Wos İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11727/4807
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Item Posttransplant Pneumonia Among Solid Organ Transplant Recipients Followed in Intensive Care Unit(2022) Yesiler, Fatma Irem; Yazar, Cagla; Sahinturk, Helin; Zeyneloglu, Pinar; Haberal, Mehmet; 0000-0002-3887-0314; 0000-0003-0159-4771; 0000-0002-3462-7632; 34269656; AAJ-1419-2021; AAJ-8097-2021Objectives: Pneumonia is a significant cause of morbidity and mortality in solid-organ transplant recipients. We studied the demographic characteristics, respiratory management, and outcomes of solid-organ transplant recipients with pneumonia in an intensive care unit. Materials and Methods: There have been 2857 kidney, 687 liver, and 142 heart transplants performed between October 16, 1985, and February 28, 2021, at our center. We retrospectively analyzed records for 51 of 193 recipients with pneumonia during the posttransplant period between January 1, 2016, and December 31, 2018. Results: Fifty-one of 193 recipients were followed in the intensive care unit. Mean age was 45.4 +/- 16.6 years among 42 male (82.4%) and 9 female (17.6%) recipients. Twenty-six patients (51%) underwent kidney transplant, 14 (27.5%) liver transplant, 7 (13.7%) heart transplant, and 4 (7.8%) combined kidney and liver transplant. Most pneumonia episodes occurred 6 months after transplant (70.6%) with acute hypoxemic respiratory failure. Mean Acute Physiology and Chronic Health Evaluation System II score was 18.9 +/- 7.7, and the Sequential Organ Failure Assessment score was 8.5 +/- 3.9 at intensive care unit admission. Whereas 66.7% of pneumonia cases were nosocomial acquired, 33.3% were community acquired. The intensive care unit and 28-day mortality rates were 39.2% and 64.7%, respectively. Conclusions: Solid-organ transplant recipients with pneumonia have been associated with poor prognosis. Our cohort followed in the intensive care unit comprised mostly patients with nosocomial pneumonia with acute hypoxemic respiratory failure, hospitalized 6 months after transplant with high Acute Physiology and Chronic Health Evaluation System II scores predictive of mortality. In this high-risk patient group, careful follow-up, early discovery of warning signs, and rapid treatment initiation could improve the outcomes in the intensive care unit.Item Treatment of Posttransplant Hepatocellular Carcinoma Recurrence(2022) Haberal, Mehmet; Karakaya, Emre; Akdur, Aydincan; Soy, Ebru Ayvazoglu; https://orcid.org/0000-0002-3462-7632; https://orcid.org/0000-0002-8726-3369; https://orcid.org/0000-0002-0993-9917; 35060449; AAJ-8097-2021; AAA-3068-2021; AAC-5566-2019Objectives: In patients who receive liver transplant to treat hepatocellular carcinoma, 10% to 15% posttransplant recurrence is observed. In the present study, we evaluated the long-term outcomes of patients who had received liver transplant for treatment of hepatocellular carcinoma. Materials and Methods: Of the 683 liver transplants that we performed, 72 were in response to hepatocellular carcinoma. The physical examination and laboratory and imaging results of the patients were retrospectively analyzed and recorded. The recipients were evaluated according to the Baskent criteria and divided into 2 groups: early diagnosis and late diagnosis. Results: Among 72 total patients in our study, 19 (26.3%) were pediatric recipients. Hepatocellular carcinoma recurred in 7 patients (9.7%; 5 adult, 2 pediatric). Except for one patient, all were in the late diagnosis group.The mean survival time of all patients was 137.45 +/- 10 months.The mean survival in the early diagnosis group was longer than in the late diagnosis group. During follow-up, 11 patients died from recurrence and distant metastasis. Conclusions: In patients with hepatocellular carcinoma who received liver transplant, we found that postoperative recurrence of hepatocellular carcinoma and distant metastasis can be treated with surgery and/or with interventional radiology methods, which may improve patient survival after liver transplant.Item Posttransplant Malignancies in Adult Renal and Hepatic Transplant Patients(2020) Rahatli, Samed; Altundag, Ozden; Soy, Ebru Ayvazoglu; Moray, Gokhan; Haberal, Mehmet; 0000-0003-2498-7287; 0000-0002-3462-7632; 0000-0002-0993-9917; 0000-0003-3163-7429; 30119617; AAE-1041-2021; AAJ-8097-2021; AAC-5566-2019; AAJ-3047-2021Objectives: The risk of some cancer types increases after organ transplant compared with that shown in the general population; this has been well documented in clinical studies. With patients having longer survival and with the higher number of transplant procedures, cancer is an increasing health concern at high-volume transplant centers. Malignancy has an important effect on short- and long-term graft and patient survival. In this study, we evaluated cancer frequency during transplant patient follow-up. Materials and Methods: This single-center retrospective study included patients who underwent solid-organ transplant at the Baskent University Medical Faculty Hospital from 1997 to 2017. Renal and hepatic transplant patients older than 16 years at the time of transplant and diagnosed with cancer after transplant were included the study. In total, 1176 of 2018 renal transplant recipients and 274 of 548 hepatic transplant recipients met the inclusion criteria. Results: We determined that 52 of 1176 renal transplant (4.5%) and 9 of 274 hepatic transplant patients (3.3%) developed posttransplant cancer during followup. Of 61 total patients with cancer posttransplant, 44 were males (72.1%) and 17 were females (27.9%), with median age at transplant of 39.2 years. Overall, the incidence of cancer in transplant recipients was 4.2%. The most frequent cancers were basal and squamous skin cancers, which were seen in 18 patients (29%), and Kaposi sarcoma, which was seen in 11 patients (18%). Of the 61 patients who developed cancer, 43 (70%) were still alive at the time of this study. Conclusions: Despite recent positive developments in the use of immunosuppressive drugs, posttransplant malignancy is still a health problem. Fortunately, most cancers in this patient group have good prognosis and can be cured by surgical resection. Transplant physicians should aim for early detection of these diseases.