Deneysel tıkanma sarılığının erken döneminde mannitolün karaciğer glukoz metabolizmasına etkisi

Bu tezin, veri tabanı üzerinden yayınlanma izni bulunmamaktadır. Yayınlanma izni olmayan tezlerin basılı kopyalarına Üniversite kütüphaneniz aracılığıyla (TÜBESS üzerinden) erişebilirsiniz.[Abstarct Not Available

Hepatocellular carcinoma experience of Florence Nightingale Hospital Liver Transplantation Unit

Amaç: Bu çalışmanın amacı hepatosellüler karsinom (HSK) tanısı ile karaciğer nakli yapılmış hastaların sonuçlarını değerlendirmektir. Hastalar ve yöntemler: 2004 ve 2015 yılları arasında toplam 841 hastaya karaciğer nakli yapıldı. Bu hastaların 192’sine (%20) kadavra vericiden, 649’una (%80) ise canlı vericiden karaciğer nakli yapıldı. Hepatosellüler karsinom tanısı konulmuş tüm hastalar (n=220) tespit edildi. Bu hastaların klinik özellikleri, ameliyat öncesi, sırası ve sonrası verileri, greft ve hasta sağkalım süreleri retrospektif olarak incelendi. Sonuçlar istatistiksel olarak analiz edildi. Bulgular: Hepatosellüler karsinom tanısıyla karaciğer nakli yapılan toplam 220 hastanın ortalama yaşı 58 yıl (IQR 53-61) olarak saptandı. Bu hastaların 54’üne (%24) kadavra vericiden, 166’sına (%76) canlı vericiden karaciğer nakli yapıldı. Ortalama MELD skoru 12 (IQR 9-17) idi. Median serum AFP değeri 27 ng/mL (IQR 7-109) idi. Milan kriterleri 139 hastada (%64) sağlandı. Milan kriterleri dışı hasta sayısı 81 (%36) idi. Patoloji raporunda üç hastada (%1) kolanjiosellüler karsinom (KSK), yedi hastada (%4) mix HSK + KSK ve 210 hastada (%95) pür HSK görüldü. Ameliyat sırası ölüm 14 hastada (%6) görüldü. Kırk üç hastada (%19) nüks hastalık görüldü. Toplam bir yıllık sağkalım oranı %89, beş yıllık sağkalım oranı %76 idi. Sonuç: Çalışmamızın bulgularına dayanarak, hastalar düşük AFP değerleri ile vasküler invazyon olmaksızın iyi seçilir ise karaciğer nakli karaciğer sirozu ile beraber olan HSK tedavisinde hastalık kürü için mükemmel bir potansiyel oluşturduğu ve önerilen tedavi seçeneği olduğu söylenebilir.Objectives: The aim of this study is to evaluate the results of the patients with Hepatocellular carcinoma (HCC), who underwent liver transplantation. Patients and methods: Between 2004 and 2015, a total of 841 patients underwent liver transplantation. Out of these patients, 192 patients (20%) were deceased donor liver transplantations and 649 patients (80%) were living donor liver transplantation. All patients who were diagnosed with HCC were indentified (n=220). The clinical characteristics, pre-, intra- and postoperative data, graft and patients survival were retrospectively reviewed. The results were statistically analyzed. Results: There were 220 patients in the age of 58 years (IQR 53-61 who underwent liver transplantation for HCC. Of these patients, 54 patients (24%) were deceased donor liver transplantation and 166 patients (76%) were living donor liver transplantation. The median lab-MELD-score was 12 (IQR 9-17). The median AFP value was 27 ng/mL (IQR 7-109). The Milan criteria were met in 139 patients (64%). Outside Milan criteria were 81 patients (36%). The pathology report has shown cholangiocellular carcinoma (CCC) in three patients (1%), mixed HCC + CCC in seven patients (4%) and pure HCC in 210 patients (95%). Perioperative death was seen 14 patients (6%). Recurrent disease occurred in 43 patients (19%). The overall one year survival was 89% Conclusion: Based on the results of our study we can conclude that liver transplantation is the treatment of choice for HCC in cirrhosis with an excellent potential to cure the disease, if the patients is well selected with low AFP value without vascular invasion

The evalution of anterior sector venous drainage in right lobe living donor liver transplantation: does one technique fit all?

İstanbul Bilim Üniversitesi, Tıp Fakültesi.In living donor liver transplantation (LDLT), an adequate hepatic venous outflow constitutes one of the basic principles of a technically successful procedure. The issue of whether the anterior sector (AS) of the right lobe (RL) graft should or should not be routinely drained has been controversial. The aim of this 10-year, single-center, retrospective cohort study was to review the evolution of our hepatic venous outflow reconstruction technique in RL grafts and evaluate the impact of routine AS drainage strategy on the outcome. The study group consisted of 582 primary RL LDLT performed between July 2004 and December 2014. The cases were divided into 3 consecutive periods with different AS venous outflow reconstruction techniques, which included middle hepatic vein (MHV) drainage in Era 1 (n=119), a more selective AS drainage with cryopreserved homologous grafts in Era 2 (n=391), and routine segment 5 and/or 8 oriented AS drainage with synthetic grafts in Era 3 (n=72). Intraoperative portal flow measurement with routine splenic artery ligation (SAL) technique (in RL grafts with a portal flow of ≥ 250 mL/min/100 g liver tissue) was added later in Era 3. These 3 groups were compared in terms of recipient and donor demographics, surgical characteristics and short-term outcome. The rate of AS venous drainage varied from 58.8% in Era 1 and 35.0% in Era 2 to 73.6% in Era 3 (P<0.001). Perioperative mortality rate of recipients significantly decreased over the years (15.1% in Era 1 and 8.7% in Era 2 vs. 2.8% in Era 3, P=0.01). After the addition of SAL technique in the 45 cases, there was only 1 graft loss and no perioperative mortality. One-year recipient survival rate was also significantly higher in Era 3 (79.6% in Era 1 and 86.1% in Era 2 vs. 92.1% in Era 3, P=0.002). Routine AS drainage via segment 5 and/or 8 veins using synthetic grafts is a technique to fit all RL grafts in LDLT. Addition of SAL effectively prevents early graft dysfunction and significantly improves the outcome

Recurrence of Hepatitis D Virus in Liver Transplant Recipients With Hepatitis B and D Virus-Related Chronic Liver Disease

1st International Transplant Network Congress -- OCT 17-21, 2018 -- Antalya, TURKEYWOS: 000487349900073PubMed: 31405744Purpose. Data on recurrence of hepatitis D virus (HDV) and its long-term impact on liver transplant (LT) are limited. in this study, we investigated the incidence of hepatitis B virus (HBV) and the long-term effect of postoperative HDV recurrence HDV coinfection in our liver transplant patients. Patients and Methods. Between 2004 and 2018, all patients with LT because of HBV (n = 361; 37.3%) were reviewed, and those with HBV and HDV coinfection (n = 104; 30% of all HBV patients) were enrolled in our study. All patients received post-transplant combination therapy with nucleos(t)ide analogue and antihepatitis B immunoglobulins. Breakthrough infection was defined as reemergence of HBV DNA or hepatitis B surface antigen during postoperative treatment. in case of recurrence, another oral nucleos(t)ide analogue was added and antihepatitis B immunoglobulins were stopped. Results. During the study period, the frequency of HDV (+) was decreased (41% to 14%). Median follow-up time was 82 months (range, 1-274 months). Post LT survival and HBV recurrence were 97% (n = 15) and 13.4%, respectively. Only 15 patients (14%) developed breakthrough infection. There was no predictive factor for recurrent HDV infection, including demographics data and concomitant hepatocellular carcinoma (P = .73). Mortality was similar between patients with and without recurrence (2.2% vs 7.1%, P = .35) Conclusions. Patients who received transplants for hepatitis B and D virus cirrhosis had favorable prognosis and good long-term results despite recurrent infection. Close follow-up of patients and effective postoperative viral suppression with appropriate medications seems to be favorable for both prevention and management of recurrence and provides comparable outcome with patients without recurrence

SPLENIC ARTERY TRANSPOSTION FOR ARTERIAL RECONSTRUCTION IN LIVING DONOR LIVER TRANSPLANTATION: A PERFECT SUBSTITUTE

WOS: 000367726703010

Left ventricular hypertrabeculation/noncompaction in hyperoxaluria reply

WOS: 000421983000026PubMed ID: 26363766

The first report of Echinococcus multilocularis strain isolation from human in Turkey

The adult form of the small cestode Echinococcus multilocularis (E. multilocularis) is found in carnivorous animals, especially in the fox. This cestode, which is observed in the northern hemisphere of the world, is the cause of a generally fatal, progressing disease in humans, known as ;quot;alveolar echinococcosis;quot; (AE). The metacestodes of E. multilocularis can be experimentally developed in the Mer'wncs unguiculatus species of rodents, and it is possible to use these metacestodes for numerous purposes, primarily for antigens required for diagnosis. It is with this aim that in this study for the first time in Turkey, E. multilocularis metacestodes were developed in Meriones unguiculatus and an indigenous strain was isolated using the surgical material from a patient diagnosed with alveolar echinococcosis. Key Words: Alveolar echinococcosis, strain isolationKüçük bir cestod olan Echinococcus multilocularis''in erişkini tilkiler başta olmak üzere etçillerde bulunmaktadır. Dünyanın kuzey yarım küresinde görülen bu cestod insanlarda genellikle ölümcül seyreden bir hastalık olan alveolar echinococcosisin etkenidir. E. multilocularis metacestodlari Meriones unguiculatus türü kemirgenlerde deneysel olarak geliştirilebilmekte, elde edilen metacestodlardan başta tanı için gerekli antijenler olmak üzere çok amaçlı yararlanılabilmektedir. Bu amaçla, çalışmada alveolar echinococcosis teşhisi alan bir hastanın operasyon materyalinden Türkiye'de ilk kez Meriones unguculatus üzerinde Echinococcus multilocularis metacestodlari geliştirilerek yerli bir suş izole edilmiştir