Publications (11)11.05 Total impact
-
Article: Paired exchange kidney transplantation experience of Turkey.
[show abstract] [hide abstract]
ABSTRACT: Paired-exchange kidney transplantation (PKD) has gained in importance because of the difficulty to obtain suitable organs. The aim of this study was to compare the biochemical and clinical parameters of PKT with those of living-related kidney transplantation (LD). We compared 272 PKD performed in 3 transplant centers with 1885 LD. The 2 groups were compared for graft and patient survivals, rejection episodes, serum creatinine levels, and other biochemical parameters. The median human leukocyte antigen, mismatch was similar: PKD, 4 (95% confidence interval [CI], 3-4) and LD; 3 (95% CI, 3-4; P = .1292). The mean creatinine level among the PKT group of 1.07 ± .37 was lower then the LD group 1.17 ± .56 (P = .0043), but after the second year it was lower in the LD group (1.39 ± 0.61 and 1.16 ± 0.43; P < .0001). The rates of patient death (PKT, 3.31% vs LD 3.58; P = .9603), graft loss (2.74% vs 2.71%; P = .8647) and acute rejection episodes (19.48% vs 19.36%; P = 0.9719), were similar between the 2 groups. Paired donation expands the living donor pool and decreases the number of waiting list patients. It is cost effective according to ABO incompetible transplantation.Transplantation Proceedings 04/2013; 45(3):860-3. · 1.00 Impact Factor -
Article: Comparison of paired exchange kidney transplantations with living related kidney transplantations.
[show abstract] [hide abstract]
ABSTRACT: Paired-exchange kidney transplantation (PETx) gains an importance because it is difficult to find suitable organs. The aim of this study was to compare biochemical and clinical parameters of PETx with those of living-related kidney transplantation (LRTx). The 57 PETx included 18 female and 39 male recipients among 1081 LRTx in 360 females and 721 males (N = 1138) whose operations were performed between November 21, 2008, and March 1, 2011. These two groups were compared for graft and patient survival, rejections, serum creatinine levels, glomerular filtration rates (GFRs), and other biochemical parameters. The PETx patients were older than the LRTx patients (45.4 ± 13.2 years versus 40.9 ± 13.5 years; P = .014). HLA mismatch was higher in the PETx group (4.7 ± 0.7 versus 3.56 ± 1.6; P = .000). First- and second-year serum creatinine and GFR values were similar between the two groups. Acute rejection episodes (PETx: 13/57; LRTx: 226/1081, P = .925), patient loss (0/57 versus 34/1081; P = .174) and graft loss (1/57 versus 55/1081; P = .257) were similar between the two groups. Our study showed similar biochemical and clinical findings of PETx versus LRTx over 2 years posttransplantation.Transplantation Proceedings 07/2012; 44(6):1626-7. · 1.00 Impact Factor -
Article: Hepatitis B surface antigen positivity is not a contraindication for living kidney donation.
[show abstract] [hide abstract]
ABSTRACT: Because of the organ shortage, the number of patients awaiting kidney transplantation has increased rapidly requiring physicians to implement new methods to increase the number of grafts. In this study, we compared clinical and biochemical parameters of patients who received kidneys from hepatitis B surface antigen-positive (group 1) versus other living related kidney donors (group 2). The study included 414 female (15 group 1 and 399 group 2) and 816 male (20 group 1 and 796 group 2) donors for 1195 living related kidney transplantations performed between April 21, 2008 and March 1, 2011. Group 1 kidney transplantations were undertaken only if the recipient displayed a hepatitis B antibody titer >10 mIU/mL and donor hepatitis B virus (HBV) DNA was negative. Demographic characteristics, 1- and 2-year serum creatinine levels, glomerular filtration rates (GFR), and liver function test results were similar between the 2 groups. There were no new HBV infections throughout the study period. Acute rejection rates (7/35 in group 1 vs 232/1195 in group 2; P = .988), graft loss (1/35 in group 1 vs 55/1195 in group 2; P = .624), and patient loss (0/35 in group 1 vs 34/1195; P = .311) were similar between the 2 groups. Our study showed that hepatitis B surface antigen positivity was not a contraindication to living kidney donation.Transplantation Proceedings 07/2012; 44(6):1628-9. · 1.00 Impact Factor -
Article: ABO-incompatible kidney transplantation: first cases in Turkey.
[show abstract] [hide abstract]
ABSTRACT: ABO compatibility has been believed to be necessary in kidney transplantation (Ktx) to prevent acute antibody-mediated rejection. However, developments in immunosuppression and immunoadsorption techniques have overcome acute antibody-mediated rejection caused by ABO incompatibility. Herein, we have presented the first ABO-incompatible Ktx cases in Turkey. All recipients did not have an ABO-compatible donor but presented significant dialysis inadequacy due to vascular access problems. Five dialysis patients with blood groups O or B underwent kidney transplantation from living related donors of blood group type A1 or AB between march 23, 2007 and August 16, 2007. All patients received Rituximab (375 mg/m(2)) at 3-4 weeks before the Ktx. Additionally, we started tacrolimus (0.15 mg/kg), mycophenolate mofetil (2 × 1 g), and simvastatin (1 × 20 mg) 1 week before the operation. Immunoadsorption therapy employing a specific filter (Glycosorbs) to remove anti-A or anti-B antibodies was continued until the titers were <1/4. After the Ktx, we again performed immunoadsorption if the anti-A or the anti-B antibody titer was >1/8 during the first postoperative week and >1/16 at the second postoperative week. We used 2 standard hemodialysis machines with a connection line to perform immunoabsorption and dialysis during the same session. Acute humoral and cellular rejection was not detected. During the follow-up 1 patient was lost due to a cardiovascular complication. Mean creatinine level was 1.1 ± 0.3 mg/dL. These first ABO-incompatible transplantation cases in Turkey suggest that this source may represent an effective approach to overcome the organ shortage.Transplantation Proceedings 07/2012; 44(6):1703-5. · 1.00 Impact Factor -
Article: Disease-specific quality of life in Turkish patients after successful kidney transplantation.
[show abstract] [hide abstract]
ABSTRACT: To investigate disease-specific quality of life (QOL) in Turkish patients after successful kidney transplantation, the End-Stage Renal Disease Symptom Checklist Transplantation Module (ESRD-SCL-TM), a multidimensional questionnaire measuring disease-specific QOL, was translated and administered to a sample of successfully transplanted patients. Intercultural differences between Turkish and German patients as well as the influence of demographic (age, gender) and clinical (duration of graft function, living versus cadaver transplantation) data in the Turkish patients were evaluated by multivariate analyses of variance, and correlative techniques. The 152 investigated Turkish patients, including 106 (69.7%) men and 46 (30.3%) women, had a mean age of 34.8 years (SD = 10.8, range, 14 to 67 years). Time since successful kidney transplantation varied between 1 and 297 months (mean = 19.2 months; SD = 36.9). One hundred twelve patients (73.7%) received a kidney from a living donor, and 40 (26.3%) from a cadaver. The Turkish patients suffered statistically significantly more from disease-specific distress than the German patients (19% explanation of variance). They reported higher distress regarding four of six subscales. Turkish women suffered statistically significantly more from "Limited Physical Capacity," and "Side-effects of Corticosteroids" (10% explanation of variance) than men. The demonstrated higher disease-specific distress in successfully transplanted Turkish patients compared to the German samples may be the result of intercultural differences in reporting psychological and disease-specific distress. On the other hand, the higher distress of women compared to men is well known. Both results pointed out the necessity of psychological support.Transplantation Proceedings 04/2006; 38(2):457-9. · 1.00 Impact Factor -
Article: Evaluation of transplantation in one center: Akdeniz University model.
Transplantation Proceedings 10/2002; 34(6):2012-3. · 1.00 Impact Factor -
Article: Attitudes and knowledge of Turkish physicians about organ donation and transplantation.
Transplantation Proceedings 10/2002; 34(6):2007-8. · 1.00 Impact Factor -
Article: Effects of donor age on renal transplant outcome.
Transplantation Proceedings 10/2002; 34(6):2019-20. · 1.00 Impact Factor -
Article: Attitudes of religious people in Turkey regarding organ donation and transplantation.
Transplantation Proceedings 06/2000; 32(3):629-30. · 1.00 Impact Factor -
Article: The role of the transplant coordinator on tissue donation in Turkey.
[show abstract] [hide abstract]
ABSTRACT: While solid organs represent the dramatic and lifesaving aspect of donation after death, the transplantation of tissues from donors after death is a much larger-scale activity that benefits enormous numbers of patients, usually in a life-enhancing rather than a lifesaving manner. Some types of tissue transplantation, such as heart valve and cornea transplantation, have been established for many decades and are reasonably well understood by health professionals and the public. Many other types of tissue donation, such as bone, skin, tendons, etc, are much less well known but nonetheless result in beneficial treatment for large numbers of patients. Skin is used to prevent fluid loss and infection following a major burn; bone is used to improve the clinical success of a range of orthopedic operations, such as joint replacements, spinal fusions, and reconstructions following trauma or tumor. In the United States more than 20,000 donors provided cadaveric tissue in 1999, compared to 6,000 in 1994. We ask all families of brain-dead donors for consent for tissue donation. Between January 1, 1999, and January 3, 2003, we had 58 actual cadaveric donors, procuring three skins, 15 tendons, six bones, 13 heart valves, and 40 corneas. We performed three skin, 40 tendon, and three bone transplants as well as storing other tissues. One donor can give health to 50 different recipients. In general, the argument runs for a transplant coordinator "if you can do it, then you must." We can save lives and present a better quality of life with solid organ and tissue donation.Transplantation Proceedings 36(1):22-3. · 1.00 Impact Factor -
Article: The solution to organ shortage in Turkey: trained transplant coordinators.
[show abstract] [hide abstract]
ABSTRACT: The organ shortage is a social, psychological, ethical, moral, and probably legal and political problem of the 21st century. It must be solved as soon as possible to save lives; transplant coordinators are important cornerstones in this effort. The first transplant coordinator training course was organized in May, 2002, including 27 participants from different hospitals, but unfortunately only 13 were able to work as transplant coordinators in their hospitals after the course. After the course, the number of cadaveric donors in Turkey increased 12%, compared to 2001. Currently, only 14 hospitals have transplant coordinators and 12 of them are transplant centers. There is no transplant coordinator at 10 transplant centers. Only two nontransplant centers have a transplant coordinator. Eightyeight percent of donors are procured from hospitals with a transplant coordinator. According to data from the Transplantation Society meeting held in Rome, August 2000, there should be 1675 donors in Turkey, but we had only 100 for 2002 and 49 in 1999. Transplant coordinators are essential to organize donation, seeking to achieve the maximum for potential generating capacity (60 brain-dead pmp). So we need approximately 200 (3/pmp) trained transplant coordinators in Turkey but we presently have only 15% of this number.Transplantation Proceedings 36(1):24-5. · 1.00 Impact Factor
