Tıp Fakültesi / Faculty of Medicine

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

Browse

Filters

2015 - 20172

Settings

Subject: search.filters.subject.Child-Pugh score

Search Results

Now showing 1 - 2 of 2
  • No Thumbnail Available
    Item
    Factors Affecting Mortality and Morbidity of Patients With Cirrhosis Hospitalized for Spontaneous Bacterial Peritonitis
    (2015) Ensaroglu, Fatih; Korkmaz, Murat; Geckil, Ali Umit; Ocal, Serkan; Koc, Bengisu; Yildiz, Ozgun; Atalay, Fatma Busra; Tas, Emine Gul; Haberal, Mehmet; 0000-0003-3719-9482; 0000-0002-9333-782X; 0000-0002-3462-7632; 26640933; ABH-4817-2020; AAM-1330-2020; AAJ-8097-2021
    Objectives: Spontaneous bacterial peritonitis, unless originating from surgery or an intra-abdominal source, is an infection diagnosed by neutrophil counts greater than 250/mm(3) in ascites. Spontaneous bacterial peritonitis is the most common infection among patients hospitalized with cirrhosis, with a prevalence of 9% and a risk of development among all patients with cirrhosis within 1 year of 10%. No valid parameters have been defined to predict the mortality related to spontaneous bacterial peritonitis. Unless it is treated, the mortality rate as a result of spontaneous bacterial peritonitis is 50%, and serious complications may arise. Materials and Methods: Medical records from 29 patients on the deceased-donor transplant waiting list and receiving treatment at the Baskent University Hospital Gastroenterology Clinic for cirrhotic ascites infection between 1996 and 2013 were analyzed. Demographic information, para centesis findings, clinical follow-up, and treatment results were reviewed and collected from patient medical records, with data recorded to the research form. Results: In our patient group, 72.4% were men and the average age was 46.6 years. Most of our patients were at advanced stage, with 55.2% having a Child-Pugh score of C and an average Model for End-Stage Liver Disease score of 17 +/- 4.1. We found that 34.5% of the patients received prophylactic treatment for spontaneous bacterial peritonitis, 72.4% received a proton pump inhibitor, and 82.8% had treatment with intravenous albumin support at the time of diagnosis. Albumin treatment showed no effect on mortality. Mortality rate among patients with Child-Pugh score of C was 81.3%. Conclusions: Existence of chronic renal failure, liver graft surgery, and hepatocellular cancer did not seem to have a significant effect on patient mortality. The albumin treatment protocol showed no significant difference despite common belief among physicians.
  • No Thumbnail Available
    Item
    Auxiliary Partial Orthotopic Living Liver Transplant for Wilson Disease
    (2017) Haberal, Mehmet; Akdur, Aydincan; Moray, Gokhan; Boyacioglu, Sedat; Torgay, Adnan; Arslan, Gulnaz; Ozdemir, Binnaz Handan; 0000-0002-6829-3300; 0000-0002-3462-7632; 0000-0003-2498-7287; 0000-0002-8726-3369; 0000-0002-7528-3557; 0000-0002-9370-1126; 28260463; AAJ-5221-2021; AAJ-8097-2021; AAE-1041-2021; AAA-3068-2021; X-8540-2019; AAE-7637-2021
    Wilson disease is a genetic disease involving copper metabolism disturbances that result in copper accumulations, especially in the liver and brain. Wilson disease can be treated with pharmacologic agents, such as chelators that induce urinary excretion of copper or zinc salts that inhibit copper absorption in the digestive tract. Liver transplant is the only treatment option for Wilson disease when liver failure has occurred. In some patients, that is, in those with Child-Pugh A score, neurologic disease can be seen without hepatic failure. Our recommendation is for these patients to have auxiliary partial orthotopic liver transplant. Here, we present a 36-year-old male patient with neurologic disease associated with Wilson disease who had successful related living-donor auxiliary partial orthotopic liver transplant using a left lobe. The patient, as a result of neurologic symptoms that included tremor walking and speaking problems and low serum ceruloplasmin level of 7 mg/dL, was diagnosed with Wilson disease, and a liver biopsy was performed. Chronic necroinflammatory disease activity was 4/18, and the patient received chelation treatment. His hepatic functions were normal. The donor was the patient's 57-year-old father whose liver function tests were also normal. The graft-to-recipient weight ratio was 1% using a left lobe graft. After transplant, serum ceruloplasmin levels on day 15 and month 1 were 14 and 19 mg/dL. At month 1, liver function tests were normal. Doppler ultrasonography showed normal vascular flow of the native liver and the graft. The patient's neurologic symptoms were progressively reduced. Progressive neurologic deterioration with no hepatic insufficiency is considered a suitable indication for auxiliary partial orthotopic liver transplant; this procedure is suggested before the neurologic and liver failure symptoms of Wilson disease occur.