Fakülteler / Faculties
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Item Relation of Anxiety, Depression, and Behavioral Problems With Time Allocated to Television, Computer, and Smartphone in Children Receiving Renal Replacement Therapy(2022) Taner, Hande Ayraler; Baskin, Esra; Kaya, Zulal Torenli; Sari, Burcu Akin; Taskiran, Candan; Akdur, Aydincan; Moray, Gokhan; Haberal, Mehmet; https://orcid.org/0000-0003-1428-0739; https://orcid.org/0000-0002-9730-7206; https://orcid.org/0000-0002-3462-7632; 35384817; AAK-7065-2021; S-3910-2019; AAJ-8097-2021Objectives: Children and adolescents with chronic diseases have more screen exposure time compared with their healthy peers. In this study, we investigated screen exposure time of children who received renal replacement therapy, which included kidney transplant and dialysis treatment, versus a healthy control group. Materials and Methods: Our study included 55 children and adolescents between the ages of 8 and 18 years. Although 28 participants did not have any chronic disease, 27 had chronic diseases and received renal replacement therapy. Among these patients, 17 had kidney transplant and 10 were receiving dialysis. A sociodemographic information form and the Conners Short-Form Parent Rating Scale were given to parents. Pediatric and adolescent patients completed the Children's Depression Inventory and Spielberger State-Trait Anxiety Scale-2. We analyzed differences between the groups with and without renal replacement therapy and examined relations between continuous variables. Results: Duration of television screen time was significantly higher in children and adolescents receiving renal replacement therapy. Patients in the renal replacement therapy group showed a positive correlation between the Conners Short-Form Parent Rating Scale anxiety subscores and duration of smartphone use. In the kidney transplant recipient group, smartphone and computer durations were positively correlated and television duration was negatively correlated with the Conners Short-Form Parent Rating Scale behavioral problems subscores. Conclusions: Children on renal replacement therapy may be at risk in terms of excessive television exposure. Children who are on dialysis and have had a kidney transplant may be more prone to the negative effects of screen exposure than healthy peers who do not have chronic illnesses. These children and adolescents should be closely monitored to avoid the negative effects of excessive screen exposure.Item Sensitization Status of Patients on the Deceased Donor Kidney Transplant Waiting List: A Single-Center Experience(2022) Erdogmus, Siyar; Celebi, Zeynep Kendi; Turgut, Didem; Sayin, Burak; Ozdemir, Fatma Nurhan; Colak, Turan; Haberal, Mehmet; 0000-0002-3462-7632; AAJ-8097-2021Objectives: This study aimed to analyze the features of patients on the deceased donor kidney transplant waiting list and risk factors associated with sensitization that affect panel reactive antibody status in our center. Methods: Patients' data were collected retrospectively. Panel reactive antibody screening and definition tests were studied for class I (A, B, and C) and class II (DR, DP, DQ) antigens with Luminex every 6 months. Patients with panel reactive antibody >5% and antibody strength >1000 median fluorescence intensity were considered panel reactive antibody-positive. Based on the panel reactive antibody status, the patients were divided into 2 groups: the panel reactive antibody-positive group and -negative group. Results: A total of 338 patients (60% male, mean age: 52.6 +/- 14.6 years) were included in the analysis. Panel reactive antibody positivity was detected in 117 (34.6) patients on the waiting list. Compared with the panel reactive antibody-negative patient group, the panel reactive antibody-positive patient group had higher rate of women and lower age (P <.001 and P <.001, respectively). The patients in the panel reactive antibody-positive group also had longer dialysis vintage (P =.027), higher rate of blood transfusion history (P <.001), organ transplant (P <.001), and higher number of blood transfusion (P <.001). Female gender (odd ratio:4.094, 95% CI:2.275-7.368, P <.001), history of blood transfusion (odds ratio:2.027, 95% CI:1.131-3.633, P =.018), and organ transplant (odds ratio:16.894, 95% CI:7.212-39.578, P <.001) were independent risk factors associated with panel reactive antibody positivity. Conclusion: Updates of the organ allocation system to consider sensitized patients and new strategies to expand the donor pool and donation rates are needed in Turkiye.Item Effect of Post-Transplant Cardiac Angiographic Procedures on Post-Transplant Renal Function(2022) Keskin, Suzan; Ciftci, Orcun; Soy, Ebru Ayvazoglu; Muderrisoglu, Haldun; Haberal, Mehmet; 0000-0002-0993-9917; 0000-0002-3462-7632; 35918191; AAC-5566-2019; AAJ-8097-2021Background. Cardiac interventions often are performed before and after renal transplant for coronary artery disease. The aim of this study was to investigate whether post-transplant cardiac coronary procedures affect post-transplant renal function. Method. We retrospectively included renal transplant recipients who underwent renal transplant procedures at Baskent University between April 28, 1997 and January 20, 2020. We analyzed the effect of cardiac catheterization in renal transplant recipients between 6 and 12 months post-transplant with post-transplant renal function assessed by glomerular filtration rate (GFR). We compared the effect of the type of coronary intervention on GFR change in group 1, whereby group 1 was divided into 2 subgroups (coronary artery bypass grafting [CABG] and stenting). Group 1 included patients who underwent cardiac intervention, whereas group 2 included those who had not undergone cardiac intervention. Results. In all, 108 patients underwent coronary angiography; 45 (41.7%) had normal coronaries or minimal coronary artery disease (CAD); 37 (34.3%) underwent stent implantation; 26 (24.1%) underwent CABG. The mean post- transplantation GFR of all patients after cardiac catheterization was 84.26+25.91 (mL/min/1.73 m(2)). The final, after 12 months mean GFR of all patients was 69.55+27.05. The final GFR was significantly lower than the initial post-renal GFR value in patients who underwent cardiac intervention but not in non-intervened patients. Conclusion. Invasive cardiac revascularization procedures showed a negative effect on posttransplant renal function in renal transplant recipients. All renal transplant recipients who underwent cardiac intervention survived the intervention, and there was no mortality. The reason for this outcome was assumed to be because of the short follow-up period.Item Corchorus olitorius L. (Jute) leaf and seed extracts exerted high antibacterial activity against food and plant pathogenic bacteria(2022) Iseri, Ozlem Darcansoy; Korpe, Didem Aksoy; Sahin, Feride Iffet; Cabi, Evren; Haberal, Mehmet; 0000-0002-3462-7632; AAJ-8097-2021Aim of this study was to comparatively evaluate antibacterial activities of methanol (MetOH), acetone (Ace), petroleum ether (PE) and aqueous (dw) leaf (L), root (R), and seed (S) extracts of Corchorus olitorius L. on both food- and plant-borne pathogens, with DPPH radical scavenging activities (DRSA), and quantitative and qualitative constituent analysis. Leaf PE has the highest strain susceptibility on both food- and plant-borne pathogens. Clavibacter michiganensis, Pseudomonas tomato, and Erwinia caratovora were susceptible to nearly all the leaf and seed extracts. Very low minimum inhibitory concentration (8-128 mL(-1)) and minimum bactericidal concentration (32-2048 mu g mL(-1)) were determined for both leaf and seed extracts against C. michiganensis. Total phenolic contents were correlated to DRSA. The phenolic compounds tested were higher in the leaf MetOH, cholorogenic acid being the most abundant one. Palmitic acid was determined in leaf PE and seed PE extracts. Results presented here demonstrate high antibacterial activity of C. olitorius leaf seed extracts against phytopathogens for the first time, and provide the most comprehensive data on the antibacterial activity screening against food-borne pathogens. Considering limitations in plant disease control, antibacterial activities of these extracts would be important in plant disease control.Item The Reality of Inadequate Patient Care and the Need for a Global Action Framework in Organ Donation and Transplantation(2022) Dominguez-Gil, Beatriz; Ascher, Nancy L.; Fadhil, Riadh A. S.; Muller, Elmi; Cantarovich, Marcelo; Ahn, Curie; Berenguer, Marina; Egawa, Hiroto; Gondolesi, Gabriel E.; Haberal, Mehmet; Harris, David; Hirose, Ryutaro; Ilbawi, Andre; Jha, Vivekanand; Lopez-Fraga, Marta; Madera, Sergio Andres; Najafizadeh, Katayoun; O'Connell, Philip J.; Rahmel, Axel; Shaheen, Faissal A. M.; Twahir, Ahmed; Van Assche, Kristof; Wang, Haibo; Haraldsson, Boerje; Chatzixiros, Efstratios; Delmonico, Francis L.; Busic, Mirela; 36279558Background. Transplant therapy is considered the best and often the only available treatment for thousands of patients with organ failure that results from communicable and noncommunicable diseases. The number of annual organ transplants is insufficient for the worldwide need. Methods. We elaborate the proceedings of the workshop entitled "The Role of Science in the Development of International Standards of Organ Donation and Transplantation," organized by the Pontifical Academy of Sciences and cosponsored by the World Health Organization in June 2021. Results. We detail the urgency and importance of achieving national self-sufficiency in organ transplantation as a public health priority and an important contributor to reaching relevant targets of the United Nations Agenda for Sustainable Development. It details the elements of a global action framework intended for countries at every level of economic development to facilitate either the establishment or enhancement of transplant activity. It sets forth a proposed plan, by addressing the technical considerations for developing and optimizing organ transplantation from both deceased and living organ donors and the regulatory oversight of practices. Conclusions. This document can be used in governmental and policy circles as a call to action and as a checklist for actions needed to enable organ transplantation as treatment for organ failure.Item A Novel Therapeutic Approach for Renal Transplant Recipient with Septic Shock and Acute Kidney Injury: A Case Report(2021) Yesiler, Fatma Irem; Yurtsever, Beyza Meltem; Gedik, Ender; Zeyneloglu, Pinar; Haberal, Mehmet; 0000-0002-0612-8481; 0000-0002-4737-7660; 0000-0002-7175-207X; 0000-0002-3462-7632; AAJ-4212-2021; ABI-2971-2020; AAJ-8097-2021Extracorporeal blood purification (EBP) therapies, using oXiris (R) haemofilter, are popular and used globally in intensive care units for management of patients with septic acute kidney injury (AKI). Herein, we present a case of an immunocompromised renal transplant recipient with sepsis and AKI who was treated with continuous renal replacement therapy (CRRT) using oXiris (R) haemofilter. A 45-year-old female who underwent cadaveric renal transplantation in 2015 was admitted due to septic shock secondary to Escherichia coli urinary tract infection (bacteraemia) and acute respiratory distress syndrome (ARDS). Her acute physiology and chronic health assessment score was 23, sepsis-related organ failure score was 11 and Glasgow coma scale was 15. She was intubated because of moderate ARDS and administered vasopressors due to hemodynamic instability. For immunosuppressive therapy, methylprednisolone (40 mg q12h) was administered. Antimicrobial therapies, including intravenous meropenem, linezolid, trimethoprim-sulfamethoxazole, voriconazole and oseltamivir, were administered. She exhibited metabolic acidosis and septic AKI and was classified as Kidney Disease Improving Global Outcomes stage 3. Therefore, CRRT with oXiris (R) haemofilter was administered at the 11th hour after admission. A full recovery of transplant renal function and diuresis was observed 7 days after admission. She was transferred to ward after 9 days and discharged after 2 weeks, without the requirement of RRT. EBP is proposed as an adjuvant therapy for sepsis and AKI. Solid organ transplant recipients with septic AKI may benefit from early usage of oXiris (R) haemofilter with CRRT as a novel approach for improving survival and clinical outcomes.Item Noncommunicable Disease Control: Clinicians and Health Policy Makers(2021) Erdal, Rengin; Haberal, Mehmet; 0000-0002-3462-7632; 34557788Item Analysis of Quality of Life, Depression, and Sexual Function in Patients on the Liver Transplant List(2021) Fidan, Cihan; Akdur, Aydincan; Kirnap, Mahir; Selcuk, Haldun; Yildirim, Sedat; Moray, Gokhan; Haberal, Mehmet; 0000-0002-3462-7632; 0000-0002-8726-3369; 34609310; AAJ-8097-2021; AAA-3068-2021Background: I he only treatment in patients developing liver failure is liver transplantation. According to the Ministry of Health, the number of patients waiting for a liver transplantation is 2141, the average waiting period for liver transplantation is approximately 5 years, and 15-18% of these patients lose their life while waiting for transplantation. In these patients, limitations in daily activities and depression-anxiety are commonly found. The aim of this study was to analyze life quality, depression symptoms, and existence of sexual functional disorders of patients waiting for liver transplantation. Methods: A total of 74 patients, who were registered in Baskent University Hospital between 2015 and 2018, were included into the study. Short Form-36, Beck Depression Inventory, and Arizona Sexual Experiences Scale were applied to 56 patients who approved study. Results: Most of the patients were male (64.3%), and the mean age was 46 (18-64). Short Form-36 scores were low in all patients. The mean Beck Depression Inventory score of patients was found as 18.4 +/- 11.3, and they were suffering from moderate depressive symptoms. According to Arizona Sexual Experiences Scale, total mean scores of males was found as 16.3 +/- 5.5, and for females, it was 19.5 +/- 5.3 with a statistically significant difference (P < .05). It was found that sexual dysfunction mostly had moderate to mild. Conclusion: Depression and sexual dysfunction are common in patients with chronic liver diseases, and their life qualities deteriorate significantly. It is anticipated that evaluation of these patients in terms of psychological issues and sexual dysfunction will increase their quality of life during the organ waiting period and affect their well-being post-transplant.Item Tacrolimus intrapatient variability in BK virus nephropathy and chronic calcineurin toxicity in kidney transplantation(2021) Turgut, Didem; Sayin, Burak; Soy, Ebru Ayvazoglu; Topcu, Deniz İlhan; Ozdemir, Binnaz Handan; Haberal, Mehmet; 0000-0002-3462-7632; 0000-0002-0993-9917; 35017328; AAJ-8097-2021; AAC-5566-2019Intrapatient variability (IPV) in tacrolimus has been increasingly acknowledged as a risk factor for poor graft survival after kidney transplantation. Although past studies have mainly accounted for IPV in acute or chronic rejection states as due to underimmunosuppression, this is not yet clear. So far, tacrolimus IPV for BK virus-associated nephropathy (BKVN) and chronic calcineurin inhibitor toxicity (CNIT) has not been investigated. Here, we evaluated IPV in tacrolimus for BKVN and chronic CNIT, which are mainly considered as overimmunosuppression states. In this caseucontrol study, kidney allograft biopsies conducted between 1998 and 2018 were included, with patients grouped by biopsy results as BKVN alone group, CNIT alone group, and normal graft function (control group). IPV was estimated as mean absolute deviation. Our study groups included 25 kidney transplant recipients with BKVN alone, 91 patients with CNIT alone, and 60 patients with normal 5-year graft survival (control group). In analyses of IPV in tacrolimus six months before graft biopsy, IPV was highest in the BKVN group (P = 0.001). The BKVN group also had the highest IPV in tacrolimus at 12 months after biopsy (P = 0.001), with all pairwise comparisons statistically different between groups. At 12 months after biopsy, five patients (20%) in the BKVN group and 10 patients (10.9%) in the CNIT group had graft loss. Among other risk factors, BKVN and chronic CNIT are consequences related to high IPV. Quantification of IVP for tacrolimus in clinical practice would help to optimize kidney transplant outcomes.Item The Effect of Renal Transplantation on Cardiac Functions(2020) Yilmaz, Kerem Can; Akgun, Arzu Neslihan; Keskin, Suzan; Ciftci, Orcun; Moray, Gokhan; Muderrisoglu, Haldun; Haberal, Mehmet; 0000-0002-3462-7632; 0000-0001-8926-9142; 33229768; AAJ-8097-2021; W-5233-2018; AAJ-1331-2021Chronic renal failure is a well-known risk factor for cardiovascular poor outcome. Despite advances in dialysis and renal transplantation, these patients still have high cardiovascular morbidity and mortality. The aim of our study was to evaluate the changes in blood parameters and echocardiographic parameters of patients undergoing renal transplantation in our center. One hundred and eighty-three patients who underwent renal transplantation between September 2012 and January 2016 were included in the study. Pre- and postoperative hemoglobin values, lipid profiles, ejection fractions, presence of left ventricular hypertrophy, presence of diastolic dysfunction, and valve pathologies were retrospectively scanned. Data were obtained from all patients in terms of blood parameters, but we compared 92 patients' echocardiographic data because of lack of both pre- and postoperative echocardiography records. In our study, 124 patients (67.8%) were male, and the mean age was 42.6 +/- 14.4 years. Hemoglobin levels (11.2 +/- 1.98, 12.7 +/- 2.2 mg/dL, P <0.001) and high-density lipoprotein (HDL) values (37.6 +/- 10.5, 46.6 +/- 13.6 mg/dL, P <0.001) were found to be different significantly. In echocardiographic evaluation, there was no difference between pre- and postoperative ejection fractions in 92 patients. However, patients with preoperative ejection fraction <50% had a significant increase in postoperative ejection fraction (40.1 +/- 6.2, 48.4% +/- 9.4%, P = 0.012). Renal transplantation can improve left ventricle ejection fraction in patients with basal ejection fraction less than 50% and also provide a significant increase in hemoglobin and HDL levels in all patients. This suggests that renal transplantation may reverse the process for dilated cardiomyopathy and may improve cardiac function in patients with low ejection fraction. However, transplantation should be performed as early as possible in these patients.