Başkent Üniversitesi Makaleler

Permanent URI for this collectionhttps://hdl.handle.net/11727/13096

Browse

Filters

2011 - 201219

Settings

Type: search.filters.itemtype.Case Report

Search Results

Now showing 1 - 10 of 19
  • No Thumbnail Available
    Item
    Kidney Transplant After Preexisting Posterior Reversible Encephalopathy Syndrome Induced by Goodpasture's Syndrome
    (Başkent Üniversitesi, 2012-06) Lahmer, Tobias; Thürmel, Klaus; Lutz, Jens; Heemann, Uwe; Schirmer, Lucas; Küchle, Claudius
    Posterior reversible encephalopathy syndrome is characterized by varying neurologic symptoms associated with brain vasogenic edema. Posterior reversible encephalopathy syndrome can be associated with severe hypertension (eg, in eclampsia or HELLP syndrome), but it also has been observed without hypertension and in several clinical conditions including infections and autoimmune disorders. The literature offers several reports of posterior reversible encephalopathy syndrome detected or induced after bone-marrow and solid-organ transplant, or induction by immuno­suppression. We describe what is, to the best of our knowledge, the first case of man who successfully underwent a kidney transplant with preexisting posterior reversible encephalopathy syndrome induced by Goodpasture's syndrome.
  • No Thumbnail Available
    Item
    Everolimus-induced Lymphedema in a Renal Transplant Recipient: A Case Report
    (Başkent Üniversitesi, 2012-06) Ersoy, Alparslan; Koca, Nizameddin
    The mammalian target of rapamycin inhibitors is commonly preferred for solid organs for trans­plantation. Although these drugs have various adverse effects, sirolimus-related lymphedema has been rarely reported. We report a case of lymphedema related to everolimus after a kidney transplant. A 60-year-old woman successfully received a deceased-donor kidney. Everolimus was added to the treatment in postoperative month 3 owing to other immunosuppressive drugs’ adverse effects. Edema occurred first on her feet in the first year after the transplant. During 3 months’ follow-up, with no immunosuppressive adjustment, the edema progressed. Diagnosis of lymphedema was established. Several weeks after discontinuing everolimus, the patient’s lymphedema began to resolve itself and completely disappeared in 3 months. The mammalian target of rapamycin inhibitors rarely causes lymphedema by inhibiting different subtypes of vascular endothelial growth factors, which results in impaired lymphangiogenesis. While there are few reports about sirolimus-related lymphedema, this case represents the first everolimus-related case of lymphedema. Further studies are warranted to explain the underlying mechanisms.
  • No Thumbnail Available
    Item
    Renal Artery Aneurysm in Robotic Donor Nephrectomy: A Case Report
    (Başkent Üniversitesi, 2012-06) Tzvetanov, Ivo; Garcia-Roca, Raquel; Benedetti, Enrico; Oberholzer, Jose; Osipova, Maria; Jeon, Hoonbae; Spaggiari, Mario
    Objectives: With the current disparity between donor organ availability and recipient need, creative techniques help optimize the use of available organs. We present a case of a woman, who was worked-up as a kidney donor, who was incidentally found to have a saccular aneurysm on her renal artery. The patient was asymptomatic, normotensive, and had normal renal function. Materials and Methods: We performed a laparoscopic robotic donor nephrectomy, repaired the aneurysm on the back table, and transplanted the organ into the recipient. Results: The donor underwent a successful robotic nephrectomy, successfully eradicating any risk of aneurysmal complications; the recipient received an anatomically normal organ with excellent function. Conclusions: An altruistic act by the donor identified a potentially fatal lesion, which was not only remedied, but the intended donation proceeded when a creative approach was used.
  • No Thumbnail Available
    Item
    Successful Transplant of a Kidney With Fibromuscular Dysplasia Having Higher Glomerular Filtration Rate Than the Contralateral Kidney
    (Başkent Üniversitesi, 2012-06) Sun, In O; Choi, Bum Soon; Kim, Yong Soo; Yang, Chul Woo; Park, Cheol Whee; Chung, Byung Ha; Choi, Sun Ryoung; Park, Hoon Suk; Kim, Hyun Gyung; Hong, Yu Ah
    Fibromuscular dysplasia is the second-most commonly encountered anatomic abnormality in potential renal donors. Normotensive patients with medial fibroplasia and low-grade lesions have been used as renal donors. However, no studies have reported the optimal choice of a kidney for donation where the kidney with fibromuscular dysplasia had a larger volume and a higher glomerular filtration rate than the unaffected side. Herein, we report a case of renal transplant using a kidney with fibromuscular dysplasia that had higher glomerular filtration rate than the normal side. After transplant, hypertension and abnormal serum creatinine did not occur in either the donor or the recipient during 12 months’ follow-up.
  • No Thumbnail Available
    Item
    ECMO After Prolonged Cardiopulmonary Resuscitation as a Successful Bridge to Immediate Cardiac Retransplant in a 6-Year-Old Girl
    (Başkent Üniversitesi, 2012-04) Bigdeli, Amir Khosrow; Kaczmarek, Ingo; Sodian, Ralf; Schmitz, Christoph; Michel, Sebastian; Beiras-Fernandez, Andres; Deutsch, Marcus-André
    Heart failure, life-threatening arrhythmias, and sudden cardiac death are common complications in patients with advanced chronic cardiac allograft rejection—the major limiting factor of long-term survival after heart transplant. In patients with sustained cardiorespiratory arrest refractory to cardiopulmonary resuscitation extracorporeal membrane oxygenation therapy is a therapeutic option. We report the case of a 6-year-old girl with severe chronic allograft vasculopathy who was successfully bridged to cardiac retransplant through extracorporeal membrane oxygenation therapy after prolonged cardiopulmonary resuscitation. Our case demonstrates extracorporeal membrane oxygenation as a rescuing therapeutic option in high-risk, bridge-to-transplant patients, with cardiac arrest. Even after prolonged cardiopulmonary resuscitation, there were no neurologic events, and our patient recovered without any neurologic damage.
  • No Thumbnail Available
    Item
    Acute Appendicitis Post Liver Transplant: A Case Report and Literature Review
    (Başkent Üniversitesi, 2012-04) Quartey, Benjamin; Cryer, Chad; Dunne, James
    Although acute appendicitis is common, reported cases after orthotopic liver transplant are rare. A 29-year-old woman presented to the emergency department with right lower-quadrant pain and mild leukocytosis 2 years after having a liver transplant. A computed tomograph­­y scan revealed an inflamed appendix. On operation, an injected appendix was noted, and she underwent an uncomplicated laparoscopic appendectomy. Histology confirmed the diagnosis and her postoperative course was unremarkable. Owing to the rarity of these cases and paucity of knowledge on management, a high index of suspicion and immediate intervention are required to prevent major complications. This case is the first successful laparoscopic appendectomy after liver transplant ever reported.
  • No Thumbnail Available
    Item
    Bladder Rupture in Immediate Postrenal Transplant Period of Uncertain Cause
    (Başkent Üniversitesi, 2012-04) Kim, Il Young; Song, Sang Heon; Kwak, Ihm Soo; Seong, Eun Young; Rhee, Harin; Lee, Dong Won; Kim, Seo Rin; Choi, Bo Kyung; Lee, Soo Bong
    Bladder rupture in patients undergoing renal transplant is rare. A 26-year-old man underwent a deceased-donor renal transplant. Postoperatively, he showed a good clinical course, but after removal of the urethral catheter, he complained of pain in the lower aspect of the abdomen and in the left flank. Findings of abdominal computed tomography and retrograde cystography revealed an extraperitoneal bladder rupture. We did not identify specific causes for this condition and believe that the bladder rupture was spontaneous. However, we could not rule out the possibility of traumatic rupture by the double-J ureteral stent. We decided to manage this case conservatively, with an indwelling urethral catheter and antibiotics, instead of by surgical repair. Results of repeated serial cystography during the treatment showed decreased contrast extravasation, and cystographic findings at 6 weeks showed no leakage of contrast medium. We confirmed complete healing of the ruptured bladder and removed the urethral catheter. Since then, the patient has maintained good renal function without any complications.
  • No Thumbnail Available
    Item
    Co-occurrence of Nonanastomotic Biliary Stricture and Acute Cellular Rejection in Liver Transplant
    (Başkent Üniversitesi, 2012-04) Sanada, Yukihiro; Egami, Satoshi; Kawarasaki, Hideo; Yasuda, Yoshikazu; Okada, Noriki; Yamada, Naoya; Wakiya, Taiichi; Ihara, Yoshiyuki; Urahashi, Taizen; Mizuta, Koichi
    Background: Nonanastomotic biliary stricture is generally considered the most troublesome biliary complication after liver transplant. Nonanastomotic biliary stricture owing to immunologic cholangiopathy (such as acute cellular rejection) has not been reported. We describe 2 patients with the co-occurrence of nonanastomotic biliary stricture and acute cellular rejection after pediatric live-donor liver transplant. Case 1: A 13-month-old male infant with liver cirrhosis underwent an ABO-identical live-donor liver transplant using a left lateral segment graft. Eighty days after the live-donor liver transplant, fever with liver dysfunction and dilatation of the intrahepatic bile duct occurred. Percutaneous transhepatic biliary drainage and a liver biopsy were performed. The histopathologic evaluation indicated the presence of acute cellular rejection. After percutaneous transhepatic biliary drainage and steroid pulse treatment, the patient showed good clinical outcome. Case 2: A 21-month-old female infant with biliary atresia underwent an ABO-identical live-donor liver transplant using a left lateral segment graft. Twenty-six days after the live-donor liver transplant, percutaneous transhepatic biliary drainage for B3 and a liver biopsy were performed, owing to fever, with liver dysfunction, and dilatation of the intrahepatic bile duct. Histopathologic evaluation indicated the presence of acute cellular rejection. After percutaneous transhepatic biliary drainage and steroid pulse treatment, the patient showed good clinical outcome. Conclusions: It is important for patients with nonanastomotic biliary stricture to undergo early liver biopsy because the nonanastomotic biliary stricture may be coincident with, or caused by, acute cellular rejection.
  • No Thumbnail Available
    Item
    Living-donor Liver Transplant in 3 Patients With Budd-Chiari Syndrome: Case Report
    (Başkent Üniversitesi, 2012-04) Bas, Koray; Tokat, Yaman; Yuzer, Yildiray; Dogusoy, Gulen Bulbul; Ulusoy, Onur Levent; Dayangac, Murat; Yaprak, Onur
    Budd-Chiari syndrome is a rare but life-threatening disorder characterized by obstruction of the hepatic venous outflow. Treatment depends on the underlying cause, the location, and extent of the obstruction, and the functional capacity of the liver. A stepwise therapeutic approach is commonly accepted. When all other therapy options are unsuccessful, or in case of end-stage liver disease, transplant should be considered. We present case reports of 3 patients with Budd-Chiari syndrome who underwent living-donor liver transplant. Characteristic features of Budd-Chiari syndrome, diagnostic and therapeutic interventions, complications, and overall outcomes are discussed. We believe that when a deceased donor graft is unavailable, a living-donor liver transplant can be a safe option for patients with end-stage liver disease associated with Budd-Chiari syndrome.
  • No Thumbnail Available
    Item
    Autoimmune Polyglandular Syndrome Type II After Bone Marrow Transplant: Real Transfer or Acceleration of a Programmed Disease?
    (Başkent Üniversitesi, 2012-02) Mellouli, Fethi; Béjaoui, Mohamed; Hmida, Slama; Othman, Tarek Ben; Ladeb, Saloua; Torjmen, Lamia; Lakhal, Amel; Ksouri, Habib
    We report a case of autoimmune polyglandular syndrome type II that developed in an 11-year-old boy with homozygous sickle cell disease after allogeneic bone marrow transplant; the donor was his father, who was human leukocyte antigen identical and had vitiligo. On day 24 after transplant, the patient developed grade 1 acute graft-versus-host disease, which was controlled over a period of 3 months with corticosteroid-induced immuno­suppression. Full donor engraftment was documented on day 31 after transplant, and this was further confirmed on days 59, 231, 321, 472, 549, and 720. Three months after transplant, the recipient developed adrenal insufficiency, and at 13 months, he developed vitiligo. Seventeen months after transplant, autoimmune thyroid disease, positive for thyroid peroxidase and thyroglobulin autoantibodies, was diagnosed. At the same time, we identified adrenal insufficiency in the donor. We analyzed a serum sample from the recipient for autoantibody markers for type 1 autoimmune diabetes mellitus. The sample was positive for antiglutamic acid decarboxylase. Antibody against 21-hydroxylase enzyme was also found (261 U/mL; normal value, < 1 U/mL). We conclude that the recipient developed autoimmune polyglandular syndrome type II after bone marrow transplant from his father, who was probably affected by the same syndrome.