Başkent Üniversitesi Yayınları
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Item Pulmonary Complications and Mortality After Liver Transplant(Başkent Üniversitesi, 2008-12) Bozbas, Serife Savas; Haberal, Mehmet; Karakayali, Hamdi; Sevmis, Sinasi; Arslan, Nevra Gullu; Ergur, Figen Ozturk; Eyuboglu, Fusun OnerObjectives: Pulmonary complications after liver transplant significantly affect mortality and morbidity; however, their relation has not been clearly established. We sought to determine pulmonary complications during the early and late term after liver transplant and identify risk factors for mortality. Materials and Methods: At our institution, 130 liver transplant patients (mean age, 40.1 ± 14.6 years; 71.1% male) were retrospectively evaluated, and 114 adult orthotopic liver transplant patients were included. Cause of liver disease, pulmonary function test results, arterial blood gas analyses, surgery duration, length of stay in the intensive care unit and the hospital, pulmonary complications, and mortality causes were noted. Results: Pulmonary complications were detected in 48 patients (42.1%), pneumonia in 24 patients (21.1%), and pleural effusion in 21 patients (18.4%). Development of pulmonary complications was found to be significantly related to survival (P = .001). Fifty-two patients (45.6%) were smokers, a significant predictor of pulmonary complications (P = .03). There was no relation between pulmonary function test results and orthodeoxia and pulmonary complications and mortality. Early and late survival rates were significantly lower in patients in whom a microorganism was isolated on deep tracheal aspirate culture, while early survival was significantly reduced in the presence of a pleural effusion (P < .005). Conclusions: Pulmonary complications after liver transplant are common. Care must be taken to determine preoperative risk factors, and patients should be observed closely for development of respiratory complications after liver transplant.Item Outcome of Mucormycosis in Liver Transplantation: Four Cases and a Review of Literature(Başkent Üniversitesi, 2003-12) Davari, Hamid Reza; Malekhossini, Seyed Ali; Salahi, Heshmato-allah; Bahador, Ali; Saberifirozi, Mehdi; Geramizadeh, Bita; Lahsaee, Seyed Masoud; Khosravi, Mohammad Bagher; Imanieh, Mohammad Hadi; Bagheri, Mohammad HadiMucormycosis is a rare but highly invasive fungal infection that occurs in transplant recipients. The literature contains descriptions of 12 cases of mucormycosis after orthotopic liver transplantation (OLT). This report describes the fatal courses in four patients at our center who developed mucormycosis after liver transplantation. Of 51 liver transplant recipients who received grafts between December 1993 and April 2003, 4 (7.8%; 3 males and 1 female) developed mucormycosis. The primary liver diseases in the four cases were Wilson’s disease, autoimmune hepatitis, primary biliary cirrhosis, and cryptogenic cirrhosis. Three of the transplants were harvested by another team and shipped to our center. We concluded that selection of poor transplant candidates, prolonged antibiotic therapy and/or hospitalization prior to OLT, and breaks in aseptic technique during harvesting, shipping, and during operation are the main reasons for the high incidence of mucormycosis in our OLT patients.