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OBJECTIVE: The aim of this study is to compare the effects of cyclosporine (CsA) and tacrolimus (TAC) on preventing acute rejection and analyze the side-effect profiles of both agents, particularly on kidney functions. PATIENTS AND METHODS: In our study, 71 patients who underwent heart transplantation were included. For maintenance immunosuppression, 28 of these patients were treated with mycophenolate mofetil (MMF), steroid, and steroid CsA, and 43 of them were treated with MMF steroid and TAC. Endomyocardial biopsy results of the patients in the first month and the first year were compared. In the follow-ups, creatinine values and other parameters were recorded. RESULTS: Endomyocardial biopsy (EMB) performed at 1 month showed no rejection in 12 patients (42.9%) in the CsA group, grade 1R rejection in 15 patients (53.6%), and grade 2R rejection in one patient (3.6%). In the TAC group, rejection was not detected in 25 patients (58.1%), while grade 1R rejection was diagnosed in 17 patients (39.5%) and grade 2R rejection in 1 patient (2.3%) (p=0.4). In EMBs performed in the first year, 14 patients (51.9%) in the CsA group did not have rejection, 12 patients (44.4%) had grade 1R rejection, and one patient (3.7%) had grade 2R rejection. In the TAC group, grade 0R rejection was diagnosed in 23 patients (60.5%), grade 1R rejection in 15 patients (39.5%), and grade 2R rejection was not detected. Postoperative firstweek creatinine values, which were found to be higher in the CsA group, were significant compared to the TAC group (p=0.028). CONCLUSIONS: TAC and CsA are drugs that help prevent acute rejection after heart transplantation and can be used safely in heart transplant recipients. Neither drug is superior to the other in preventing rejection. TAC may be preferred to CsA as it has fewer negative effects on kidney functions in the early postoperative period. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Renal dysfunction or renal failure is a common complication in patients undergoing a left ventricular assist device (LVAD). Measurement of serum creatinine and estimated glomerular filtration rate (eGFR) is the most commonly used inexpensive and easy method for the evaluation of kidney function. In studies, the development of acute kidney injury (AKI) after LVAD has generally been studied at 1, 3 months and 1 year, but there are almost no studies with 1-week data. PATIENTS AND METHODS: We retrospectively analyzed the incidence of AKI, risk factors, length of stay in hospital and intensive care unit (ICU), and postoperative complications of 138 patients who underwent LVAD implantation in our center between 2012 and 2021, according to Kidney Disease Improving Global Outcomes (KDIGO) criteria. We evaluated the preoperative, postoperative 1st day, 2nd day, 1st week, 1st month, 3rd month and 1st year serum creatinine, eGFR and blood urea nitrogen (BUN) values. RESULTS: The mean age of 138 patients who underwent LVAD implantation and evaluated the development of AKI was 50.4 (±10.86) and 119 (86.2%) were males. The incidence of AKI, the need for renal replacement therapy (RRT) and dialysis after LVAD implant were respectively 25.4%, 25.3% and 12.3%. According to the KDIGO criteria, in the AKI (+) patient group, 21 (15.2%) cases were identified as stage 1, 9 (6.5%) as stage 2 and 5 (3.6%) as stage 3. The incidence of AKI was found to be high in cases with diabetes mellitus (DM), age, preoperative creatinine level ≥1.2, and eGFR ≤60 ml/min/m². There is a statistically significant relationship between having AKI and right ventricular (RV) failure (p=0.0033). Right ventricular failure developed in 10 (28.6%) of 35 patients who developed AKI. CONCLUSIONS: If perioperative AKI is recognized early, the development of advanced stages of AKI and mortality can be reduced with nephroprotective measures. [ABSTRACT FROM AUTHOR]

Background: Aspirin reduces the odds of an arterial thrombotic event in highrisk patients. However, 10%-20% of patients with an arterial thrombotic event who are treated with aspirin have a recurrent arterial thrombotic event during long-term followup. Aspirin resistance has been described in some patient populations such as those with an acute coronary syndrome, ischemic stroke, percutaneous coronary intervention with drug-eluting stent, stent re-stenosis, and diabetes mellitus (DM). The aim of this study was to assess aspirin resistance and to compare it to the use of oral anti-diabetic drugs and insulin in patients with diabetes. Methods and Results: Platelet aggregation was measured after aspirin treatment in 101 diabetic patients undergoing percutaneous coronary intervention. Two patient populations were included in the investigation: use of insulin (group 1) and use of oral anti-diabetic agents (OAD) (group 2) in diabetic patients. Platelet aggregation was determined using a multichannel Multiplate analyzer. Among group 1 patients, 4.7% were aspirin non-responders and among group 2 patients, 8.6% were aspirin non-responders. Statistical differences were not found between the groups (p = 0.359). Conclusions: This study demonstrated that there was no significant difference in aspirin resistance between type 2 diabetes mellitus patients on insulin treatment and type 2 diabetes mellitus patients on OAD treatment. [ABSTRACT FROM AUTHOR]