1
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Akarsu M, Dolu S, Harputluoglu M, Yilmaz S, Akyildiz M, Gencdal G, Polat KY, Dincer D, Adanir H, Turan I, Gunsar F, Karasu Z, Gokcan H, Karademir S, Kabacam G, Kayhan MA, Kiyici M, Gulsen MT, Balaban Y, Dogrul AB, Senkaya A, Ellik ZM, Eren F, Idilman R. Changing trends in the etiology of liver transplantation in Turkiye: A multicenter study. Hepatol Forum 2024; 5:3-6. [PMID: 38283275 PMCID: PMC10809344 DOI: 10.14744/hf.2023.2023.0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 09/17/2023] [Accepted: 09/27/2023] [Indexed: 01/30/2024]
Abstract
Background and Aim This study aimed to identify the indications for liver transplantation (LT) based on underlying etiology and to characterize the patients who underwent LT. Materials and Methods We conducted a multicenter cross-sectional observational study across 11 tertiary centers in Turkiye from 2010 to 2020. The study included 5,080 adult patients. Results The mean age of patients was 50.3±15.2 years, with a predominance of female patients (70%). Chronic viral hepatitis (46%) was the leading etiological factor, with Hepatitis B virus infection at 35%, followed by cryptogenic cirrhosis (24%), Hepatitis C virus infection (8%), and alcohol-related liver disease (ALD) (6%). Post-2015, there was a significant increase in both the number of liver transplants and the proportion of living donor liver transplants (p<0.001). A comparative analysis of patient characteristics before and after 2015 showed a significant decline in viral hepatitis-related LT (p<0.001), whereas fatty liver disease-related LT significantly increased (p<0.001). Conclusion Chronic viral hepatitis continues to be the primary indication for LT in Turkiye. However, the proportions of non-alcoholic fatty liver disease (NAFLD) and ALD-related LT have seen an upward trend over the years.
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Affiliation(s)
- Mesut Akarsu
- Department of Gastroenterology, Dokuz Eylul University School of Medicine, Izmir, Turkiye
| | - Suleyman Dolu
- Department of Gastroenterology, Dokuz Eylul University School of Medicine, Izmir, Turkiye
| | - Murat Harputluoglu
- Liver Transplantation Institute, Inonu University School of Medicine, Malatya, Turkiye
| | - Sezai Yilmaz
- Liver Transplantation Institute, Inonu University School of Medicine, Malatya, Turkiye
| | - Murat Akyildiz
- Department of Gastroenterology, Koc University School of Medicine, Istanbul, Turkiye
| | - Genco Gencdal
- Department of Gastroenterology, Koc University School of Medicine, Istanbul, Turkiye
| | - Kamil Yalcin Polat
- Liver Transplant Center, Memorial Atasehir/Bahcelievler Hospitals, Istanbul, Turkiye
| | - Dinc Dincer
- Department of Gastroenterology, Akdeniz University School of Medicine, Antalya, Turkiye
| | - Haydar Adanir
- Department of Gastroenterology, Akdeniz University School of Medicine, Antalya, Turkiye
| | - Ilker Turan
- Department of Gastroenterology, Ege University School of Medicine, Izmir, Turkiye
| | - Fulya Gunsar
- Department of Gastroenterology, Ege University School of Medicine, Izmir, Turkiye
| | - Zeki Karasu
- Department of Gastroenterology, Ege University School of Medicine, Izmir, Turkiye
| | - Hale Gokcan
- Department of Gastroenterology, Ankara University School of Medicine, Ankara, Turkiye
| | - Sedat Karademir
- Department of Gastroenterology, Guven Hospital, Ankara, Turkiye
| | - Gokhan Kabacam
- Department of Gastroenterology, Guven Hospital, Ankara, Turkiye
| | - Meral Akdogan Kayhan
- Department of Gastroenterology, University of Health Sciences, Ankara City Hospital, Ankara, Turkiye
| | - Murat Kiyici
- Department of Gastroenterology, Uludag University School of Medicine, Bursa, Turkiye
| | - Murat Taner Gulsen
- Department of Gastroenterology, Gaziantep University School of Medicine, Gaziantep, Turkiye
| | - Yasemin Balaban
- Department of Gastroenterology, Hacettepe University School of Medicine, Ankara, Turkiye
| | - Ahmet Bulent Dogrul
- Department of General Surgery, Hacettepe University, School of Medicine, Ankara, Turkiye
| | - Ali Senkaya
- Department of Gastroenterology, Ege University School of Medicine, Izmir, Turkiye
| | | | - Fatih Eren
- Department of Gastroenterology, Uludag University School of Medicine, Bursa, Turkiye
| | - Ramazan Idilman
- Department of Gastroenterology, Ankara University School of Medicine, Ankara, Turkiye
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2
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Polat KY, Acar S, Gencdal G, Yazar S, Kargi A, Donmez R, Aslan S, Kavlak ME, Arikan C, Akyildiz M. Hepatocellular Carcinoma and Liver Transplantation: A Single-Center Experience. Transplant Proc 2020; 52:259-264. [PMID: 31911056 DOI: 10.1016/j.transproceed.2019.10.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Accepted: 10/06/2019] [Indexed: 01/11/2023]
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3
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Acar S, Kavlak ME, Demir B, Ozkan P, Polat KY, Akyildiz M, Arikan C. Posterior Reversible Encephalopathy Syndrome in a Five-Year-Old Child: A Case Report. Transplant Proc 2019; 51:2495-2497. [PMID: 31351771 DOI: 10.1016/j.transproceed.2019.01.186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 01/28/2019] [Indexed: 10/26/2022]
Abstract
Posterior reversible encephalopathy syndrome (PRES) is a neuroradiologic syndrome. The etiology of PRES is still unclear. Some factors were described. We present a case of a pediatric patient with liver transplant who developed PRES following blood transfusion while receiving tacrolimus therapy. A 5½-year-old boy who underwent living donor liver transplantation, and PRES developed on the sixth day post transplant under tacrolimus treatment after 6 hours of red blood transfusion. PRES is a rare condition; it should be kept in mind about patients who have received organ transplants and develop sudden neurologic symptoms.
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Affiliation(s)
- Sencan Acar
- Department of Gastroenterology and Organ Transplant Center, Sakarya University School of Medicine, Sakarya, Turkey.
| | - Mustafa Emre Kavlak
- Department of Anesthesiology and Organ Transplant Center, Memorial Atasehir Hospital, Istanbul, Turkey
| | - Baris Demir
- Department of Family Practice and Organ Transplant Center, Koc University School of Medicine, Istanbul, Turkey
| | - Perihan Ozkan
- Department of Radiology, Memorial Atasehir Hospital, Istanbul, Turkey
| | - Kamil Yalcin Polat
- Department of General Surgery and Organ Transplant Center, Memorial Atasehir Hospital, Istanbul, Turkey
| | - Murat Akyildiz
- Department of Gastroenterology and Organ Transplant Center, Memorial Atasehir Hospital, Istanbul, Turkey
| | - Cigdem Arikan
- Department of Pediatric Gastroenterology and Organ Transplant Center, Koc University School of Medicine, Istanbul, Turkey
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4
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Acar S, Gencdal G, Kirimlioglu H, Polat KY, Cagatay AA, Akyildiz M. Varicella-Zoster Virus-Induced Hepatitis in a Liver Transplant Recipient: A Case Report. Transplant Proc 2019; 51:1193-1195. [PMID: 30981408 DOI: 10.1016/j.transproceed.2019.01.092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 01/30/2019] [Indexed: 10/27/2022]
Abstract
Infections after solid organ transplantation are a major cause of mortality and morbidity. Varicella-zoster virus (VZV) infection after solid organ transplantation is rare. Here we present a case presenting with acute hepatitis and shingles after a liver transplantation (LT). A 36-year-old male patient underwent a liver transplantation; 7 months later his liver function tests increased. An examination and test results revealed that he had VZV-induced hepatitis. After VZV treatment, his test results returned to normal levels. Hepatic involvement of VZV infection is rare, but it may be fatal in immunocompromised individuals. Early diagnosis and early initiation of antiviral therapy is important in the control of hepatitis and rare hepatotropic viruses in immunocompromised individuals.
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Affiliation(s)
- S Acar
- Department of Gastroenterology and Organ Transplantation Center, Sakarya University School of Medicine, Sakarya, Turkey.
| | - G Gencdal
- Department of Gastroenterology and Organ Transplantation Center, Memorial Atasehir Hospital, Istanbul, Turkey
| | - H Kirimlioglu
- Department of Pathology, Acibadem University School of Medicine and Nisantasi Pathology Center, Istanbul, Turkey
| | - K Y Polat
- Department of General Surgery and Organ Transplantation Center, Memorial Atasehir Hospital, Istanbul, Turkey
| | - A A Cagatay
- Department of Infectious Disease, Istanbul University School of Medicine, Istanbul, Turkey
| | - M Akyildiz
- Department of Gastroenterology and Organ Transplantation Center, Koc University School of Medicine, Istanbul, Turkey
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5
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Acar S, Donmez G, Acar RD, Kavlak ME, Yazar S, Aslan S, Donmez R, Kargi A, Polat KY, Akyildiz M. Idiopathic Pulmonary Hypertension After Liver Transplantation. Transplant Proc 2019; 51:1196-1198. [PMID: 30981407 DOI: 10.1016/j.transproceed.2019.01.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 01/21/2019] [Indexed: 11/30/2022]
Abstract
Pulmonary hypertension is one of the problems that can be encountered before liver transplantation. It is not expected in cases with no additional disease in postoperative period. Herein, we report on a 43-year-old woman who developed idiopathic pulmonary hypertension in the early postoperative period. Further investigation both pathologically and clinically is needed in patients undergoing living donor liver transplantation that may help to solve the problems such as pulmonary arterial hypertension before it occurs and manage complex hemodynamic changes successfully in the future.
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Affiliation(s)
- S Acar
- Department of Gastroenterology and Organ Transplantation Center, Sakarya University School of Medicine, Sakarya, Turkey.
| | - G Donmez
- Department of Cardiology, Memorial Atasehir Hospital, Istanbul, Turkey
| | - R D Acar
- Department of Cardiology, Kartal Kosuyolu High Speciality Educational and Research Hospital, Istanbul, Turkey
| | - M E Kavlak
- Department of Anesthesiology and Intensive Care Unit and Organ Transplantation Center, Memorial Atasehir Hospital, Istanbul, Turkey
| | - S Yazar
- Department of General Surgery and Organ Transplantation Center, Memorial Atasehir Hospital, Istanbul, Turkey
| | - S Aslan
- Department of General Surgery and Organ Transplantation Center, Memorial Atasehir Hospital, Istanbul, Turkey
| | - R Donmez
- Department of General Surgery and Organ Transplantation Center, Memorial Atasehir Hospital, Istanbul, Turkey
| | - A Kargi
- Department of General Surgery and Organ Transplantation Center, Memorial Atasehir Hospital, Istanbul, Turkey
| | - K Y Polat
- Department of General Surgery and Organ Transplantation Center, Memorial Atasehir Hospital, Istanbul, Turkey
| | - M Akyildiz
- Department of Gastroenterology and Organ Transplantation Center, Topkapı, Istanbul, Turkey
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6
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Atalan HK, Gucyetmez B, Donmez R, Kargi A, Polat KY. Advantages of Epidural Analgesia on Pulmonary Functions in Liver Transplant Donors. Transplant Proc 2018; 49:1351-1356. [PMID: 28736006 DOI: 10.1016/j.transproceed.2017.03.087] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 03/07/2017] [Accepted: 03/30/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Epidural analgesia (EA) has positive effects on anesthetic requirement, blood loss, postoperative analgesia, and pulmonary function tests (PFTs). The purpose of the present study was to investigate the effect of EA on postoperative PFTs in liver transplant donors (LTDs). METHODS In the present study, 66 LTDs were classified as total intravenous anesthesia (TIVA) and TIVA+EA groups. Patient's age, sex, body mass index, induction and maintenance dose of propofol (IDP and MDP), operation duration, forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), FEV1/FVC ratio, visual analog scale (VAS), atelectasis scores, and lengths of intensive care unit (ICU) and hospital stays were recorded. RESULTS In the TIVA+EA group, IPD, MPD, delta-FEV1 delta-FVC, VAS for all time, atelectasis score and length of hospital stay were significantly lower than in the TIVA group (P < .001 for all). Whereas VAS at the end of the operation was negatively correlated with delta-FEV1 and delta-FVC (r2 = 0.26 P < .001; r2 = 0.41 P < .001; respectively), it was positively correlated with atelectasis score and length of ICU stay (r2 = 0.49, P < .001; and r2 = 0.41, P < .001; respectively). Atelectasis score was positively correlated with length of ICU stay (r2 = 0.86, P < .001). CONCLUSIONS Reduced anesthetic requirement, better postoperative analgesia, reduced atelectasis score, and preserved PFTs can be provided with the use of EA in LTDs. Positive effects of EA on anesthesia requirement, pain management and pulmonary function are associated with outcomes.
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Affiliation(s)
- H K Atalan
- Department of Anesthesiology, Ataşehir Memorial Hospital, Istanbul, Turkey
| | - B Gucyetmez
- Department of Anesthesiology, Acibadem University School of Medicine, Istanbul, Turkey.
| | - R Donmez
- Department of Transplantation, Ataşehir Memorial Hospital, Istanbul, Turkey
| | - A Kargi
- Department of Transplantation, Ataşehir Memorial Hospital, Istanbul, Turkey
| | - K Y Polat
- Department of Transplantation, Ataşehir Memorial Hospital, Istanbul, Turkey
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7
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Atalan HK, Gucyetmez B, Donmez R, Berktas M, Kargi A, Erturer A, Sozenoglu İR, Denizalti TB, Polat KY. The effects of high lumbar epidural analgesia on postoperative pulmonary function tests in liver transplant donor patients. Intensive Care Med Exp 2015. [PMCID: PMC4797765 DOI: 10.1186/2197-425x-3-s1-a693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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8
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Gucyetmez B, Atalan HK, Aslan S, Berktas M, Yazar S, Erturer A, Sozenoglu IR, Denizalti TB, Polat KY. Effects of intraoperative magnesium sulfate administration on postoperative tramadol requirement in liver transplant patients. Intensive Care Med Exp 2015. [PMCID: PMC4796239 DOI: 10.1186/2197-425x-3-s1-a694] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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9
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Tanoglu A, Artis T, Donmez R, Kargi A, Sit M, Aslan S, Yazar S, Beyazit Y, Polat KY. Liver transplantation from living donors with Gilbert's syndrome is a safe procedure for both donors and recipients. Clin Transplant 2015; 29:965-70. [PMID: 26271485 DOI: 10.1111/ctr.12615] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2015] [Indexed: 01/01/2023]
Abstract
Liver transplantation (LT) has become a favorable therapeutic option for patients with end-stage liver diseases. Gilbert's syndrome (GS) is a benign condition characterized by intermittent mild jaundice due to unconjugated hyperbilirubinemia. It is not obvious whether living-donor liver transplantation (LDLT) from a donor with GS could result in a normal outcome for both the recipient and the donor. We aimed to determine whether right lobe hepatectomy is a safe procedure for living donors with GS and LT recipients. Between September 2011 and March 2015, 305 LDLT procedures using right lobe grafts were performed at Atasehir Memorial Hospital, Istanbul, Turkey. Nineteen of 305 LT candidates who had been diagnosed with GS were included in the current study. After a 12-h overnight fast, total and indirect bilirubin levels of donors and recipients were measured. The median follow-up after transplant was 16 months (range 3-36 months). The median age of donors was 25 (range 20-55 yr). Four donors (21%) were female, and 15 donors (89%) were male. The median age of donors was 51 (range 23-68 yr). Eleven recipients (57%) were female, and 8 (43%) were male. The median preoperative total bilirubin level of donors was 1.69 mg/dL (range 1.26-2.43 mg/dL) (normal range <1.2 mg/dL). The median total bilirubin level of donors on postoperative day 7 was 1.04 mg/dL (range 0.71-3.23 mg/dL). As our study has included a large number of donors with GS, it produced reliable evidence that right lobe hepatectomy is a safe procedure for living donors with GS and LT recipients.
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Affiliation(s)
- Alpaslan Tanoglu
- Department of Gastroenterology, GATA Haydarpasa Training Hospital, İstanbul, Turkey
| | - Tarik Artis
- Department of General Surgery, Istanbul Medeniyet University, Istanbul, Turkey
| | - Ramazan Donmez
- Department of Transplant Surgery, Memorial Atasehir Hospital, Istanbul, Turkey
| | - Ahmet Kargi
- Department of Transplant Surgery, Memorial Atasehir Hospital, Istanbul, Turkey
| | - Mustafa Sit
- Department of Transplant Surgery, Memorial Atasehir Hospital, Istanbul, Turkey
| | - Serdar Aslan
- Department of Transplant Surgery, Memorial Atasehir Hospital, Istanbul, Turkey
| | - Serafettin Yazar
- Department of Transplant Surgery, Memorial Atasehir Hospital, Istanbul, Turkey
| | - Yavuz Beyazit
- Department of Gastroenterology, Canakkale State Hospital, Canakkale, Turkey
| | - Kamil Yalcin Polat
- Department of Transplant Surgery, Memorial Atasehir Hospital, Istanbul, Turkey
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10
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Keles M, Eyerci N, Uyanik A, Aydinli B, Sahin GZ, Cetinkaya R, Pirim I, Polat KY. The frequency of familial mediterranean Fever related amyloidosis in renal waiting list for transplantation. Eurasian J Med 2015; 42:19-20. [PMID: 25610112 DOI: 10.5152/eajm.2010.06] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2010] [Accepted: 04/08/2010] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Our goal is to investigate the distribution of MEFV mutations in patients with renal amyloidosis who are in renal transplant waiting list which is prepared for transplantation. MATERIALS AND METHODS FMF was diagnosed in 25 of the 297 patients between the years 2004 and 2008, who were involved in the study (15 male, 10 female; age 34±7.8). 5 out of 25 patients were transplanted, remaining were waiting for Tx. Biopsy results were amyloidosis and taken from renal (n:16), rectal (n:8) and duodenal (1).All of them were carrier of mutations in both pyrin alleles.The primer cause of chronic renal failure in our group was secondary AA amyloidosis. DNA was isolated from 25 whole blood samples. The NanoChip Molecular Biology Workstation (Nanogen) uses electronic microarrays for mutation detection. Exon 2,3,5 and 10 of pyrin gene genotypes were identified in the NanoChip. RESULTS Genetic analysis of the patients demonstrated that each subject carries either homozygote or compound heterozygote mutations of the gene. The most common mutations were M694V, V726A, E148Q and M680I. CONCLUSIONS The clinic manifestation and complain of our patients were febrile and painful attacks such as in the abdomen, chest and joints due to inflammation of the peritoneum, pleura and synovial membrane. The major problem in FMF is the occurrence of amyloidosis that primarily affects the kidneys causing proteinuria and renal failure. Dialysis and renal transplantation can be treatment, but it is important to diagnose FMF at earliest stages. The percentage of FMF patients in our waiting list was 8.4%. Moreover, in our region FMF incidence is highly frequent, so FMF should be chased by genetically so as to prevent chronic renal failure due to amyloidosis.
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Affiliation(s)
- Mustafa Keles
- Department of Nephrology, Faculty of Medicine, Atatürk University, Erzurum, Turkey
| | - Nilnur Eyerci
- Medical Biology, Faculty of Medicine, Atatürk University, Erzurum, Turkey
| | - Abdullah Uyanik
- Department of Nephrology, Faculty of Medicine, Atatürk University, Erzurum, Turkey
| | - Bulent Aydinli
- General Surgery, Faculty of Medicine, Atatürk University, Erzurum, Turkey
| | - Gonul Zisan Sahin
- Medical Biology, Faculty of Medicine, Atatürk University, Erzurum, Turkey
| | - Ramazan Cetinkaya
- Department of Nephrology, Faculty of Medicine, Atatürk University, Erzurum, Turkey
| | - Ibrahim Pirim
- Medical Biology, Faculty of Medicine, Atatürk University, Erzurum, Turkey
| | - Kamil Yalcin Polat
- General Surgery, Faculty of Medicine, Atatürk University, Erzurum, Turkey
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11
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Kantarci M, Aydin U, Doganay S, Aydinli B, Yuce I, Polat KY. A Rare Presentation of an Entrapment in a Liver Transplant Candidate Depicted by MDCT Angiography. Eurasian J Med 2015; 42:95-7. [PMID: 25610132 DOI: 10.5152/eajm.2010.26] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2010] [Accepted: 05/24/2010] [Indexed: 11/22/2022] Open
Abstract
Hypertrophic caudate lobe veins can mimic a normal venous configuration. In cases of multiple vascular collaterals, Doppler evaluations must be conducted, and the flow direction of these veins as well as the IVC should be evaluated. If the flow in the IVC is reversed, Budd-Chiari syndrome should be suspected; moreover, at the supra diaphragmatic level, which may be considered a blind spot, particularly for radiologists, a web should be searched for in the area where the IVC opens into the right atrium. In this study, we present the unique findings of multidetector computed tomography (MDCT) angiography for a liver transplant candidate with Budd-Chiari syndrome caused by a web in the proximal IVC.
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Affiliation(s)
- Mecit Kantarci
- Department of Radiology, Medical Faculty, Ataturk University, Erzurum, Turkey
| | - Unal Aydin
- Department of General Surgery, Medical Faculty, Gaziantep University, Gaziantep, Turkey
| | - Selim Doganay
- Department of Radiology, Erciyes University, Kayseri, Turkey
| | - Bulent Aydinli
- Department of General Surgery, Medical Faculty, Ataturk University, Erzurum, Turkey
| | - Ihsan Yuce
- Department of Radiology, Medical Faculty, Ataturk University, Erzurum, Turkey
| | - Kamil Yalcin Polat
- Department of General Surgery, Medical Faculty, Ataturk University, Erzurum, Turkey
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12
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Atalan HK, Gucyetmez B, Aslan S, Berktas M, Polat KY. Intraoperative use of gelatin in living donor liver transplantation and postoperative acute kidney injury. Crit Care 2015. [PMCID: PMC4470756 DOI: 10.1186/cc14437] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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13
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Polat KY, Tosun MS, Ertekin V, Aydinli B, Emre S. Brucella infection with pancytopenia after pediatric liver transplantation. Transpl Infect Dis 2012; 14:326-9. [PMID: 22260451 DOI: 10.1111/j.1399-3062.2011.00709.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2011] [Revised: 08/08/2011] [Accepted: 10/06/2011] [Indexed: 12/15/2022]
Abstract
Brucellosis is considered the most widespread zoonosis in the world. It has been reported that the prevalence of seropositivity among the Turkish population varies from 3% to 14%. We present a case of brucellosis after pediatric liver transplantation. A 15-year-old boy with the diagnosis of neuro Wilson's disease underwent deceased-donor liver transplantation. The postoperative immunosuppressive protocol consisted of steroids and tacrolimus. Two months after the operation the patient experienced fever to 40°C. The patient complained of poor appetite, headache, and diarrhea. He had had pancytopenia. Despite administration of appropriate antibiotics, antiviral and antifungal agents, fever persisted for > 1 month. Multiple blood, urine, stool, and sputum cultures were negative. Bone marrow aspirate revealed hypocellularity. Liver biopsy was performed, but rejection was not observed on biopsy specimen. Brucella serology was positive and Brucella agglutination titer was 1:320. Bone marrow culture was positive for Brucella but blood culture was negative. The patient was then treated with oral doxycycline and rifampin for 8 weeks. No previous case report about Brucella infection after liver transplantation has appeared in the literature, to our knowledge; our case is presented as the first. Bone marrow hypoplasia is a rare feature of Brucella infection. Our patient with brucellosis and pancytopenia had had hypocellular bone marrow. The clinical and hematologic findings resolved with treatment of the infection. Brucella infection should be suspected in liver transplanted recipients with fever of unknown origin, especially in a recipient who has lived in an endemic area. Brucella also should be considered as a possible diagnosis in patients with pancytopenia.
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Affiliation(s)
- K Y Polat
- Department of Transplant Surgery, Memorial Atasehir Hospital, Istanbul, Turkey
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14
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Polat KY, Aydinli B, Keles M, Uyanik A, Ozturk G, Ceviz M, Gundogdu C, Kantarci M. Spontaneous mycotic external iliac artery aneurysm rupture after perforated acute appendicitis in a renal allograft recipient. EXP CLIN TRANSPLANT 2011; 9:211-213. [PMID: 21649572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Acute appendicitis is uncommon after renal transplant. Infection with Candida albicans can produce serious complications by compromising the vascular anastomosis. In such cases, the origin of Candida albicans is often in the gastrointestinal system. Here, we report 2 uncommon complications that occurred in the same patient. A 27-year-old female renal transplant patient with appendicitis presented to our institution with acute graft failure. The patient was treated with an appendectomy and a transplant nephrectomy. Subsequently, the patient had a mycotic pseudoaneurysm rupture of the external iliac artery secondary to Candida albicans infection that originated possibly in the gastrointestinal system. This complication was further treated with a cross-femoral bypass. The occurrence of these 2 complications together is rare.
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Affiliation(s)
- Kamil Yalcin Polat
- Department of General Surgery, Faculty of Medicine, Ataturk University, Erzurum, Turkey
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15
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Keles M, Yildirim R, Uyanik A, Turkmen M, Bilen Y, Aydinli B, Cetinkaya R, Polat KY. Neutropenia related to valacyclovir and valganciclovir in 2 renal transplant patients and treatment with granulocyte colony stimulating factor: a case report. EXP CLIN TRANSPLANT 2010; 8:181-183. [PMID: 20565377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
OBJECTIVES Posttransplant leukopenia is frequently observed in renal transplant. Granulocyte colony-stimulating factor controls the production of functional neutrophils and their release into peripheral blood. Granulocyte colony-stimulating factor has been widely and frequently used for many conditions and disorders in the field of hematology and oncology. MATERIALS AND METHODS We present the cases of valacyclovir-related and valganciclovir-related neutropenia in 2 renal transplant recipients. RESULTS Both cases had renal transplants from live donors. The first one was an 18-year-old man. Laboratory investigations revealed his leukocyte count as 1.7 x 10(9)/L. The patient was using mycophenolate mofetil, cyclosporine, and valganciclovir. Mycophenolate mofetil was stopped because he had neutropenia, and later, valganciclovir was also stopped because the neutropenia persisted. Because the neutropenia did not recover after we discontinued valganciclovir, the patient was administered granulocyte colony-stimulating factor. The neutrophil count increased to 2.2 x 10(9)/L (leucocyte count to 6.5 x 10(9)/L) after 24 hours. The second case was a 37-year-old man and was using mycophenolic acid, tacrolimus, and valacyclovir. Laboratory investigations revealed his leukocyte count to be 1.3 x 10(9)/L. Mycophenolic acid and valganciclovir were stopped owing to neutropenia. The patient was administered granulocyte colony-stimulating factor, and the neutrophil count increased to 3.8 x 10(9)/L (leucocyte count to 5.8 x 10(9)/L). The kidney functions did not deteriorate in either patient, and the patients' kidney functions were similar to baseline levels 12 months after surgery. CONCLUSIONS We conclude that granulocyte colony-stimulating factor can be used safely and effectively in renal transplant patients.
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Abstract
BACKGROUND AND AIM Hepatic alveolar echinococcosis (HAE) involves both the vascular and biliary structures of the liver. Endoscopic retrograde cholangiopancreatography (ERCP) is said to be an alternative for the diagnosis and treatment of biliary complications of HAE. We present here our experience with ERCP in HAE. METHODS We followed 13 patients who underwent ERCP for the treatment of biliary complications of HAE in the endoscopy unit of our clinic at Ataturk University School of Medicine, Erzurum between January 2002 and June 2008. RESULTS Eight men and five women were followed up. Mean age was 43.2 (24-64 years). All patients had non-resectable HAE. Indications for ERCP were biliary fistula in seven patients, obstructive jaundice in five patients and cholangitis in one patient. Endoscopic sphincterotomy (ES) was carried out in 12 patients, and in one patient with biliary leakage, a stent was inserted into the right hepatic branch. ERCP findings were dilated common bile duct, irregular narrowing and distortion of the common bile duct and common hepatic duct, communication with the cystic cavity or biliocutaneous fistula and complete disappearance of the biliary tree above the level of the common hepatic duct or hepatic bifurcation. In patients with biliary leakage, biliary drainage decreased only in two patients after ERCP and in patients with obstructive jaundice, the high bilirubin levels decreased in only one patient. CONCLUSION ERCP showed structural changes of the external biliary tract and ES has a limited effect on these changes and stents can be used in selected cases.
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Affiliation(s)
- Gurkan Ozturk
- Department of General Surgery, Ataturk University School of Medicine, Erzurum, Turkey.
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Polat KY, Aydinli B, Polat O, Aydin U, Yazici P, Ozturk G, Gundogdu C, Kiziltunc A. The protective effect of aprotinin and alpha-tocopherol on ischemia-reperfusion injury of the rat liver. Transplant Proc 2008; 40:63-8. [PMID: 18261548 DOI: 10.1016/j.transproceed.2007.11.047] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND Liver injury caused by ischemia-reperfusion (I/R) processes is a complication of hepatic resection surgery and transplantation, particularly using grafts from marginal donors. Despite improvements in organ preservation and advances in surgical techniques, I/R injury remains a significant clinical problem. In this study, we investigated whether aprotinin provided protection against the adverse effects of I/R injury in liver tissue. METHODS Forty rats were randomized into four groups (n = 10): group I: (control group) I/R + no medication; group II: sham-operated group + no medication or I/R; group III: I/R + aprotinin; group IV: I/R + alpha-tocopherol. Malondialdehyde (MDA) was measured in the liver tissue and superoxide dismutase (SOD), catalase (CAT), aspartate aminotransferase (AST), alanine aminotransferase (ALT), as well as lactate dehydrogenase (LDH) in rat serum. RESULTS Administration of aprotinin and alpha-tocopherol before I/R resulted in significant reductions of MDA levels compared to the I/R alone group (group I; P = .01 and P < .01, respectively). Administration of aprotinin or alpha-tocopherol prior to I/R resulted in significant increases in SOD and CAT levels compared with the I/R group (P < .05 each). Compared to the I/R group, significant decreases in plasma AST, ALT, and LDH levels were observed both in the aprotinin and in the alpha-tocopherol group (P < .05). Histological evaluation revealed the injury grade to be relatively lower among groups III and IV compared to group I. DISCUSSION In conclusion, rat hepatic structures in aprotinin and alpha-tocopherol administered groups were well protected. Therefore, aprotinin may provide protection against the adverse effects of I/R injury in liver transplantation.
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Affiliation(s)
- K Y Polat
- Department of General Surgery, Ataturk University, Erzurum, Turkey
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Duran C, Aydinli B, Tokat Y, Yuzer Y, Kantarci M, Akgun M, Polat KY, Unal B, Killi R, Atamanalp SS. Stereological evaluation of liver volume in living donor liver transplantation using MDCT via the Cavalieri method. Liver Transpl 2007; 13:693-8. [PMID: 17457928 DOI: 10.1002/lt.21132] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
In living donor liver transplantation (LDLT), obtaining the precise volume of the graft is very important to decrease volume-related postoperative complications, especially in cases with suspected small-for size grafts. We used stereology based on the Cavalieri method (CM), a new method to measure liver graft volume, and compared the results with those obtained through intraoperative measurement (IOM) and through multidetector computed tomography (MDCT) measurement. Liver volumes estimated using the 3 methods were well-correlated with each other (r(2) = 0.94 and P < 0.001 for IOM and CM; r(2) = 0.91 and P < 0.001 for IOM and MDCT, and r(2) = 0.95 and P < 0.001 for CM and MDCT); however, they were different from each other (in descending order, 908 +/- 124 cm(2), 861 +/- 121 cm(2), and 777 +/- 168 cm(2) for MDCT, CM, and IOM, respectively). Although MDCT and CM overestimated the volumes, the results of CM were almost similar to those obtained via IOM. In conclusion, our results suggest that CM measured the liver graft volume more reliably. Thus, its use, particularly in cases with suspected small-for-size graft, may prove useful.
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Affiliation(s)
- Cihan Duran
- Department of Radiology, Medical Faculty, Bilim University, Istanbul, Turkey
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Aydinli B, Kantarci M, Polat KY, Unal B, Atamanalp SS, Durur I, Unal D, Akgun M. Stereological evaluation of treatment response in patients with non-resectable hepatic alveolar echinococcosis using computed tomography via the Cavalieri method. Liver Int 2006; 26:1234-40. [PMID: 17105589 DOI: 10.1111/j.1478-3231.2006.01363.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
INTRODUCTION The purposes of this study were to describe and adapt the relevant methods of computed tomography (CT) and stereology to estimate parasitic volume in the liver, to compare the efficiency of benzimidazole treatment in hepatic alveolar echinococcosis (AE), and to determine whether the response rates measured by the stereological method are correlated with those measured by simple volumetric measurements (SVM). METHODS Nine eligible patients with non-resectable AE were included in the study. By using their abdominal CT at the baseline and after a year of treatment, treatment responses of the cases were evaluated both by the stereological method via a software and by SVM, retrospectively. The volume estimation was performed in our study using a different approach that consisted of three separate stages combined with the Cavalieri method of modern design stereology. RESULTS The response rates were -17 +/- 55% and -12 +/- 37% by the Cavalieri method and SVM, respectively; however, they were not statistically significant (P = 0.59 and 0.21 for the Cavalieri method and SVM, respectively). Although some cases had comparable results, others had different response rates, and the two methods showed no significant correlation (r = -0.31, P = 0.41). CONCLUSIONS Because this modified method provides accurate results by reducing margin of errors, even in case of bizarre shape of AE, a correct, unbiased, and reliable management of the cases with AE via this method may be possible. Owing to lack of a correlation with SVM, it is suggested that a measurement via SVM may be wrong and its use in the evaluation of the treatment response in such cases will not be sufficient and completely true.
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Affiliation(s)
- Bulent Aydinli
- Department of General Surgery, Medical Faculty, Atatürk University, Erzurum, Turkey.
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Abstract
Hepatocellular carcinoma (HCC) has a tendency for fatal spontaneous rupture leading to massive haemorrhage. A 64-year-old man presented with sudden, severe epigastric pain for 6 h. Systolic blood pressure was 80/50 mmHg, and pulse rate was 100/min. The patient's history did not reveal any operation or disease up to date. Contrast enhancement-axial computed tomography (CT) scan showed a tumoral lesion with a necrotic centre measuring 6 x 5 cm within 6th segment of the liver and a fluid collection (haemoperitoneum) at the periphery of the liver. At exploratory laparotomy, the liver was found to be cirrhotic, and an actively bleeding tumour confirmed in 6th segment of the liver. The tumour was resected. Post-operative recovery was unremarkable, and the patient was discharged on the 14th post-operative day. Ruptured HCC should be included in the differential diagnosis of non-traumatic intra-abdominal haemorrhage.
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Affiliation(s)
- K Y Polat
- Department of General Surgery, Atatürk University Medical Faculty, Erzurum, Turkey
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Basoglu M, Yildirgan MI, Yilmaz I, Balik A, Celebi F, Atamanalp SS, Polat KY, Oren D. Late complications of incisional hernias following prosthetic mesh repair. Acta Chir Belg 2004; 104:425-8. [PMID: 15469155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
BACKGROUND Incisional hernias still continue to be a serious problem for surgeons. In this study, we aimed to investigate the effects of polypropylene mesh and mersilene mesh, which are frequently employed in incisional hernias, as well as the effects of their application techniques on late complications. METHODS Two-hundred-sixty-four open abdominal hernia repairs were performed between 1986--2000, using prosthetic materials: polypropylene mesh and mersilene mesh were used in hernia repair. Mesh was placed as onlay, underlay and sandwich techniques. Follow-up data were obtained from medical records. RESULTS Comparisons were made with respect to surgical techniques and to late complications such as recurrence, enterocutaneous fistula, intestinal obstruction, and infections. Enterocutaneous fistulas developed in two patients. Recurrence occurred in 6.4 per cent. Chronic infection and wound sinus formation occurred in 5 per cent. The causes of recurrence included smoking, cellulitis, chronic infection/sinus tract, upper abdominal localization, and obstruction. Fistula formation occurred in patients with no peritoneal prevention, which was statistically significant (p=0.012). Chronic infection/sinus tract was high in patients for whom mersilene mesh was used, and enterocutaneous fistula occurred in 2 patients. CONCLUSION To prevent late complications, it is necessary to avoid the contact of mesh with bowel.
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Affiliation(s)
- M Basoglu
- Department of General Surgery, School of Medicine, Ataturk University, Erzurum, Turkey.
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Abstract
Tuberculous liver abscess (TLA) is an extremely rare condition, even in the country where tuberculosis is an alarming public health problem. Primary TLA, with no evidence of infection elsewhere, is even less common. Herein, we report a case with primary TLA and review the literature.
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Affiliation(s)
- M N Akçay
- General Surgery Department, Atatürk University Medical Faculty, Erzurum, Turkey.
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Abstract
BACKGROUND Previously surgical operation was the only accepted treatment for hydatid liver cysts. Recently percutaneous management has become more preferable because of its low morbidity rate and lower cost. PATIENTS AND METHODS In all, 101 patients harbouring 120 hydatid cysts of the liver were treated by percutaneous drainage between October 1994 and December 1997. Of these cysts, 89 were in the right liver and 31 in the left liver.Thirty-one patients had had previous operations for hydatid disease. All cysts had an anechoic or hypoechoic unilocular appearance on ultrasound scan. The mean dimension of the cysts was 7.5+/-2.9 cm (range 3-10.4 cm). All patients received oral albendazole 10 mg/kg perioperatively. After aspiration under sonographic guidance, cysts were irrigated with 95% ethanol. RESULTS The amount of cyst fluid aspirated was 220+/-75 ml and the amount of irrigation solution used was 175+/-42 ml. Four patients developed mild fever and three had urticaria. Mean length of hospital stay was 2.1+/-0.7 (range 1-4) days, and patients were followed up for 43-62 months (mean 54+/-5.4 months). Maximal cyst diameter decreased from 7.5+/-2.9 cm to 3.2+/-15 cm (p<0.001). Sonographic examinations revealed high-level heterogeneous echoes in the cyst cavity (heterogeneous echo pattern), while the cyst cavity was completely obliterated by echogenic material (pseudotumour echo pattern). DISCUSSION Most hydatid cysts of the liver can be managed successfully by a combination of drug therapy and percutaneous drainage.
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Affiliation(s)
- KY Polat
- Department of General Surgery, Ataturk University, School of MedicineErzurumTurkey
| | - AA Balik
- Department of General Surgery, Ataturk University, School of MedicineErzurumTurkey
| | - D Oren
- Department of General Surgery, Ataturk University, School of MedicineErzurumTurkey
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Celebi F, Balik AA, Polat KY, Yildirgan MI, Böyük A, Oren D. [Hepatic injuries. Surgical treatment experience]. Ulus Travma Derg 2001; 7:185-8. [PMID: 11705222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
PURPOSE To evaluate the results of the surgical treatment of hepatic injuries in our institution for liver injuries. PATIENTS AND METHODS One hundred seventy four patients who underwent operations between January 1986-December 1999 in Atatürk University Medical School, Emergency Service were reviewed retrospectively. RESULTS 135 patients were male (77.5%). The mean age was 25.4 (range 3-84). Sixty three patients (36.3%) had only hepatic injuries and the others had co-existing abdominal organ injury [62 patients (35.7%) had one organ, 29 (16.7%) had two, 17 (9.7%) had three, 2 (1.1%) had four, and 1 (0.5%) had 5 organ injuries]. Five patients (2.8%) had inferior vena cava and 1 (0.5%) had vena porta injuries. One hundred seven patients (61.4%) had blunt, 44 (25.3%) had stab wound and 23 (13.3%) had gunshot injuries. Management was simple suture in 104 patient (60%), primary suture + surgical cell patching in 52 (29.8%), hepatectomy (5 right hepatectomy, 5 non anatomic hepatectomy) in 10 (5.7%), perihepatic packing in 4 (2.3%), primary suture + omental patch in 2 (1.1%), primary suture + arterial ligation in 2 (1.1%). Eleven patients (16.4%) in penetrating trauma group "Penetrating Abdominal Trauma Index" (PATI) score were higher than 25. Fever was the most common complaint postoperatively (5%). Three patients (1.7%) underwent reoperation. Twenty-six patients (14.9%) which one of them ware died. Died in the postoperative periods, 23 (13.2%) had blunt and 3 (1.7%) had penetrating traumas. CONCLUSION Liver trauma still has high mortality rate injuries are very momentous. Especially blunt trauma related hepatic.
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Affiliation(s)
- F Celebi
- Atatürk Universitesi Tip Fakültesi Genel Cerrahi Anabilim Dali Erzurum.
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Balik A, Celebi F, Başoğlu M, Yildirgan I, Dalga S, Polat KY, Oren D. [Perforated peptic ulcers]. Ulus Travma Derg 2000; 6:234-6. [PMID: 11813477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Two hundred forty-eight patients were operated for perforated peptic ulcer between 1983 and 1998. Of the patients 112 (45.1%) had chronic, 34 (13.7%) had acute ulcer history and 102 (41.2%) had no ulcer history. Of the patients 228 (92.0%) had duodenal, 9 (3.6%) had juxtapyloric, 6 (2.4%) had marginal, and 5 (2.0%) had antral ulcer. Forty two patients (16.9%) admitted within 12 hours and 206 patients (83.1%) between 12 hours and six days after perforation. Simple closure and omental patch was performed in 32 patients (12.9%) who had severe concomitant illness and 126 (50.8%) intraabdominal sepsis, truncal vagotomy + pyloroplasty in 32 (12.9%), simple closure + omental patch + truncal vagotomy + gastroenterostomy in 34 (13.7%), simple closure + omental patch + parietal cell vagotomy in 21 (8.5%), truncal vagotomy + antrectomy in 3 (1.2%). Patients who didn't have definitive procedure received H2 receptor blockers or proton pomp inhibitors. One hundred ninety-three patients (77.8%) underwent endoscopic control. Two of 53 patients with definitive procedure (3.8%) and 34 of 140 patients (24.3%) with simple closure had recurrence. Two patients in simple closure group underwent parietal cell vagotomy, the others received medical treatment. The recurrence rate was significantly higher in simple closure group (p < 0.01).
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Affiliation(s)
- A Balik
- Atatürk Universitesi Tip Fakültesi Genel Cerrahi Anabilim Dali, Erzurum.
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Balik AA, Başoğlu M, Celebi F, Oren D, Polat KY, Atamanalp SS, Akçay MN. Surgical treatment of hydatid disease of the liver: review of 304 cases. Arch Surg 1999; 134:166-9. [PMID: 10025457 DOI: 10.1001/archsurg.134.2.166] [Citation(s) in RCA: 94] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
HYPOTHESIS To review the results of different modalities of treatment of hydatid disease of the liver. DESIGN Retrospective study of 304 patients. SETTING A university hospital in Turkey. PATIENTS Three hundred four patients with hepatic hydatid disease who underwent operation between 1981 and 1996. MAIN OUTCOME MEASURES Mortality and morbidity. RESULTS Two hundred thirty-eight patients had a cyst on the right lobe, 41 patients had a cyst on the left lobe, and 25 patients had a cyst on both lobes. Forty-five patients had multiple hepatic cysts and 18 patients had coexisting cysts in other intra-abdominal organs. Surgical procedures were tube drainage, capitonnage, omentoplasty, cystectomy, segmentectomy, and cystoenterostomy. Of the patients with tube drainage, 36 developed an infection of the remaining cavity, 10 developed long-lasting biliary fistula, 8 developed cholangitis, and 6 developed septicemia. Four patients died of unreleated complications. Of the patients with capitonnage, 7 developed cholangitis and 3 developed an infection of the remaining cavity. Of the patients with omentoplasty, 1 developed an infection of the remaining cavity and 1 developed cholangitis. One patient who underwent segmentectomy developed pulmonary complications. Of the patients with cystoenterostomy, 1 developed cholangitis, 1 developed septicemia, and 1 developed pulmonary complications. CONCLUSION For management of hydatid disease of the liver, capitonnage, omentoplasty, cyst excision, segmentectomy, or cystoenterostomy are all superior to tube drainage.
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Affiliation(s)
- A A Balik
- Department of General Surgery, Atatürk University School of Medicine, Erzurum, Turkey.
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Karaoğlanoğlu N, Eroğlu A, Polat KY. Surgical procedure for bilateral lung and liver hydatid cysts. Ann Thorac Surg 1998; 66:988-9. [PMID: 9768987 DOI: 10.1016/s0003-4975(98)00682-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Affiliation(s)
- E Varoğlu
- Department of Nuclear Medicine, Atatürk University, Medical School, Erzurum, Turkey
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