Başkent Üniversitesi Yayınları

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Author: search.filters.author.Hakim, NadeySubject: search.filters.subject.Complication

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    Ureteric Stenting in Kidney Transplants
    (Başkent Üniversitesi, 2013-04) Damji, Samir; Hakim, Nadey; Hakim, David; Atinga, Angela
    The routine use of ureteric stents after a kidney transplant for prophylactic measures is debatable. Concerns have been raised regarding the potential complications and costs of routine stenting. Here, we review the literature based on studies in favor of and against the routine placement of ureteric stents in kidney transplant patients. Some studies have shown a benefit to patients who have routine stents placed, while others have not shown this benefit but have highlighted the associated financial implications. The decision to stent renal transplant patients will depend on robust multicenter, randomized controlled trials being carried out, as well as both short-term and long-term cost analyses.
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    Prevention and Management of Graft Thrombosis in Pancreatic Transplant
    (Başkent Üniversitesi, 2012-06) Patel, Shaneel R.; Hakim, Nadey
    Pancreatic transplant effectively cures type 1 diabetes mellitus and maintains consistent long-term euglycemia. However, technical failure, and in particular graft thrombosis, accounts for the vast majority of transplants lost in the early postoperative period. The pancreas’ inherently low microvascular flow state makes it vulnerable to vascular complications, as does the hypercoagulable blood of diabetic patients. Ultimately, the phenomenon is most definitely multifactorial. Prevention, as opposed to treatment, is key and should focus on reducing these multiple risk factors. This will involve tactical donor selection, optimal surgical technique and some form of anticoagulation. Close monitoring and early intervention will be crucial when treating thrombosis once preventative methods have failed. This may be achieved by further anticoagulation, graft salvage, or pancreatectomy with retransplant. This article will explore the multiple factors contributing to graft thrombus formation and the ways in which they may be addressed to firstly prevent, or more likely, reduce thrombosis. Secondly, we will consider the management strategies which can be implemented once thrombosis has occurred.