Fakülteler / Faculties
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Item A Case of Cerebral Tuberculosis After Liver Transplant and Literature Review(2014) Tunca, M. Zeyneb; Akcay, Eda Yilmaz; Moray, Gokhan; Ozen, Ozlem; Ozdemir, B. Handan; https://orcid.org/0000-0001-6831-9585; https://orcid.org/0000-0003-2498-7287; https://orcid.org/0000-0002-9082-1317; https://orcid.org/0000-0002-7528-3557; 24635807; AAK-1960-2021; AAE-1041-2021; AAK-4468-2021; X-8540-2019The risk of active tuberculosis is high in solid-organ recipients. We evaluated the clinical presentation of tuberculosis. Pulmonary locations were the most frequent, and extrapulmonary locations were rarely seen. Among extrapulmonary sites, intracranial tuberculosis is rare, with a few case reports reported in the literature. We report a case of 27-year-old man, who received deceased-donor liver transplant due to hepatitis B virus-related chronic liver failure. One month after the liver transplant, neurologic symptoms developed, then he had attacks of tonicclonic convulsions. Cerebral stereotactic needle biopsy of left temporal lobe was performed. Histopathologically gliosis, rare lymphocyte infiltration, and epithelioid histiocytes were seen. Histochemical staining by Ziehl Neelsen stain noted acid-fast resistant bacillus. The case was diagnosed as granulomatous inflammation which led to tuberculosis. In addition to antituberculosis therapy, he was given antiviral therapy for prophylaxis. During therapy, reactivation of hepatitis B virus was noted, and the recurrent diseases of hepatitis B virus-related viral hepatitis was diagnosed on serial biopsies. Ten months after transplant, he died from liver failure. Tuberculosis is a serious opportunistic infection in transplant recipients. The incidence of transplant recipients worldwide ranges from 0.35% to 15%. In nonrenal transplant, rejection within 6 months before the onset of tuberculosis and type of primary immunosuppressive regimen were predictors of tuberculosis infection occurring 12 months after transplant. The diagnosis and effective management of tuberculosis after transplant warnings recognition of the epidemiologic and clinical characteristics of tuberculosis in transplant recipients.Item Lung Biopsy Findings of Patients Who Have Undergone a Liver and Kidney Transplant(2016) Ozgun, Gonca; Tepeoglu, Merih; Ozdemir, Binnaz Handan; Akcay, Eda Yilmaz; Ayva, Ebru Sebnem; Deniz, Emine Ebru; Haberal, Mehmet; 0000-0002-9894-8005; 0000-0002-7528-3557; 0000-0001-6831-9585; 0000-0002-2280-8778; 0000-0002-3462-7632; 27805533; AAK-5222-2021; X-8540-2019; AAK-1960-2021; AAK-1967-2021; AAJ-8097-2021Objectives: Our objective was to analyze the incidence of pulmonary disorders in solid-organ transplant recipients and report on outcomes in these patients. Materials and Methods: Seventy liver and kidney transplant patients, who underwent lung biopsy because of pulmonary symptoms between January 2000 and December 2015, were enrolled in the study. We examined and evaluated histopathologic findings of these patients based on clinical data recorded in patients' files. Results: Patients' mean age was 44.5 +/- 16.4 years. Of 70 patients, 25 underwent liver transplant and 45 patients underwent kidney transplant. Forty-six patients received organs from living donors and 24 from deceased donors. Biopsy results of all patients included nonspecific findings (28), organized pneumonia (2), tuberculosis (6), fungal infections (11), tumors (5), amyloidosis (1), diffuse alveolar damage (4), mixed bacterial infection (1), and bronchopneumonia (12). Forty-two patients (60%) died within 54.1 +/- 53.3 months after transplant and 24.6 +/- 41.9 months after lung biopsy. Autopsies were performed on 14 patients. The causes of fatal lung diseases included fungal infections (8), malignant tumors (4), amyloidosis (1), diffuse alveolar damage (4), and mixed bacterial infection (1). Aspergillosis was the most frequently implicated lung infection, occurring in 54.5% of patients with fungal infections. Conclusions: Pulmonary diseases remain an important cause of morbidity and mortality in solid-organ transplant recipients. Fungal infection, especially aspergillosis, was the leading cause of early death in these patients.Item 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-8097-2021Splenic 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.