Başkent Üniversitesi Yayınları

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Author: search.filters.author.Dayangac, Murat

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    Living-donor Liver Transplant in 3 Patients With Budd-Chiari Syndrome: Case Report
    (Başkent Üniversitesi, 2012-04) Bas, Koray; Tokat, Yaman; Yuzer, Yildiray; Dogusoy, Gulen Bulbul; Ulusoy, Onur Levent; Dayangac, Murat; Yaprak, Onur
    Budd-Chiari syndrome is a rare but life-threatening disorder characterized by obstruction of the hepatic venous outflow. Treatment depends on the underlying cause, the location, and extent of the obstruction, and the functional capacity of the liver. A stepwise therapeutic approach is commonly accepted. When all other therapy options are unsuccessful, or in case of end-stage liver disease, transplant should be considered. We present case reports of 3 patients with Budd-Chiari syndrome who underwent living-donor liver transplant. Characteristic features of Budd-Chiari syndrome, diagnostic and therapeutic interventions, complications, and overall outcomes are discussed. We believe that when a deceased donor graft is unavailable, a living-donor liver transplant can be a safe option for patients with end-stage liver disease associated with Budd-Chiari syndrome.
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    Right-lobe Liver Transplant From Donors With Gilbert Syndrome
    (Başkent Üniversitesi, 2012-12) Demirbas, Tolga; Akyildiz, Murat; Yuzer, Yildiray; Tokat, Yaman; Yaprak, Onur; Dayangac, Murat; Piskin, Turgut
    Objectives: Donor safety is one of the most important aspects of living-donor liver transplant. The preoperative evaluation of candidates for such transplants essentially starts with serologic and biochemical analyses. However, some potential liver donors with normal liver function test results may have isolated mild hyperbilirubinemia (serum indirect bilirubin level > 20.5 µmol/L [1.2 mg/dL]). Gilbert syndrome is an autosomal recessive condition that is a common cause of nonhemolytic unconjugated hyperbilirubinemia, and its prevalence is 3% to 10% in the healthy US population. Mild hyperbilirubinemia episodes are expected in people with Gilbert syndrome when they are exposed to physical stress, such as operative intervention or low energy intake. The liver morphologic findings of these individuals are normal; however, there is a debate on the use of people with Gilbert syndrome as living-liver donors. The purpose of this study was to assess the results of right-lobe living-donor hepatectomy of liver donors with Gilbert syndrome. Materials and Methods: Between 2004 and 2010, two hundred twenty-five living-donor liver transplants using right-lobe grafts were performed in our hospital. Donors with Gilbert syndrome were defined as those whose serum bilirubin level was greater than 20.5 µmol/L (1.2 mg/dL). Six of 225 right-lobe living-donor liver transplants were performed using donors with Gilbert syndrome. Results: The median follow-up after transplant was 34 months (range, 18 to 51 mo). One week after the operation, the median bilirubin level for right-lobe liver donors was 34.5 µmol/L (2.02 mg/dL) (range, 17.1 to 51.3 µmol/L [1 to 3 mg/dL]), and the median prothrombin time (international normalized ratio) was 1.36 (range, 1.1 to 1.7). The median bilirubin level of the donors after 6 months was 29 µmol/L (1.7 mg/dL) (range, 20.5 to 41 µmol/L [1.2 to 2.4 mg/dL]). Conclusions: Living-donor liver transplant from Gilbert syndrome donors can be safely performed.
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    Analysis of Right Lobe Living-Liver Donor Complications: A Single Center Experience
    (Başkent Üniversitesi, 2011-02) Yaprak, Onur; Tokat, Yaman; Yuzer, Yildiray; Tabendeh, Babek; Demirbas, B. Tolga; Dayangac, Murat
    Objectives: Living-donor liver transplant provides an alternative source of organ to patients with end-stage liver disease. This study sought to determine and classify the donor morbidities after right lobe donor hepatectomy in a single center. Materials and Methods: One-hundred eighty-one right lobe living-donor hepatectomy were performed in our center between January 2004 and December 2009. Of the 181 donors, 104 donors were men and 77 donors were women. Mean age of the donors was 38 years (range, 18-63 years). The mean follow-up was 33.3 months (range, 3-66 months). Complications after the operation were stratified according to the Clavien classification. Results: Eighty-one complications occurred in 73 of the 181 donors (40.3%). The most common complication was wound infection, which was seen in 14 of 181 donors (7.7%). Biliary complications were seen in 4.4% of donors. There was no postoperative mortality. Also, grade 4 complications, which are life-threatening, did not occur. Blood transfusion were not required during the operation. The incidence of reoperation was 1.6% in all donors. Conclusions: Living-donor liver transplant ensures a new graft to patients with end-stage liver disease. Donor morbidity is one of the realities of the donor hepatectomy procedure. Because the donors are healthy individuals, the aim of the process must be to eliminate the donor mortality while decreasing the complication rates.