Fakülteler / Faculties

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Author: search.filters.author.Kirnap, MahirSubject: search.filters.subject.Children

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    Results of Pediatric Liver Transplant: A Single-Center Experience
    (2015) Moray, Gokhan; Tezcaner, Tugan; Akdur, Aydincan; Ozcay, Figen; Sezgin, Atilla; Kirnap, Mahir; Yildirim, Sedat; Arslan, Gulnaz; Haberal, Mehmet; 0000-0002-3641-8674; 0000-0002-8726-3369; 0000-0002-3462-7632; 0000-0002-5735-4315; 0000-0002-5214-516X; 0000-0003-2498-7287; 25894129; AAH-9198-2019; AAD-9865-2021; AAA-3068-2021; AAJ-8097-2021; AAF-4610-2019; ABG-5684-2020; AAE-1041-2021
    Objectives: Liver transplant is an established curative therapy for children with chronic end-stage liver disease or acute liver failure. In this study, we aimed to evaluate pediatric liver transplant in terms of outcomes, complications, and long-term follow-up results. Materials and Methods: Pediatric patients who had liver transplant in our institution were included. We retrospectively evaluated demographic features including body weight, Child-Pugh score, etiology of liver disease, graft source, perioperative outcomes, perioperative complications, postoperative complications, and long-term results. Outcomes of treatment of complications and revision transplant were evaluated. Results: Between September 2001 and December 2013, there were 188 pediatric liver transplants performed in our institution. Most grafts (90.9%) were obtained from living-related donors. There were 13 patients (6.9%) who had an intervention because of a hemorrhage postoperatively. Biliary leakage was observed in 33 patients (17.5%) and biliary stricture during follow-up was observed in 32 patients (17%). Thrombosis rates in the hepatic artery and portal vein were 12.3% and 0.5%. Revision transplant was performed in 11 patients (5.8%); reason for revision transplant was rejection in 50% patients. The remaining children were alive with good graft functioning after treatment of complications and revision transplant. The overall 5- and 10-year survival rates were 82.3% and 78.9%. Conclusions: The overall outcomes of pediatric liver transplant at our center are very promising. With improved care of younger children and the combined efforts of the parents and medical team, the number of the children receiving transplants will increase in the future.
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    Timing for Removal of Peritoneal Dialysis Catheters in Pediatric Renal Transplant Patients
    (2016) Melek, Engin; Baskin, Esra; Gulleroglu, Kaan Savas; Kirnap, Mahir; Moray, Gokhan; Haberal, Mehmet; 0000-0003-4361-8508; 0000-0003-1434-3824; 0000-0003-2498-7287; 0000-0002-3462-7632; 27805518; B-5785-2018; AAJ-8833-2021; AAH-9198-2019; AAE-1041-2021; AAJ-8097-2021
    Objectives: Peritoneal dialysis, the preferred long-term renal replacement modality in the pediatric population, can also be used during the post transplant period. Although it is well known that peritonitis or other complications may occur related to the peritoneal dialysis catheter, less is known about complications related to the peritoneal dialysis during the post transplant period. Our objective was to evaluate the complications related to use of a peritoneal dialysis catheter during the posttransplant period and to determine the optimum time for removal of the peritoneal dialysis catheter. Material and Methods: We retrospectively analyzed 33 chronic peritoneal dialysis patients. Pretransplant and posttransplant demographics and clinical and laboratory data for each patient were recorded, including incidence of peritonitis and incidence of peritoneal dialysis catheter requirement after transplant. Results: Mean age of patients at transplant was 12.8 +/- 4.0 years (range, 3.5-18.0 y). Mean catheter removal time was 81.1 +/- 36.2 days (range, 22.0-152.0 d). The peritoneal dialysis catheter was used in 6 of 33 patients (18.2%); none of these patients developed peritonitis. In contrast, 2 of the 27 patients who did not use the peritoneal dialysis catheter developed peritonitis. Our data suggest that the need for catheter use occurs predominantly during the first month, and infectious complications usually happen later. Conclusions: Previously, the trend was to not remove the peritoneal dialysis catheter at the time of transplant. However, in light of recent literature and our present study, we recommend that the time of catheter removal should be modified and decided for each patient on an individual basis.