Araştırma Çıktıları
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Item Therapeutic plasma exchange in patients with COVID-19 pneumonia in intensive care unit: a retrospective study(BMC, 2020-01-01) Gucyetmez, Bulent; Atalan, Hakan Korkut; Sertdemir, Ibrahim; Cakir, Ulkem; Telci, Lutfi; Grp, Covid 19 StudyItem 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, IbrahimIntroduction: 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.Item Transvaginal Route for Kidney Extraction in Laparoscopic Donor Nephrectomy(SOC LAPAROENDOSCOPIC SURGEONS, 2014-01-01) Gurluler, Ercument; Berber, Ibrahim; Cakir, Ulkem; Gurkan, AlihanBackground and Objectives: The aim of this retrospective study was to compare conventional laparoscopic living-donor nephrectomy with transvaginal natural orifice transluminal endoscopic surgery-assisted living-donor nephrectomy in terms of feasibility and reproducibility. Methods: A total of 115 consecutive female patients who underwent laparoscopic living-donor nephrectomy (n = 70) or transvaginal natural orifice transluminal endoscopic surgery-assisted living-donor nephrectomy (n = 45) were included and compared in terms of operative characteristics, as well as donor and recipient outcomes. Results: No significant difference was observed between the laparoscopic living-donor nephrectomy and transvaginal natural orifice transluminal endoscopic surgery-assisted living-donor nephrectomy groups in terms of mean duration of warm and cold ischemia, operation time, length of hospital stay, arterial anastomoses, visual analog scale pain scores, serum creatinine levels, and receiver outcomes, whereas a significantly higher number of venous anastomoses was noted in the laparoscopic living-donor nephrectomy group than in the transvaginal natural orifice transluminal endoscopic surgery-assisted living-donor nephrectomy group (P = .029). Conclusions: Transvaginal natural orifice transluminal endoscopic surgery-assisted living-donor nephrectomy seems to be a feasible and reproducible alternative to conventional laparoscopic living-donor nephrectomy in female donors provided the viability of the vagina as an organ retrieval route.Item 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, UlkemIntroduction: 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.Item The frequency and severity of metabolic acidosis related to topiramate(SAGE PUBLICATIONS LTD, 2016-01-01) Ture, Hatice; Keskin, Ozgul; Cakir, Ulkem; Bingol, Canan Aykut; Ture, UgurObjective: We planned a cross-sectional analysis to determine the frequency and severity of metabolic acidosis in patients taking topiramate while awaiting craniotomy. Methods: Eighty patients (18 - 65 years) taking topiramate to control seizures while awaiting elective craniotomy were enrolled. Any signs of metabolic acidosis or topiramate-related side effects were investigated. Blood chemistry levels and arterial blood gases, including lactate, were obtained. The severity of metabolic acidosis was defined according to base excess levels as mild or moderate. Results: Blood gas analysis showed that 71\% (n = 57) of patients had metabolic acidosis. The frequency of moderate metabolic acidosis was 56\% (n = 45), while that of mild metabolic acidosis was 15\% (n = 12). A high respiratory rate was reported in only 10\% of moderately acidotic patients. Conclusions: In patients receiving topiramate, baseline blood gas analysis should be performed preoperatively to determine the presence and severity of metabolic acidosis.Item 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, UlkemObjective: 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 tacrolimusItem Cofilin-1 as a potential biomarker to evaluate acute kidney injury(WALTER DE GRUYTER GMBH, 2019-01-01) Coskun, Abdurrahman; Ucal, Yasemin; Berber, Ibrahim; Cakir, Ulkem; Serteser, Mustafa; Moldur, Derya Emel; Derelioglu, Ecenur Izzete; Yozgatli, Tahir Koray; Ozpinar, Aysel; Unsal, IbrahimAcute kidney injury (AKI) is a worldwide health problem and defined by rapid loss of excretory function of the kidney with the accumulation of metabolic end products. For effective treatment and prevent complications the early diagnosis of AKI is crucial. The current analytes used to diagnose AKI are not adequately sensitive and specific and therefore clinicians need new biomarkers. One of the new promising biomarker candidates of renal injury is cofilin-1. Previously, in our laboratory we isolated cofilin-1 in kidney preservation solution prior to transplantation and attempted to measure serum cofilin-1 in renal transplanted patients. However, cofilin-1 was not accurately measured in serum samples due to the methodological issues. In this mini-review, we summarized the current knowledge and concepts both in the literature and our experiences with cofilin-1 as a potential biomarker for the diagnosis and management of AKI.