Wos İndeksli Açık & Kapalı Erişimli Yayınlar

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Author: search.filters.author.Moray, GokhanSubject: search.filters.subject.Kidney transplantation

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    The New Anterior Less Invasive Crescentic Incision for Living Donor Nephrectomy
    (2020) Haberal, Mehmet; Soy, Ebru H. Ayvazoglu; Akdur, Aydincan; AlShalabi, Omar; Yildirim, Sedat; Moray, Gokhan; Torgay, Adnan; 0000-0002-8726-3369; 0000-0002-3462-7632; 0000-0002-5735-4315; 0000-0002-0993-9917; 0000-0002-6829-3300; 0000-0003-2498-7287; 33143599; AAA-3068-2021; AAJ-8097-2021; AAF-4610-2019; AAC-5566-2019; AAJ-5221-2021; AAE-1041-2021
    Objectives: Living-donor nephrectomy is a devoted procedure performed in a healthy individual; for these procedures, it is essential to complete the surgery with the lowest possible risk and morbidity and allow donors to regain their normal daily activity. To minimize anatomic and physiologic damage, we modified a surgical technique. Here, we report our experiences with the new anterior less invasive crescentic donor nephrectomy technique. Metarials and Methods: We retrospectively evaluated 728 donor nephrectomy patients who had the new anterior less invasive cresentic incision (n = 224), the classic open (n = 431), or the laparoscopic living-donor nephrectomy (n = 73) procedures. Demographic characteristics, preoperative and postoperative parameters, acute renal graft dysfunction, and firstyear graft and patient survival rates were compared between groups. Results: During the operation, the new cresentic incision living-donor nephrectomy allowed a safe and comfortable position for the patient and the anesthesiologist. Also, it procures safe access especially for grefts with multiple vessels. Patients had lower pain scores (P = .010), shorter hospital stays (2.25 vs 3.49 days) than those who received the classic open living-donor nephrectomy. Patients who received laparoscopic living-donor nephrectomy had significantly longer mean operation time (P = .016) and warm ischemia time (P <= .001) than those who had the new cresentic incision technique. All groups showed similar rates of first-year survival and delayed graft dysfunction. Conclusions: The new anterior less invasive cresentic incision open-donor nephrectomy approach is a safe, comfortable, effective, and less invasive modification of the living donor nephrectomy. Also, it procures safe access for grefts with multiple vessels.
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    Preoperative Cardiac Risk Assessment in Renal Transplant Recipients: A Single-Center Experience
    (2019) Yilmaz, Kerem Can; Akgun, Arzu Neslihan; Ciftci, Orcun; Muderrisoglu, Haldun; Sezer, Siren; Moray, Gokhan; Haberal, Mehmet; 0000-0002-9635-6313; 29025386; AAG-8233-2020
    Objectives: Cardiovascular disease is the major cause of morbidity and mortality in patients on renal replacement therapy and in kidney transplant recipients. There are no specific recommendations for preoperative cardiac risk assessment before renal transplant. The aim of our study was to analyze preoperative cardiac test frequencies, test results, patient characteristics, and relations between cardiac stress test results and severe coronary artery disease. Materials and Methods: We retrospectively examined patients who underwent renal transplant between December 2011 and December 2016 in our hospital (Ankara, Turkey). Our study group included 216 patients. All patients had preoperative echocardiography. We recorded results of exercise stress tests, myocardial perfusion scintigraphy, and coronary angiography. For all patients, preoperative complete blood cell count, creatinine, high-density lipoprotein, triglycerides, low-density lipoprotein, and red cell distribution width values were obtained and recorded. Results: We classified patient groups according to presence or absence of severe coronary artery disease. Fourteen of 66 patients had severe coronary artery disease. In univariate analyses, age, having a history of familial coronary artery disease, diabetes mellitus, presence of coronary artery disease, and triglyceride levels were risk factors for severe coronary artery disease. In multivariate analysis, diabetes mellitus, presence of coronary artery disease, and having a history of familial coronary artery disease were statistically significant. Conclusions: Renal transplant recipients are a special patient population, and there must be specific suggestions for this population. If patients present with more than 1 risk factor, a stress test should be performed to evaluate cardiovascular risk. In some patients, especially those whose risk factors include prior cardiovascular disease or diabetes mellitus, stress tests should be skipped and patients should directly undergo coronary angiography to look for severe coronary artery disease.