATERIALS and METHODS: Between November 2013 and May 2018, the records of 968 newborn infants admitted to the Istanbul Hospital NICU of Baskent University School of Medicine were retrospectively analyzed. RESULTS: Of the babies, 43.8% were female, median birth weight was 2598 (1478-3228) grams, median birth week was 36.5 (30-39) weeks and median hospitalization days were 32 (15-67.5) days. The most commonly used blood group was A Rh (+), the least used blood group AB Rh (-). 39.9% of the transfusions were fresh frozen plasma, 36.2% erythrocyte and 23.5% platelet suspension. In addition to prematurity and related diseases, diseases requiring surgery of central nervous system, congenital heart or gastrointestinal system diseases were the most common transfused group. According to term babies, the rate of use of thrombocyte suspension was higher in preterm infants, however the rate of use of other products was similar. CONCLUSIONS: Knowledge of the selection, preparation of blood products to be used in transfusion and the specific methods for reducing the risks of transfusion will reduce the potential risks and increase the safety of transfusion.