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Item Early Postoperative Acute Kidney Injury Among Pediatric Liver Transplant Recipients(2018) Sahinturk, Helin; Kundakci, Aycan; Zeyneloglu, Pinar; Gedik, Ender; Pirat, Arash; Haberal, Mehmet; 0000-0003-0159-4771; 0000-0002-7175-207X; 0000-0002-3462-7632; AAJ-1419-2021; AAH-7003-2019; ABI-2971-2020; AAJ-8097-2021Item Successful Treatment With Direct-Acting Antiviral Agents of Hepatitis C in Patients With End-Stage Renal Disease and Kidney Transplant Recipients(2019) Etik, Digdem Ozer; Suna, Nuretdin; Ocal, Serkan; Selcuk, Haldun; Dagli, Ulku; Colak, Turan; Hilmioglu, Fatih; Boyacioglu, Ahmet Sedat; Haberal, Mehmet; 0000-0003-3719-9482; 0000-0003-0664-0976; 0000-0002-9370-1126; 30719954; ABH-4817-2020; AAE-7637-2021; S-4068-2018Objectives: The introduction of direct-acting antiviral agents has allowed significant chances for treatment for difficult-to-treat populations. This study aimed to investigate the efficacy, tolerability, and safety of these therapies in both patients with end-stage renal disease and kidney transplant recipients with chronic hepatitis C virus infection. Materials and Methods: This study was a retrospective analysis with prospective follow-up of patients. The antiviral combination of ombitasvir 25 mg, paritaprevir 75 mg, ritonavir 50 mg, and dasabuvir 50 mg was prescribed to patients with end-stage renal disease or kidney transplant recipients with noncirrhotic or compensated cirrhotic liver disease. The other antiviral combination consisted of sofosbuvir 400 mg and ledipasvir 90 mg, which was recommended to patients with decompensated cirrhosis or those who could not tolerate the first combination regimen. Ribavirin was given to all patients with genotype 1a hepatitis C virus infection. All clinical and laboratory data were recorded at week 4, at end of the treatment, and at 12 weeks after completion of treatment. Results: In terms of efficacy, sustained virologic response at 12 weeks was achieved in 94% of patients in the end-stage renal disease group and 92% of patients in the kidney transplant group. In terms of tolerability, antiviral treatment was well tolerated in both groups. Cardiac arrest and cerebrovascular accident were seen in the end-stage renal disease group; severe mucositis and glossitis were seen in the kidney transplant group. Hospitalization was needed in 2 patients for treatment of drug interactions with tacrolimus and sirolimus. Renal allograft function worsened in 2 patients, with 1 patient having biopsyproven antibody-mediated rejection. Conclusions: We observed great efficacy and safety in both kidney transplant recipients and patients with end-stage renal disease with these agents in treatment of chronic hepatitis C. However, clinicians should remain aware of drug interactions and adverse events in this fragile patient population.Item Relationship Between Preoperative Diastolic Transpulmonary Gradient With Pulmonary Vascular Resistance and 1-Year and Overall Mortality Rates Among Patients Undergoing Cardiac Transplant(2019) Ciftci, Orcun; Unsal, Esma Nur; Dellaloglu, Zeynep; Aydan, Alp; Aksoy, Gokcen; Karakas, Makbule; Aydmalp, Alp; Sezgin, Atilla; Muderrisoglu, İbrahim Haldun; Haberal, Mehmet; 0000-0001-8926-9142; 30251939; W-5233-2018Objectives: Cardiac transplant is a life-saving procedure for patients with end-stage heart failure. Preoperative pulmonary vascular resistance is indicative of intrinsic pulmonary vascular disease and correlates with posttransplant survival. However, its measurement is costly and time consuming. Therefore, simpler techniques are required. Diastolic transpulmonary gradient reportedly indicates intrinsic pulmonary vascular disease. Here, we investigated the relationship between preoperative diastolic transpulmonary gradient with preoperative pulmonary vascular resistance and 1-year and overall mortality among cardiac transplant patients. Materials and Methods: Fifty-one patients who underwent cardiac transplant between 2006 and 2017 were included. All patients underwent preoperative right and left heart catheterization and oxygen study. Among these, diastolic transpulmonary gradient, mean transpulmonary gradient, and pulmonary vascular resistance were correlated with one another and 1st-year and overall mortality rates. Patients were grouped according to whether they received diastolic transpulmonary gradient or not, and both groups were compared with respect to 1-year and overall mortality. Binary logistic regression analysis was done to test whether diastolic transpulmonary gradient was a significant predictor of 1-year and overall mortality. Results: Mean patient age was 45.5 +/- 9.8 years. The 1-year and overall mortality rates were 21.6% (11/51) and 37.3% (19/51), respectively. Diastolic transpul monary gradient was significantly correlated with pulmonary vascular resistance, 1-year mortality, and overall mortality (P<.05) and was a significant predictor of 1-year and overall mortality (odds ratio 6.0; 95% confidence interval, 1.4-25.3; P <.05 and odds ratio 4.8; 95% CI, 1.4-17.5; P <.05, respectively). Patients with a diastolic transpulmonary gradient of >= 7 mm Hg had significantly higher 1-year and overall mortality (P<.05). Conclusions: Diastolic transpulmonary gradient can be used as a promising easy-to-use parameter of intrinsic pulmonary vascular disease and a predictor of 1-year and overall mortality among patients undergoing cardiac transplant.Item Incidence, clinical features, and outcomes of food allergy in children who underwent liver transplant: 16-year experience(2019) Baris, Zeren; Koksal, Burcu; Ozbek, Ozlem; Ozcay, Figen; Haberal, Mehmet; 0000-0001-9580-7656; 30884056; ABG-5684-2020; AAB-4153-2020Food allergies often develop after liver transplant, especially in young children. However, data are scarce on clinical characteristics and patient outcomes. When we evaluated our pediatric liver transplant patients over a 16-year period, food allergy incidence was 8% (19/236 patients). All patients with food allergies were <18 months old, with incidence in this age group of 19.2% (19/99). Two patients had a single food and 17 had multiple food allergies. Five patients showed only non-IgE-mediated food allergies. Eggs, milk, nuts, and wheat were the most common allergens. Presenting symptoms included diarrhea, flushing, angioedema attacks, wheezing/chronic cough, and vomiting. Seven patients had EBV, and two patients had CMV infections at time of food allergy diagnosis. Twelve patients had eosinophilia. Seven patients (36.8%) were able to regain tolerance to all food allergens. However, one patient with single nut allergy and three with multiple food allergies were still on allergen-eliminated diets. Eight patients with multiple food allergies gained tolerance to some of the food allergens. In conclusion, food allergies in our patients were mainly against multiple foods and IgE mediated. Infections like EBV and CMV may play a role in food allergies after liver transplant, especially in pretransplant-naive patients.Item Experience with antiviral agents for treatment of hepatitis C virus infection in hemodialysis patients on the kidney wait list(2019) Torun, Dilek; Soydas, Baris; Tekkarismaz, Nihan; Ozelsancak, Ruya; Micozkadioglu, Hasan; Haberal, Mehmet; 30762283Introduction Hepatitis C virus (HCV) infection is associated with increased mortality and morbidity in kidney transplant patients. The ability to establish a sustained viral response before renal transplant is important for these patients. Direct-acting antiviral agents can increase the sustained viral response in most patients with HCV infection. In this case series, we aimed to determine the efficacy and safety of a combined therapy of ombitasvir, paritaprevir, ritonavir, and dasabuvir with or without ribavirin in patients with HCV genotype 1 infection without cirrhosis and on hemodialysis who were awaiting deceased-donor kidney transplant. Methods Our study included eight male and two female HCV ribonucleic acid (RNA)-positive hemodialysis patients (mean age 50.7 +/- 15 years, mean hemodialysis duration 14 +/- 5.5 years, mean HCV duration 18 +/- 3.7 years). Findings Three patients with genotype 1a received oral therapy with 12.5 mg ombitasvir, 150 mg paritaprevir, 7 5 mg ritonavir, and 250 mg dasabuvir plus 200 mg ribavirin for 12 weeks. Seven patients with genotype 1b received 12.5 mg ombitasvir, 150 mg paritaprevir, 75 mg ritonavir, and 250 mg dasabuvir without ribavirin treatment for 12 weeks. The sustained virologic response rate was 100% at 12 weeks after completion of antiviral treatment in both treatment groups. No serious adverse effects were observed in either treatment group. Five patients had constitutional symptoms such as nausea, anorexia, and fatigue. During the treatment period, hemoglobin, white cell blood count, thrombocyte, and ferritin levels were similar to pretreatment levels. Treatment did not affect weekly erythropoietin and monthly intravenous iron treatment doses. Discussion Direct-acting antiviral agents are safe and effective for generating a sustained viral response in HCV genotype 1-infected hemodialysis patients on kidney wait lists.Item Adequacy of Infective Endocarditis Prophylaxis Before Dental Procedures among Solid Organ Transplant Recipients(2019) Karacaglar, Emir; Akgun, Arzu; Ciftci, Orcun; Altiparmak, Nur; Muderrisoglu, Haldun; Haberal, Mehmet; 0000-0002-9635-6313; 31464231; AAG-8233-2020Infective endocarditis (IE) is a life-threatening condition with high morbidity and mortality. The current IE guidelines recommend antibiotic prophylaxis only in patients with certain cardiac conditions and before certain dental procedures. However, there is not enough data about solid organ transplant (SOT) recipients. In this study, we aimed to investigate the IE prophylaxis in general dental and periodontal surgical procedures among our SOT recipients. Medical records of 191 SOT recipients (32 liver transplant recipients, 54 heart transplant recipients, and 105 kidney transplant recipients) who were admitted to our hospital between January 2016 and January 2018 were evaluated. A total of 65 patients who underwent dental procedures were included in the study. We investigated the adequacy of IE prophylaxis according to the current guidelines. Two groups were created according to whether they received antibiotic prophylaxis or not. The mean age was 44.2 +/- 13.6 years, and 66.1% were male. The majority of patients (67.6%) received antibiotic prophylaxis. The most commonly used antibiotic was amoxicillin (48.8%). Among the procedures, 23.1% were classified as invasive and 76.9% were classified as noninvasive. No complication was observed after invasive and noninvasive dental procedures. There were no complications in both antibiotic prophylaxis and no-prophylaxis groups. According to our results, IE prophylaxis has been used appropriately in SOT recipients in our center. No serious infection has been reported. In addition, no complication due to antibiotic use was also observed.Item Social and psychological impacts of having a child with liver transplant(2019) Soy, Ebru H. Ayvazoglu; Ozdemir, Aydan; Baris, Zeren; Moray, Gokhan; Haberal, Mehmet; http://orcid.org/0000-0002-0993-9917; AAB-4153-2020; AAC-5566-2019Item Prevalence of infections in infants within first six months of liver transplantation(2019) Sezer, Oya Balci; Baris, Zeren; Ecevit, Zafer; Ozcay, Figen; Haberal, Mehmet; ABG-5684-2020; AAB-4153-2020Item The influence of vitamin d3 treatment on the risk of development of acute rejection, epithelial-mesenchymal transition (EMT), and interstitial fibrosis among pediatric renal transplant patients(2019) Ozdemir, B. Handan; Baskin, Esra; Ozdemir, F. Nurhan; Akcay, Eda Yilmaz; Moray, Gokhan; Haberal, Mehmet; 0000-0003-4361-8508; B-5785-2018Item The importance of age and CD4/CD8 ratio on the presenting time and the prognosis of the polyoma virus associated nephropathy (PVAN) after renal transplantation(2019) Ozdemir, B. Handan; Ozdemir, F. Nurhan; Baskin, Esra; Atilgan, Alev Ok; Moray, Gokhan; Haberal, Mehmet; 0000-0003-4361-8508; B-5785-2018