Intraperitoneal Ultrasound-Guided Safe Laparoscopic Fenestration of Lymphocele After Kidney Transplantation

Background: Lymphocele is a common complication after kidney transplantation, which does not require treatment unless it is symptomatic. In this study, we aimed to evaluate the incidence, clinical symptoms, treatment choices, and success of different treatment methods of symptomatic lymphocele

Discrepancy between colistin and polymyxin B susceptibility results among Escherichia coli and Klebsiella pneumoniae clinical isolates

The selection of therapeutic agent to be used for the treatment of multidrug-resistant bacteria is a major concern. Polymyxin B use has been commenced in Turkey, although its clinical breakpoint is not listed in the EUCAST. This study aimed to determine the correlation between the MIC values of polymyxin B and colistin. A total of 505 isolates, including 122 isolates of Escherichia coli and 383 isolates of Klebsiella pneumoniae were included in the present study. All the isolates were assessed for colistin and polymyxin B using the broth microdilution method. The categorical agreement in the E. coli isolates was 98.4%, and the rate of very major error was 33.3%. The categorical agreement in the K. pneumoniae isolates was 99.5%, the rate of major error was 0.36%, and the rate of very major error was 0.98%. In the evaluation of the essential agreement, 1.6% error in E. coli and 2.3% error in K. pneumoniae were observed. It was concluded that polymyxin B should never be used in the treatment of the isolates reported as colistin-resistant, and if the MIC values are above 4 mg/L in E. coli and K. pneumoniae. Our results indicate importance of reporting both polymyxin B and colistin susceptibility results of clinical isolates

Unexpected colonic perforation in a renal recipient: a case report

Gastrointestinal complications such as gastrointestinal bleeding and perforation due to immunosuppressant use are seen more frequently after solid organ transplantation. A 52-year-old male was admitted on the 7th day of a living donor renal transplantation with serous drainage at the incision site. He had no abdominal complaints. He was on triple immunosuppressant therapy. Abdominal plain X-ray and ultrasonography were normal, but diffuse extraluminal air was detected on the computed tomography scan. There were no pathological laboratory findings regarding the function of the renal allograft. We began the operation laparoscopically and then converted to laparotomy. Sigmoid colonic perforation was detected on the antimesenteric side. Neither diverticulitis nor ischemia was observed, and no evidence of iatrogenic injury was seen. There was no transrectal instrumentation history. Omentoplasty and sigmoid loop colostomy were performed. He was discharged on the 9th day following the operation. His colostomy was closed one year after the operation. Gastrointestinal complications can be fatal, but do not seem to influence the long-term survival or renal allograft function. Most of them are seen after using high doses of immunosuppressants to manage the early postoperative period or episodes of acute rejection. Early diagnosis and aggressive treatment play an important role in survival

High soluble CD30 levels and associated anti-HLA antibodies in patients with failed renal allografts

Introduction: Serum soluble CD30 (sCD30), a 120-kD glycoprotein that belongs to the tumor necrosis factor receptor family, has been suggested as a marker of rejection in kidney transplant patients. The aim of this study was to evaluate the relationship between sCD30 levels and anti-HLA antibodies, and to compare sCD30 levels in patients undergoing hemodialysis (HD) with and without failed renal allografts and transplant recipients with functioning grafts

Incidentally Detected Gastric Foregut Duplication Cyst: A Case Report

Gastric foregut duplication cyst is a rare congenital disease. It is usually revealed with imaging study during the diagnosis of nonspecific symptoms, such as abdominal pain, nausea, and vomiting. Here we report the case of a male patient who underwent imaging study for the examination of a benign prostatic hyperplasia. A 3-cm mass containing cystic areas behind the gastric fundus was revealed on abdominal computed tomography. Laparoscopic gastric wedge resection was performed and the histopathological work-up of the specimen was reported as a foregut duplication cyst

Incidentally Detected Gastric Foregut Duplication Cyst: A Case Report

Gastric foregut duplication cyst is a rare congenital disease. It is usually revealed with imaging study during the diagnosis of nonspecific symptoms, such as abdominal pain, nausea, and vomiting. Here we report the case of a male patient who underwent imaging study for the examination of a benign prostatic hyperplasia. A 3-cm mass containing cystic areas behind the gastric fundus was revealed on abdominal computed tomography. Laparoscopic gastric wedge resection was performed and the histopathological work-up of the specimen was reported as a foregut duplication cyst

Can Direct-Acting Antiviral Treatment Change the Immunologic Risk Profile in Patients Infected with Hepatitis C Virus Who Are on the Cadaveric Waiting List?

Background. In patients with hepatitis C virus (HCV) infection, the activation of theimmune system by the virus or viral proteins leads to the production of numerous autoantibodiesand clinical manifestations. The objectives of this study were to investigate therelationship between HCV and anti-HLA antibodies, as well as the effect of viremia on theantibody response and of direct-acting antivirals (DAAs) on anti-HLA antibodypersistence in patients on the waiting list for a cadaveric kidney transplant.Methods. A total of 395 patients from the cadaveric renal transplant waiting list wereincluded in the study. The patients were grouped according to the presence of HCVinfection, and patients with HCV positivity were further divided into a spontaneousclearance group and a persistent group. Anti-HLA antibodies were examined before andafter treatment of the patients in the persistent group. The One Lambda Luminexmethod (Thermo Fisher Scientific, Waltham, MA, United States) was used to assessboth HLA class I and II alleles and the anti-HLA antibody profile.Results. Anti-HLA class I and II antibodies were detected in 48.2% and 55.1%,respectively, of the patients infected with HCV and in 21.8% and 20.4%, respectively, ofthe patients who were not infected. The level of anti-HLA A3, A11, B72, B52, Cw6, Cw16,DR3, and DQ4 antibodies was significantly higher in the patients infected with HCV.There was no statistically significant difference in class I and II antibody titrationbetween the HCV-infected spontaneous clearance group and the persistent group (classI mean fluorescence intensity [MFI] SD: 13,583 6224, 13,450 9540, P ¼ .808;Class II MFI SD: 13,000 8673, 8440 8302, P ¼ .317, respectively). There was nosignificant difference in the class I and class II anti-HLA antibody profile and titrationin the persistent group after treatment with DAAs (P > .05).Conclusions. The results of this study demonstrated that hepatitis C DAA treatment didnot change the anti-HLA antibody profile and titration