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Author: search.filters.author.Akcay, Eda YilmazSubject: search.filters.subject.Kidney transplant

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    Pretransplant Thyroid Findings in Patients With End-Stage Renal Disease
    (2016) Akcay, Eda Yilmaz; Tepeoglu, Merih; Ozdemir, Binnaz Handan; Ozgun, Gonca; Kazanci, Semih; Haberal, Mehmet; https://orcid.org/0000-0001-6831-9585; https://orcid.org/0000-0002-9894-8005; https://orcid.org/0000-0002-7528-3557; https://orcid.org/0000-0002-3462-7632; 27805516; AAK-1960-2021; AAK-5222-2021; X-8540-2019; AAJ-8097-2021
    Objectives: Patients with end-stage renal diseases can display abnormal thyroid gland function due to altered hormone excretion and transport. In this study, we aimed to evaluate the incidence of thyroid diseases by fine-needle aspiration cytology in kidney trans plant candidates and to estimate the outcomes of these patients. Materials and Methods: We reevaluated thyroid fine-needle aspiration biopsies, which were performed between January 2000 and December 2015, of 181 candidates for kidney transplant. Patient demographics and thyroid ultrasonography and biopsy findings were recorded. Results: The fine-needle aspiration biopsy findings of 181 patients were as follows: 162 were benign 5 were thyroiditis, 9 were atypia of undetermined significance/follicular lesion of undetermined significance, and 5 were malignant. Only 13 patients (7.1%) underwent thyroid operation after fine-needle aspiration, with 5 of these patients receiving a benign diagnosis, 3 receiving diagnosis of atypia of unde-termined significance/follicular lesion of undetermined significance, and 5 patients showing malignancy. In the 5 patients with benign cytology, histopathologic findings were also benign. In the 3 patients with atypia of undetermined significance/follicular lesion of undetermined significance, the final diagnosis was adenomatous hyperplasia. Finally, in the 5 patients (2.8%) showing malignancy, results after fine-needle aspiration showed papillary thyroid carcinoma. In the 5 patients with papillary thyroid carcinoma, 4 underwent renal transplant. Survival of these 4 patients was 92 +/- 42 months without tumor recurrence. Conclusions: Fine-needle aspiration is a useful diagnostic modality in evaluation of thyroid nodules in kidney transplant candidates. Early detection and treatment of thyroid nodules are essential to decrease the morbidity and mortality of these patients.
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    Splenic Peliosis Resulting in Spontaneous Splenic Rupture in a Concomitant Hepatic and Renal Allograft Recipient
    (2016) Borcek, Pelin; Ozdemir, B. Handan; Akcay, Eda Yilmaz; Haberal, Mehmet; 0000-0002-7528-3557; 0000-0001-6831-9585; 0000-0002-3462-7632; 27805528; X-8540-2019; AAK-1960-2021; AAJ-8097-2021
    Splenic peliosis is an exceedingly rare complication following liver and kidney transplant, with few previously reported cases. A 24-year-old man with chronic renal and hepatic failure due to primary oxalosis underwent concomitant renal and hepatic transplant. On the eighth day of successful transplant, he showed signs and symptoms of hypovolemia with suspicion of intra-abdominal bleeding. Diagnostic laparotomy was performed, yielding splenic rupture, and a splenectomy was performed. Macroscopically, the spleen was ruptured, and the cut surface displayed multiple parenchymal blood-filled cysts. Microscopically, the splenic microarchitecture was distorted by numerous irregular hemorrhagic lacunes partially lined by sinusoidal endothelium. Splenic peliosis was diagnosed. The patient recovered with splenectomy. Peliosis is a condition characterized by multiple blood-filled cavities in parenchymatous organs, and it most frequently affects the liver. It is thought to be related to many conditions, including hematologic malignancies, acquired immuno deficiency syndrome, chronic alcoholism, use of oral contraceptives, and posttransplant immunodeficiency state. However, peliosis of the spleen, compared with the liver, is relatively rare, and it may cause spontaneous splenic rupture. Although rare, splenic peliosis and secondary splenic rupture is a significant post transplant complications leading to unexplained hypovolemia.