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Tuncer M, Tekin S, Yuksel Y, Yücetin L, Dosemeci L, Sengul A, Demirbaş A. First International Paired Exchange Kidney Transplantations of Turkey. Transplant Proc 2016; 47:1294-5. [PMID: 26093701 DOI: 10.1016/j.transproceed.2015.04.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE We estimated that many patients on the waiting list for kidney transplantation in Turkey have immunologicaly incompatible suitable living donors. Paired exchange kidney transplantation (PETx) is superior to desensitization for patients with incompatible donors. Recently we decided to begin an international PETx program. METHODS We report three international living related paired kidney transplantations which occurred between May 14,2013, and March 7, 2014. The international donor and recipient operations were performed at Medical Park Hospital, Antalya, Turkey. All pairs were living related and written proofs were obtained according to Turkish laws. As with the donor procedures, the transplantation procedures were performed at the same time. RESULTS The uniqueness of these transplantations was that they are the first international exchange kidney transplantations between Turkey and Kirghizia. Currently all recipients are alive with wel-functioning grafts. CONCLUSION In our institute, a 5% increase was obtained in living-related kidney transplantations by the help of PETx on a national basis. We believe that international PETx may also have the potential to expand the donor pool.
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Affiliation(s)
- M Tuncer
- Department of Nephrology, Istanbul Kemerburgaz University, Istanbul, Turkey; Organ Transplant Center, Medical Park Antalya, Antalya, Turkey.
| | - S Tekin
- Organ Transplant Center, Medical Park Antalya, Antalya, Turkey; Department of General Surgery, Istanbul Kemerburgaz University, Istanbul, Turkey
| | - Y Yuksel
- Organ Transplant Center, Medical Park Antalya, Antalya, Turkey
| | - L Yücetin
- Organ Transplant Center, Medical Park Antalya, Antalya, Turkey
| | - L Dosemeci
- Organ Transplant Center, Medical Park Antalya, Antalya, Turkey; Department of Anesthesiology, Istanbul Kemerburgaz University, Istanbul, Turkey
| | - A Sengul
- Organ Transplant Center, Medical Park Antalya, Antalya, Turkey
| | - A Demirbaş
- Organ Transplant Center, Medical Park Antalya, Antalya, Turkey
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Tekin S, Yavuz HA, Yuksel Y, Ateş I, Yucetin L, Dosemeci L, Tuncer M, Demirbas A. Renal Transplantation in Recipients Older Than 65 Years: Retrospective Analysis of the Results of a 4-year (2008-2012) Experience. Transplant Proc 2015; 47:1356-9. [PMID: 26093718 DOI: 10.1016/j.transproceed.2015.04.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND We analyze the results of renal transplantation among recipients older than 65 years old over a 4-year period (2008-2012) from a single renal transplantation unit and compare results with younger recipients. METHODS We retrospectively analyzed the outcomes of 2018 renal transplantations performed between November 2008 and December 2012. The χ(2) test was used for the comparison of categorical data, and the Student t test was used for the analysis of continuous variables. Patient and graft cumulative actuarial survivals were calculated using the Kaplan-Meier analysis and we tested for differences with the Mantel-Cox log-rank test. RESULTS Seventy-five (3.7%) recipients were aged ≥ 65 years with a median age of 68 (range, 65 to 82) years. Actuarial graft survivals at 1, 2, and 3 years were 93.8%, 92.5%, and 90.3%, respectively, for the <65 group and 89.7%, 88.1%, and 83.1%, respectively, for the ≥ 65 group (P < .03). Actuarial patient survivals at 1, 2, and 3 years were 96.3%, 95.5%, and 94.7%, respectively, for the younger and 91.8%, 90.2%, and 88%, respectively, for the older samples (P < .03). When graft survival was censored for patient death with a functioning kidney at 1, 2, and 3 years, the results were similar between groups with 95.5%, 94%, and 92.8%, respectively, for recipients aged <65 years and 94.7%, 89.2%, and 89.2%, respectively, for recipients aged ≥ 65 years (P = .213). CONCLUSIONS Our results showed that renal transplantation in selected patients older than 65 years was associated with good outcomes; this indicates that it seems safe and effective to treat end-stage renal disease in the elderly knowing there are acceptable rates of graft and patient survival.
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Affiliation(s)
- S Tekin
- General Surgery and Transplantation Unit, Medical Park Hospital, Kemerburgaz University, Antalya, Turkey
| | - H A Yavuz
- Nephrology and Renal Transplantation, Atakent Research and Education Hospital, Acibadem University, Istanbul, Turkey.
| | - Y Yuksel
- General Surgery and Transplantation Unit, Medical Park Hospital, Antalya, Turkey
| | - I Ateş
- Department of Cardiology, Medlina BSK Lara, Antalya, Turkey
| | - L Yucetin
- Organ Transplantation Coordination Unit Medical Park Hospital, Antalya, Turkey
| | - L Dosemeci
- Intensive Care Unit, Medical Park Hospital, Antalya, Turkey
| | - M Tuncer
- Nephrology and Renal Transplantation, Antalya Medical Park Hospital, Kemerburgaz University, Antalya, Turkey
| | - A Demirbas
- General Surgery and Transplantation Unit, Medical Park Hospital, Antalya, Turkey
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Yilmaz M, Cengiz M, Sanli S, Yegin A, Mesci A, Dinckan A, Hadimioglu N, Dosemeci L, Ramazanoglu A. Neurological Complications after Liver Transplantation. J Int Med Res 2011; 39:1483-9. [DOI: 10.1177/147323001103900437] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
This was a single-centre, prospective study to assess the frequency of neurological complications and their impact on prolonged hospitalization in 137 liver transplant patients presenting between September 1997 and June 2010. Neurological complications were seen in 22 (16%) patients during their postoperative stay in the intensive care unit. Complications included new-onset, recurrent headache (five patients), generalized seizures (four patients), dysarthria (two patients), delirium with agitation (three patients), persistent flapping tremor (two patients), alteration in level of consciousness (three patients), central pontine myelinolysis (one patient), myopathy (one patient) and visual hallucinations (one patient). Seizures were associated with immunosuppressive drug toxicity (tacrolimus). Myopathy presenting as quadriplegia was diagnosed by muscle biopsy. The patient with central pontine myelinolysis lived in a persistent vegetative state for 2 years and died of pneumonia. In conclusion, neurological complications are frequently encountered after liver transplantation, and are an important cause of severe morbidity and prolonged intensive care unit and hospital stay.
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Affiliation(s)
- M Yilmaz
- Department of Anaesthesiology and Intensive Care Medicine, Akdeniz University, Antalya, Turkey
| | - M Cengiz
- Department of Anaesthesiology and Intensive Care Medicine, Akdeniz University, Antalya, Turkey
| | - S Sanli
- Department of Anaesthesiology and Intensive Care Medicine, Akdeniz University, Antalya, Turkey
| | - A Yegin
- Department of Anaesthesiology and Intensive Care Medicine, Akdeniz University, Antalya, Turkey
| | - A Mesci
- Department of Surgery, School of Medicine, Akdeniz University, Antalya, Turkey
| | - A Dinckan
- Department of Surgery, School of Medicine, Akdeniz University, Antalya, Turkey
| | - N Hadimioglu
- Department of Anaesthesiology and Intensive Care Medicine, Akdeniz University, Antalya, Turkey
| | - L Dosemeci
- Anaesthesiology and ICU, Medicalpark Hospital Complex, Antalya, Turkey
| | - A Ramazanoglu
- Department of Anaesthesiology and Intensive Care Medicine, Akdeniz University, Antalya, Turkey
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Erdogan T, Erdogan G, Dosemeci L, Yilmaz M, Cengiz M, Ramazanoglu A. Crit Care 2005; 9:P357. [DOI: 10.1186/cc3420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Cengiz M, Dosemeci L, Yilmaz M, Purnek Akin F, Ramazanoglu A. Crit Care 2005; 9:P60. [DOI: 10.1186/cc3123] [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: 11/10/2022] Open
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Yegin A, Sanli S, Dosemeci L, Kayacan N, Akbas M, Karsli B. The analgesic and sedative effects of intrathecal midazolam in perianal surgery. Eur J Anaesthesiol 2004; 21:658-62. [PMID: 15473622 DOI: 10.1017/s0265021504008129] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND OBJECTIVE Our purpose was to evaluate the analgesic and sedative effects of intrathecal midazolam when added to spinal bupivacaine in patients undergoing perianal surgery under spinal anaesthesia. METHODS Forty-four patients were randomly allocated into two equal groups: Group I (B) received hyperbaric bupivacaine 0.5% 2 mL + saline 0.9% 1 mL in a total volume of 3 mL intrathecally; Group II (BM) received hyperbaric bupivacaine 0.5% 2 mL + 1 mL of 2mg preservative-free midazolam in a total volume of 3 mL intrathecally. In both groups, the onset and recovery times of sensory block, the degree and recovery times of motor block as well as the sedation and visual analogue pain scores were recorded, and statistically compared. RESULTS In Group BM, the postoperative visual analogue pain scores were significantly lower at the first 4 h (P < 0.05), the average time until the first dose of additional analgesic requirement was significantly longer (P < 0.05), and sedation scales were significantly higher (P < 0.05), compared to Group B. There were no statistically significant differences in the onset and the full recovery times of sensory and motor blocks in the two groups. CONCLUSION The use of intrathecal midazolam combined with intrathecal bupivacaine produces a more effective and longer analgesia with a mild sedative effect in perianal surgery.
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Affiliation(s)
- A Yegin
- Akdeniz University Medical Faculty, Department of Anaesthesiology, Antalya, Turkey.
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Dosemeci L, Yilmaz M, Akyuz M, Ucar T, Cengiz M, Ramazanoglu A. Crit Care 2004; 8:P315. [DOI: 10.1186/cc2782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Yilmaz M, Dosemeci L, Hadimioglu N, Dora B, Cengiz M, Ramazanoglu A. Crit Care 2004; 8:P303. [DOI: 10.1186/cc2770] [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: 11/10/2022] Open
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Akin F, Yilmaz M, Dosemeci L, Cengiz M, Ramazanoglu A. The relationship between catheter indwelling time and catheter-related infections. Crit Care 2003; 7. [PMCID: PMC3301565 DOI: 10.1186/cc2009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- F Akin
- Department of Anaesthesiology and ICU, University of Akdeniz, Faculty of Medicine, Antalya, Turkey
| | - M Yilmaz
- Department of Anaesthesiology and ICU, University of Akdeniz, Faculty of Medicine, Antalya, Turkey
| | - L Dosemeci
- Department of Anaesthesiology and ICU, University of Akdeniz, Faculty of Medicine, Antalya, Turkey
| | - M Cengiz
- Department of Anaesthesiology and ICU, University of Akdeniz, Faculty of Medicine, Antalya, Turkey
| | - A Ramazanoglu
- Department of Anaesthesiology and ICU, University of Akdeniz, Faculty of Medicine, Antalya, Turkey
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Yilmaz M, Dosemeci L, Kaplan E, Yagmur R, Ramazanoglu A. Crit Care 2003; 7:P088. [DOI: 10.1186/cc1977] [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: 11/10/2022] Open
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Celikbilek G, Dosemeci L, Yilmaz M, Cengiz M, Ramazanoglu A. Crit Care 2003; 7:P084. [DOI: 10.1186/cc1973] [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: 11/10/2022] Open
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Gurkan A, Tuncer M, Colak T, Erdoğan O, Demirbas A, Dosemeci L, Yakupoglu G. Comparison of tacrolimus and neoral-based immunosuppressive regimens in renal transplantation patients: singles-center experience. Transplant Proc 2002; 34:1661-2. [PMID: 12176525 DOI: 10.1016/s0041-1345(02)02970-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Alihan Gurkan
- Department of General Surgery, Akdeniz University Medical School, 07070 Antalya, Turkey
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Dosemeci L, Gurpinar F, Yilmaz M, Ramazanoglu A. Pediatric airway exchange catheter can be a life-saving device for adult patients who have risk factors for difficult tracheal reintubation. Crit Care 2001. [PMCID: PMC3333196 DOI: 10.1186/cc1076] [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: 11/29/2022] Open
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Dosemeci L, Dora B, Gurpinar F, Yilmaz M, Balkan S, Ramazanoglu A. Clinical utility and reliability of transcranial Doppler ultrasonography for the confirmation of brain death. Crit Care 2001. [PMCID: PMC3333375 DOI: 10.1186/cc1255] [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: 11/13/2022] Open
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