Browsing by Author "Ozer, Ali"

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    Prolonged Mechanical Ventilation Predictors in Patients Undergoing Liver Transplantation
    (BEZMIALEM VAKIF UNIV, 2019-01-01) Can, Meltem Guner; Ozer, Ali
    Objective: Liver transplantation is the current treatment modality for end-stage liver disease. While there is increasing drive towards early extuhation in patients undergoing liver transplantation, prolonged meachanical ventilation (PMV) related to various factors can be observed. We tried to determine the risk factors associated with PMV. Methods: One hundred twenty five patients (age>18 years) of with the American Society of Anesthesiology (ASA) III-IV group undergoing liver transplantation were enrolled in this retrospective study. Patient charts, intraoperative and intensive care unit follow-up forms, and electronic medical recording system were used for data collection. Patients were categorized as having received (with) or not received (without) prolonged mechanical ventilation (>24 hours), and perioperative risk factors were attempted to determine. Results: No significant intergroup differences were found in demographic variables but ASA and model for end-stage liver disease (MELD) scores were significantly higher in the with- than in the without-PMV group. Total amount of suspension of erythrocytess suspension, fresh frosen plasm, and cell-saver blood used intraoperatively was higher in the with-PMV group but difference did not reach statistical significance. Patients with-PMV had significantly higher cryoprecipitate transfusion rates than did those without-PMV (p=0.007). While no significante intergroup differences were found in mortality and lenght of hospital stay
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    The essential predictors of recurrence in patients with hepatocellular carcinoma after liver transplantation
    (BAYRAKOL MEDICAL PUBLISHER, 2020-01-01) Ozer, Ali
    Aim: Liver transplantation is the optimal treatment for a selected group of patients with hepatocellular carcinoma (HCC). Post-transplant recurrence is common and markedly reduces the long-term survival of patients with HCC. The present study focuses on determining the predictive factors affecting the recurrence of HCC. Materials and Methods: Data of 106 patients with HCC who underwent liver transplantation between May 2012 and June 2018 were collected retrospectively. Variables were as follows: age, gender, preoperative alpha-fetoprotein (AFP) levels, MELD score, number of tumors, total tumor size and histological features. Results: Recurrence-free survival and overall survival rates were 91.5\% and 94.3\%, respectively. Cox regression analysis demonstrated that age, gender, MELD score, and Milan criteria had no effect on recurrence. Microvascular invasion (MVI) was detected in 55 patients (52\%), and 51 patients (48\%) had no MVI. The presence of MVI had a negative effect on tumor recurrence, and there was a statistically significant difference (p<0.001). There was also a significant difference in tumor recurrence between patients who had AFP levels under 400 IU/mL and those who had AFP levels above 400 IU/mL (p<0.001). Discussion: AFP level and the presence of MVI are significantly useful for predicting recurrence-free survival in patients with HCC following liver transplantation.
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    Trans-Arterial Chemoembolization with 50 mu m Degradable Starch Microspheres Versus 300-500 mu m Drug Eluting Beads in Hepatocellular Carcinoma: A Comparative Analysis of Initial Treatment Outcomes
    (UBIQUITY PRESS LTD, 2022-01-01) Yildiz, Isil; Deniz, Sinan; Ozer, Ali; Caliskan, Kosti
    Background and Aims: Trans-arterial chemoembolization (TACE) has become a widely accepted treatment in unresectable hepatocellular carcinoma (HCC). We aimed at comparing the efficacy of Degradable Starch Microspheres (DSMs)-TACE with 50 +/- 7 mu m versus 300-500 mu m Drug Eluting Beads (DEB)-TACE in terms of initial clinical and radiological treatment response parameters. Material and Methods: A total of 54 patients with unresectable HCC who underwent DEB-TACE (n = 25) or DSMs-TACE (n = 29) were included in this retrospective study. Baseline demographic and clinical characteristics, duration of follow-up, local recurrence and survival status, as well as treatment outcome including treatment response via modified Response Evaluation Criteria in Solid Tumors (mRECIST) criteria, viable and total tumor diameter and serum alpha-fetoprotein (AFP) levels were analyzed in both study groups. Results: No significant difference was noted between the two groups in terms of local recurrence (31.6 vs. 16.7\%) or mortality (73.9 vs. 85.7\%) rates after 36-month and 12-month follow-up, respectively. DSMs-TACE vs. DEB-TACE was associated with significantly higher complete response rate (27.6 vs. 0.0\%, p = 0.011) and significant decrease in serum AFP levels (p = 0.013). Conclusion: Both DSMs-TACE with 50 +/- 7 mu m microspheres and 300-500 mu m DEB-TACE are effective for local control of unresectable HCC. Our findings revealed superiority of DSMs-TACE over DEB-TACEnin terms of initial clinical and radiological tumor response