Scopus İndeksli Açık & Kapalı Erişimli Yayınlar
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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 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.