Browsing by Author "Yilmaz, Gulay"

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Assessment of clinical outcomes in renal transplant recipients with COVID-19
(WILEY, 2021-01-01) Yilmaz, Gulay; Ebru, Ozdemir; Ibrahim, Berber; Ulkem, Cakir
The coronavirus disease 2019 (COVID-19) has affected more than a hundred million individuals and caused more than three million deaths worldwide. Specific risk groups were defined for increased risk of mortality and morbidity in COVID-19, and renal transplant recipients are at a significantly increased risk regarding outcomes due to their immunosuppressed conditions. This study evaluated the general characteristics of kidney transplant recipients with COVID-19 infection. Among 1257 transplant cases, 56 had COVID-19 infection, and 23 (41\%) were hospitalized during the 9-month study period. Among all COVID-19 cases, 58\% were male with a mean age of 45.5 (+/- 13.2, 19-71) years, and the most frequent comorbidities were hypertension (70.9\%) and diabetes (23.6\%). Hospitalized patients were older (p = 0.03) and had higher rates of hypertension (p = 0.008), diabetes (p = 0.002), and ischemic heart disease (p = 0.03). Therapeutic management included antimetabolite withdrawal and prednisolone increase in 71\%, calcineurin inhibitor withdrawal in 8\% and decrease in 58\%, hydroxychloroquine in 17\%, tocilizumab in 3\%, and antivirals in 67\% of patients. Acute kidney injury and respiratory failure developed in 34\% and 85\%, respectively. The mortality rate was 23\%. These results emphasized that the COVID-19 infection in renal transplant recipients significantly increases the risk of morbidity and mortality. Therefore, these patients should be intervened earlier and monitored closely to prevent poor outcomes.
Graft and Patient Survival in Kidney Transplant Recipients Over the Age of Sixty-Five
(CUREUS INC, 2022-01-01) Yilmaz, Gulay; Ozdemir, Ebru; Yildar, Murat; Karayagiz, Hamit; Berber, Ibrahim; Cakir, Ulkem
Introduction: Elderly patients have increased morbidity and mortality compared to younger patients due to existing comorbid diseases and chronic immunosuppression. Therefore, the option of kidney transplantation for renal replacement therapy in elderly patients is still being controversial. Our aim in this study was to evaluate graft function, graft and patient survival, and associated factors in kidney transplant recipients over 65 years of age, at 11 years of follow-up. Methods: The study included 53 patients aged 65-76 years, out of a total of 1319 patients who underwent live kidney transplantation in the Organ Transplant Center of Acibadem International Hospital between October 2010 and July 2021. Demographic characteristics and creatinine values were recorded. Graft survival rates and patient survival rates at one, three, and five years were analyzed. Results: Fifty-three patients, 14 female, 39 male, aged 65-76 years were included in the study. The follow-up period of the patients was 7-125 months. During the follow-up, 20 patients died. Graft loss occurred in two of 20 patients who died, and 18 patients died with working grafts. Graft loss developed in two of the 33 surviving patients. In the whole group, one-, three-, and five-year patient survival rates were 94\%, 81\%, and 76\%, respectively. Conclusion: These results emphasize that kidney transplantation is a viable treatment option in elderly patients who have been well evaluated before kidney transplantation.
Novel Once-daily Extended-release Tacrolimus Versus Twice-daily Tacrolimus in De Novo Kidney Transplant Recipients During the Early Posttransplant Period
(GALENOS PUBL HOUSE, 2022-01-01) Yilmaz, Gulay; Ozdemir, Ebru; Yildar, Murat; Karayagiz, Abdulhak Hamit; Berber, Ibrahim; Cakir, Ulkem
Objective: Tacrolimus is used in more than 80\% of kidney transplant recipients due to its ability to avoid rejection. Irregularities in tacrolimus level may affect clinical outcomes by subjecting patients to adverse events associated with graft rejection or immunosuppressive therapy. There are two forms of tacrolimus
Renal Arterial and Venous System Variations in 1,073 Kidney Donors in Turkey
(ISTANBUL TRAINING \& RESEARCH HOSPITAL, 2021-01-01) Karayagiz, Abdulhak Hamit; Cenal, Ulukan; Erturk, Turker; Ozdemir, Ebru; Polatkan, Seyit Ali Volkan; Yilmaz, Gulay; Cakir, Ulkem; Berber, Ibrahim
Introduction: Renal vasculature variations are seen in both arterial and venous systems, In Turkey, 80\% of kidney transplantations are performed by living donors. Therefore, this study aimed to identify the incidence and morphologic variations of renal vessels in a group of Turkish kidney donors. Methods: The computed tomography angiography of 1,073 kidney donors were retrospectively evaluated for vascular variations, such as multiple renal arteries (MRA), polar or accessory renal arteries (ARA), early division of renal artery, multiple renal veins (MRV), retro-aortic renal vein (RARV), and inferior vena cava duplication. Results: One vascular variation in the renal vascular system was found in 637 of 1,073 (59.4\%) kidney donors. The MRA was observed in 380 (35.4\%) donors. The ARA were reported in 180 (16,8\%) and 227 (20.2\%) donors, respectively. Renal arteries were divided earlier than expected in 230 (21.4\%) donors. The MRV and RARVS were seen in 205 (19.1\%) and 77 (7.2\%) patients, respectively. Only 2 cases of inferior vena cava duplication were determined. Conclusion: Renal arterial and venous system variations are very common, and detailed preoperative evaluation provides an opportunity to choose the best surgical modality and minimize intra- and post-operative complications.