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At the present time, with the development of medicine, surgery and the use of technologically advanced modern drugs, many diseases, including kidney diseases, have become treatable. Kidney transplantation has become a treatment option for kidney diseases and kidney transplant rates have increased as well as life expectancy has been prolonged by means of obtained success. Immunosuppressive drugs are used in the posttransplant treatment process of renal transplant patients. With the new treatment options, it is aimed to increase the success rate of kidney transplantation and also to eliminate the side effects which are caused by the use of immunosuppressive drugs. Cellular therapies are one of the treatment options that are studied for use in kidney transplantation. Regulator T cells, regulator B cells, regulator macrophages, dendritic cells, mesenchymal stem cells are cell sources that are searched and experimented for use in organ transplantation. It has been shown that successful results have been obtained by using cell therapies in studies carried out with experimental animal models for transplantation. In this review, cell therapies used in and candidate for renal transplantation are discussed. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Reconstructive Urology is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Tepecik Education & Research Hospital / İzmir Tepecik Eğitim ve Araştırma Hastanesi Dergisi is the property of Logos Medical Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Exercise Therapy & Rehabilitation is the property of Yavuz Yakut and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Online Turkish Journal of Health Sciences (OTJHS) / Online Türk Sağlık Bilimleri Dergisi is the property of Oguz KARABAY and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: The success rates of renal transplantation in pediatric age groups increased rapidly with the improvement of surgical technique, development of immunosuppressive drugs and the establishment of follow-up protocols specific to the pediatric age group and achieved the success rates of adult transplantation. In this study, we retrospectively analyzed the results of pediatric renal transplants performed in our center in 9 years. Method: Between January 2010 and December 2018, 41 pediatric renal transplants were performed in our center. In our study, demographic data of donors and recipients, immunosuppressive treatment protocols applied to the recipients, post-transplant complications and renal functions of these donors were evaluated. Results: Mean age of the recipients was 13.44 ± 3.72 and 48.8% of the recipients were female. The mean follow-up period was 46.90 ± 30.04 months. During the follow-up period, no complications due to surgery developed. One patient (2.4%) had urologic complications requiring endoscopic intervention. One patient (2.4%) had sepsis-related mortality, one patient (2.4%) had recurrence of primary disease, and three patients (7.2%) had graft loss due to medical noncompliance. The mean age was 43.15 ± 9.28 years and 53.7% of the donors were female . During the followup, wound-related complications were observed in two patients (4.8%). There was no change in renal function detected. Conclusions: The results of our study show that pediatric renal transplantation was performed safely and successfully in our center when compared with the literature data published from the studies conducted in centers with high number of patients and systematic reviews. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to evaluate the parameters that may be a risk factor for the development of rejection in our patient population. Materials and Methods: The results of the biopsies performed in our organ transplantation unit were evaluated retrospectively. Demographic data of the patients about primary renal disease, concomitant disease and laboratory data in the time of biopsy were recorded. Forty-nine biopsies made for 45 patients and the results were compared. Results: The most common cause of kidney biopsy was acute renal injury (34 biopsies, 69.4%). Histopathological examination revealed rejection in 23 (46.7%) biopsies. BK nephropathy was detected in 4 patients (8,1%), while the calcineurin inhibitor toxicity was found in 10 patients (20.5%). Chronic allograft nephropathy was observed in 11 biopsies (22.6%) and recurrent glomerulonephritis was detected in 1 biopsy (2.1%). Serum glucose, uric acid and total cholesterol levels were higher and hemoglobin levels were lower in the rejection group. By logistic regression analysis, uric acid and glucose elevation were defined as independent risk determinants for the development of rejection. Conclusion: Hyperuricemia and hyperglycemia may predict the development of rejection after renal transplantation. [ABSTRACT FROM AUTHOR]

Aim: Valganciclovir is the preferred drug for chemoprophylaxis for the prevention of cytomegalovirus (CMV) infection in kidney recipients. Low-dose (450 mg/day) valganciclovir use is gaining popularity because standard dose (900 mg/day) has negative effect on renal function and side effects such as leukopenia. We present our results with low-dose valganciclovir prophylaxis in kidney recipients. Methods: One hundred thirteen kidney transplant recipients who were operated between 1 December 2017 and 1 September 2018 in İstanbul Aydın University Faculty of Medicine, Training and Research Hospital and İstinye University Training and Research Hospital were retrospectively evaluated. Demographic data, preoperative CMV status, incidence of CMV infection and leukopenia rates were recorded. Results: A total of 113 patients (46 women, 67 men) with a mean age of 42.85 years were evaluated. All the recipients and donors were preoperative CMV IgG-positive. The mean follow-up was seven (6-13) months. In this period, only two (1.76%) CMV infection occurred and treated with intravenous ganciclovir. There were no complications due to CMV infection. There was no leukopenia related with valganciclovir. Conclusion: This study showed that low-dose valganciclovir is an effective prophylaxis for CMV infection in kidney transplantation with CMV-positive donors and recipients. We recommend low-dose valganciclovir due to low incidence of CMV infection found in our study. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to evaluate changes in lumbar and femoral bone mineral density (BMD) in the post-transplant period. Material and Methods: A total of 69 consecutive adult (>18 years of age) patients who underwent kidney transplantation between Jan 2016 and Jul 2019 were included in this retrospective study. The demographic features and laboratory findings of the patients (serum corrected calcium, phosphorus, alkaline phosphatase, creatinine, eGFR, i-parathormone and 25(OH) D vitamin levels) were recorded. BMD was evaluated by dual energy X-ray absorptiometry (DEXA). Results: According to the DEXA results, lumbar and femoral T scores were -1.1±1.3 and -1.1±1.1, respectively. Lumbar assessment revealed osteoporosis in 12 (17.4%) patients and osteopenia in 24 (34.8%) patients. Femoral assessment revealed osteoporosis in 7 (10.1%) patients and osteopenia in 29 (42.0%) patients. The first year, 1-2 year and >2 years follow up data revealed osteoporosis in 4.3%, 5.8% and 7.2% of patients in the lumbar region and in 2.9%, 2.9% and 4.3% of patients in the femoral region, respectively. There was no significant difference in cumulative steroid dose between patients with BMD loss in the lumbar (p=0.197) and femoral (p=0.971) region and patients with normal BMD measurement. In addition, no significant relation was observed between the induction therapy and loss of BMD in the lumbar region (p=0.671) and femur (p=0.126). Conclusion: As a result, 25(OH) D vitamin deficiency is quite common in transplant patients and the loss of BMD is observed especially in the lumbar region in the first year after transplantation. [ABSTRACT FROM AUTHOR]

Renal transplantation, which is the best treatment for end-stage renal failure, increases the life expectancy and provides a better quality of life when compared to dialysis. Scintigraphy is a non-invasive, frequently repeated, and easily applicable study for evaluating vascular complications, urinary leakage, and obstructions as well as graft function after transplantation and during follow-up. It is also a guide for the evaluation of medical complications such as acute tubular necrosis and acute rejection. Basal transplant kidney scintigraphy performed within 2-3 days after transplantation also has prognostic value. Although its application is not very different from normal dynamic renal scans, it has some differences in terms of both quantitative and qualitative evaluations of kidney perfusion compared to other renal scans. [ABSTRACT FROM AUTHOR]

Aim: Infections developing in the early phase of post transplant period may be life-threatening for patient under intense immunosuppression. Although urinary infections are the most frequently observed type of infections in this phase, infections in other systems are also needed to be evaluated in detail. In this study, we examined infections developing in the post-transplant period. Material and Method: In 306 patients who underwent renal transplantation, infections requiring hospitalization were retrospectively evaluated. These infections were studied in two periods. Results: In both periods, female patients (55.3%) developed infectious diseases more frequently compared to male patients. The median age of the patients is 35 (18-66) years. In the first period, surgical infections (25.9%), clinical sepsis (10.3%) and catheter infections (6.4%) were more frequently observed while urinary infections (46.7%), lower respiratory tract infections (16.1%), acute gastroenteritis (%16.1) and CMV infections (4.8%) were more frequently observed in the second period. Urinary infections were the most frequently observed type of infections in both periods (41.5% - 46.7%). The most common infectious factor was E.coli (64%) and GSBL synthesis rate was 51.4%. Conclusion: This study may contribute to the planning of empiric treatments in our hospital where post-transplant infections and their factors are observed. [ABSTRACT FROM AUTHOR]

Objective: Renal transplantation provides better outcomes for end stage renal disease patients in comparison to dialysis. Living kidney donation provides better long-term patient and graft survival compared to deceased-donor transplantations. In the long term, complications such as mild proteinuria, an increase in blood pressure, preeclampsia, end stage renal disease and mortality are the main problems for donors. In this study, we aimed to evaluate the causes of kidney donor rejections in our hospital. Material and Method: The medical files of individuals presented as donor candidates were retrospectively examined. Screening tests, cross match test, tissue typing, routine evaluation of cardiologic system, respiratory system, psychiatric condition and cancer screenings, if necessary, were performed as part of the donor candidate work-up. Data was expressed as mean±SD. Results: Two hundred and forty five individuals presented themselves as donor candidates in our hospital. Of these, 118 patients could not be donors. Of these 118 individuals, 21 potential donors were rejected donor despite completing all evaluations. The main causes for rejection of 97 individuals were hypertension, diabetes mellitus-obesity and asymmetry in glomerular filtration rate/parenchymal abnormalities. In addition, we diagnosed cancer in 5 potential donors. Conclusion: Potential kidney donor evaluation is of paramount importance in order to minimize possible risks. [ABSTRACT FROM AUTHOR]

Type 1 primary hyperoxaluria is an autosomal, recessive metabolic disease triggering calcium oxalate accumulation in tissues. The liver lacks the peroxisomal enzyme alanine-glyoxylate amino transferase. Clinically, patients develop kidney stones, urinary tract infections, and progressive renal failure. We evaluated liver and kidney transplantation to performed for type 1 primary hyperoxaluria in our study. In this study, we retrospectively evaluated 7 patients with type 1 primary hyperoxaluria who underwent liver and kidney transplantation. Two main groups were established; Sequential and simultaneous liver and kidney transplantation group. Mortality rates were compared between these two groups. Sequential liver and kidney transplantation was performed in 5 (71.4%) patients and simultaneous liver and kidney transplantation was performed in 2 (28.6%) patients. All patients died in simultaneous liver and kidney transplantation group. Sequential liver and kidney transplantation group mortality rates were lower therefore treatment for type 1 primary hyperoxaluria more preferable. [ABSTRACT FROM AUTHOR]

Objective: The types of post-transplantation malignancies may vary among different geographic regions and ethnic populations. The aim of the present study was to determine the risk and incidence of de novo carcinomas, clinical characteristics, and outcomes in renal transplant recipients (RTRs) who are followed up in our center and if there is an accumulation of one type of malignity and to examine screening procedures and frequency. Methods: The files of 322 RTRs who were transplanted between January 1, 2005 and December 31, 2016 were screened retrospectively. The main data included the date of transplantation, patients' age, gender, date of the last follow-up, and cancer diagnosis. Results: In eight patients (M/F=7/1), de novo malignancy was identified. The mean age of patients with malignancy was 54.87±12.5 years. The median duration of dialysis was 44 (2- 107) months. The average time from transplantation to tumor development was 50 (7-93) months. Malignity development rate was found to be 2.5% among all RTRs. Conclusion: Every patient with renal transplantation should be followed up carefully by regular physical examination, laboratory findings, and imaging studies due to the risk of malignancy. Early diagnosis of malignancy is very important for both patient survival and functional renal graft. Renal transplantation is the most favorable renal replacement therapy, and complications, such as malignancy, that may develop later should be a cause to follow-up this treatment more carefully during the course of the procedure. [ABSTRACT FROM AUTHOR]

Objective: For those with severe kidney disease, renal transplantation is the best treatment option when compared with dialysis methods; however, it is important to consider potential complications that may occur and the negative effects on graft survival. The aim of this study was to investigate the effects of iron parameters on the development of post-transplant anemia (PTA) and post-transplant erythrocytosis (PTE). Methods: This retrospective study was conducted with 214 renal transplant recipients. PTA was defined as a hemoglobin (Hb) level of <13g/dL for men and <12g/dL for women 6 months after transplantation, PTE was defined as an Hb level of >17g/dL for men and >15g/ dL for women. The remaining patients were defined as the control group. Results: PTA developed in 79 patients (36.9%), and PTE developed in 25 patients (11.7%). The iron level was lower in the PTE group before the transplantation and in the first 3 months after transplantation; however, it was also determined that in the PTA group, the iron level was low at 6 and 12 months. Even though the PTA patients' transferrin saturation (TS) was rose significantly in the first month after transplant, it was observed that the TS was lower in the PTE group at all time points. Conclusion: Even if iron levels are low before kidney transplantation in case of proper replecement is performed and graft functions are intact; anemia may improve and even polycythemia may develop. TS increased in the initial post-transplant period; it may be an early indicator of PTA and the development of graft function failure. [ABSTRACT FROM AUTHOR]

After a successful kidney transplantation, renal and endocrine functions quickly return to normal in many women and ovulation ensues. Woman with a renal transplant can have a successful pregnancy, however, there are many risks for both the mother and the fetus. For this reason, these patients should be carefully monitored with a multidisciplinary approach including a nephrologist and an obstetrician. Counseling about contraception and pregnancy after transplant should be initiated during the pretransplant evaluation process. The live birth rate appears comparable to the general population. Pregnancy timing depends on whether the graft function is optimal, but the general recommendation is to wait a year after transplantation. The recommended maintenance immunosuppressive therapy in pregnant women includes the use of calcineurin inhibitors (preferably tacrolimus), azathioprine, and low dose prednisone. Vaginal delivery should be preferred in kidney transplant patients. Cesarean section may be considered only when there is an absolute indication. Kidney transplant patients can breastfeed their children with appropriate drug combinations after birth; patients should be encouraged in this regard. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Coronavirus disease 2019 (COVID-19) has become a pandemic, with a mortality of up to 10% in the general population. Comorbidities such as diabetes and hypertension are common among the elderly. The clinical manifestations of viral pneumonia associated with COVID19 vary widely, from mild to severe, in patients who underwent solid organ transplantation, an immunosuppressed patient group. Further large-scale studies regarding the screening and treatment approaches for COVID-19 among patients undergoing transplantation are required. Herein, we report the case of a patient who underwent renal transplantation and developed the COVID-19 infection that resulted in mortality. [ABSTRACT FROM AUTHOR]

Much of our limited knowledge in this area comes from multiple case reports describing a common underlying risk factor that appeared associated with Plesiomonas illness. Immunocompromised patients and foreign travel is a major major risk factors associated with plesiomonas gastroenteritis. Plesiomonas shigelloides is a rare etiologic agent of gastroenteritis in our country that can lead to different severity of diarrhea. Watery diarrhea is the most common clinical presentation of Plesiomonas gastroenteritis, with between 50% and 88% of all patients presenting with this type of diarrhea. In this report, we want to present the difficulties such as acute kidney injury, metabolic acidosis, electrolyte imbalances, immunosupressive dose adjustments of severe cholera-like diarrhea due to Plesiomonas shigelloides in an 11-year-old girl who had liver transplantation in 2012, renal transplantation in 2015. [ABSTRACT FROM AUTHOR]

Object: The purpose of the study was to evaluate the immunological response to graft and its association with related factors in the sera samples collected periodically from patients transplanted from deceased or alive donors in Izmir Tepecik Education and Research Hospital. Material and Method: Anti-HLA antibody screening and identification tests of 31 patient sera samples were tested by flow cytometric method. The sera samples were collected periodically (1st day, 1st week, 2nd week, 4th week, 12th week, 24th week and 52nd week) after transplantations in our hospital. After the screening of all samples, anti-HLA antibodies of PRA positive samples were identified. All of procedures were performed according to the manufacturer's instructions. The other parameters were statistically evaluated by Pearson correlation test. Results: Of the patients, 12.9% and 6.45% were only class I and only class II positive in the post-transplant 52nd week, respectively. The patients were not positive for class I and II antibodies at the same time. It was observed that the patients did not produce donor specific antibodies on the 1st day, 1st, 2nd, and 4th week after transplantation. The antibodies were produced after the 12th week in a patient. There were statistically significant correlations between last creatinine levels-donor ages and GFR values-patient ages (p<0.001, p<0.01, respectively), whereas there was no significant association between antibody production and creatinine levels. Conclusion: It was observed that anti-HLA antibodies were produced after 12th week in a patient with pre-transplant blood transfusion. The antibodies were produced in 24th week in five patients. Therefore, anti- HLA antibody screening tests to be performed on the 12th week after transplantation may be important for the treatment protocol. [ABSTRACT FROM AUTHOR]

Objective: Even after successful kidney transplantation, 10% to 50% of kidney transplant recipients have persistent hyperparathyroidism. Parathyroidectomy (PTX) has been reported to be associated with deterioration of renal function and reduced graft survival. The aim of this single-center, retrospective study was to analyze the long-term effect of PTX on calcium, phosphorus, and parathyroid hormone (PTH) levels, as well as the estimated glomerular filtration rate (eGFR), in renal transplantation patients who underwent PTX. Methods: The study population consisted of 154 patients followed between January 2014 and December 2017, 9 of whom underwent PTX. The median PTH, calcium, phosphorus, and eGFR values were recorded before and after PTX. Results: The median preparathyroidectomy PTH, calcium, phosphorus, and eGFR values were 311.57 pg/mL, 11.02 mg/dL, 2.35 mg/dL, and 90.88 mL/minute, respectively. When compared with the baseline figures, there was a decrease in PTH (311.5 vs. 147.5 pg/mL; p=0.015), calcium (11.02 vs. 9.01 mg/dL; p=0.017), and eGFR (90.88 vs. 75.44 mL/minute; p=0.008), and an increase in the phosphorus level (2.35 vs. 3.4 mg/dL; p=0.06) 1 month after surgery. The eGFR returned to the baseline rate 1 year after surgery (90.88 vs. 79.39 mL/minute; p=0.11). Conclusion: PTX in renal transplant recipients appears to be a safe procedure. Although renal function deteriorates in the acute period following PTX, long-term stabilization occurs. [ABSTRACT FROM AUTHOR]

Objective: Voiding cystourethrography (VCUG) is widely performed in the pretransplant evaluation of patients with a history of urological disorders to detect vesicoureteral reflux (VUR). The aim of this study was to evaluate the relationship between the primary etiology of end-stage renal disease (ESRD) and the prevalence of VUR, thereby determining the necessity for VCUG in pretransplant patients. Methods: A total of 319 pretransplant cases that underwent VCUG were retrospectively reviewed. Results: VCUG revealed VUR in 53 (16.6%) cases. VUR was left-sided in 21 (41.2%), rightsided in 18 (35.3%), and bilateral in 12 (3.8%), and grade 1 in 10 (19.6%), grade 2 in 19 (37.3%), grade 3 in 20 (39.2%), and grade 4 in 2 (3.9%). The etiology of ESRD was hypertension in 125 (39.2%), diabetes mellitus (DM) in 46 (14.4%), polycystic kidney disease (PKD) in 21 (6.6%), amyloidosis in 16 (5%), VUR in 11 (3.4%), and glomerulonephritis (GN) in 11 (3.4%). The incidence of VUR was significantly higher in female patients. Hypertension, DM, PKD, amyloidosis, and GN were not found to predict VUR. The rate of abnormal VCUG findings was similar in cases with secondary and idiopathic ESRD. Conclusion: The findings demonstrate that only sex was a predictor of VUR in pretransplant cases. The presence of VUR was not related to any cause of ESRD; therefore, VCUG is not needed in all cases as a part of pretransplant evaluation. [ABSTRACT FROM AUTHOR]

Cytomegalovirus (CMV) infection is an important cause of morbidity and mortality among kidney transplant recipients. Generally it is presented with a clinical picture called CMV syndrome, but it may cause invasive tissue involvement as well. The most frequently infected tissues are lung and gastrointestinal system tissues. Cardiovascular involvement is rare and generally associated with atherosclerosis and transplant artery stenosis. In this paper, we present the case of a renal transplant recipient with aortic aneurysm infection/dissection and pneumonia associated with CMV infection. [ABSTRACT FROM AUTHOR]

Aim: GRenal transplantation is the most prominent treatment of renal insufficiency. Vitamin D deficiency found to be common in renal transplant patients. Through renin-angiotensin-aldosterone system inhibition, it protects from hypertension and cardiovascular diseases. In this study, we investigated the relation between vitamin D levels and 24-hour ambulatory blood pressure monitoring and parameters (body mass index, fasting plasma glucose, lipid profile) that may affect graft function. Material and Method: Association of clinical parameters with vitamin D levels and blood pressure were prospectively compared in renal transplant patients. All patients blood pressure levels were evaluated by 24-hour ambulatory blood pressure monitoring. Results: A total of 115 renal transplant recipients were enrolled in the study. Mean level of vitamin D was 16.28±5.2ng/ml, 10.4 % of the patients had severe vitamin D insufficiency (<10ng/ml), 70.4 % with a level between 10-20ng/ml. The vitamin D deficiency (10-20ng/ml) was seen more frequently in women than man. Patients has been divided into two groups, the first with levels of less than 20 ng/ml, the second one with levels of equal or higher than 20 ng/ml. There were no statistically significant difference in age, body mass index and donor features between two groups. Systolic, diastolic, and mean artery 24-hour ambulatory blood pressures in two groups were similar. Conclusion: Vitamin D deficiency was found to be common in renal transplant patients. Vitamin D status was not found to be associated with blood pressure in renal transplant patient. [ABSTRACT FROM AUTHOR]

Amaç: Uzun dönemdeki surviye ve allograft fonksiyonuna etkili olan faktörler her merkezde farklılıklar gösterebilmektedir. Bu nedenle ünitemizden takipli renal allograft biyopsi yapılmış olan hastaların biyopsi sonuçları ve greft sağ kalımları arasındaki ilişkilerin değerlendirilmesi amaçlanmıştır. Yöntemler: 70 hastaya yapılan 94 adet biyopsi retrospektif olarak incelemiştir. Ultrason rehberliğinde tek kullanımlık 16G otomatik iğne ile 2 kore biyopsi alınmıştır. Her biyopsi ışık mikroskopisi ve immunfloresan boyama ile incelenmiştir. Hastalar akut selüler rejeksiyon (ASR), kalsinörin inhibitörü(KNI) toksisitesi, intersitisyel fibrozis tübüler atrofi (IFTA), akut tubüler hasar(ATH) ve greft kaybı gelişenler olarak gruplara ayrılarak alt analizleri yapılmıştır. Bulgular: Toplamda 34(%36,2) biyopsi ile en sık tespit edilen patolojiyi akut selüler rejeksiyon oluşturmaktadır. IFTA, ATH, nüks/de novo glomerülonefrit biyopsi sayıları sırasıyla 21(%22,3), 20(%21,3), 15(%16) olarak bulunmuştur. Akut rejeksiyon öyküsü olanlarda greft sürvisinin daha kısa olduğu tespit edilmiştir (p<0.05). Greft kaybı olan grupta IFTA daha fazla görülmüştür (p<0.05). Surviler logrank testi ile IFTA ya göre kıyaslandığında istatistiksel anlamlılığını yitirmiştir. Çalışmaya alınan hastalarda KNI toksisitesi, ATH ile greft sürvileri arasında anlamlı fark tespit edilememiştir. Biyopsi sırasındaki albümin seviyesi greft kaybı olan grupta anlamlı olarak daha düşük bulunmuştur (p<0.05). Sonuç: Biyopsilerin yaklaşık üçte birinde öntanıdan farklı bir tanı ile karşılaşılmıştır. Bu da biyopsi olmadan diğer klinik ve laboratuvar bulguların yetersizliğini göstermektedir. Greft survisini ön görmede biyopsi önemli yer teşkil etmektedir. Non-invaziv olarak biyopsi öncesi bakılan serum albumin seviyesi greft kaybını öngörmede bir parametre olarak değerlendirilebilir. Objective: Factors affecting long-term survival and allograft function may differ in each center. Therefore, it is aimed to evaluate the relation between biopsy results and graft survival of patients who have undergone renal allograft biopsy. Methods: We retrospectively analyzed 94 biopsies of 70 renal transplant recipients. Disposable 16 G needles were used to perform 2 ultrasound-guided core biopsies. Each specimen was examined under light and immunofluorescence microscopy. Patients were divided into acute cellular rejection (ACR), calcineurin inhibitor (CNI) toxicity, graft loss, interstitial fibrosis tubular atrophy (IFTA), acute tubular damage (ATD) groups and analyzed. Results: The most frequent pathology was ACR, diagnosed in total of 34 (36.2%) specimens. IFTA, ATD and recurrent de novo glomerulonephritis biopsy were 21 (22.3%), 20 (21.3%) and 15 (16%), in number, respectively. Graft survival in patients with a history of acute rejection was shorter than without history (p<0.05). IFTA was more common in the group with loss of graft (p<0.05). When compared with survival in log-rank test IFTA have lost their statistical significance. There was no significant difference between CNI toxicity, ATD and graft survival. Graft loss was more common in patients with lower albumin levels during biopsy (p<0.05). Conclusions: Approximately one third of the biopsies were diagnosed differently than presumed. This demonstrates the inadequacy of other clinical and laboratory findings without biopsy. Renal allograft biopsy is an important tool to predict graft survival. Serum albumin level before biopsy can be considered as a parameter for predicting loss of graft. [ABSTRACT FROM AUTHOR]

Background:Organ transplantation is a teamwork that requires a multidisciplinary approach, big effort, dedication and sacrifice. Despite an increasing number of transplant centers each year, they can not meet the organ requirements and organ deficit is increasing in our country. In order to eliminate this deficit, we consider that a transplant center should be established at a university hospital in the region. The aimof the study is to share our experiences with the Organ Transplant Center of Süleyman Demirel University, which was established on 15/05/2015.Materials and Methods:Fir st, the training of academic staff of Süleyman Demirel University Medical Faculty hospital and transplant coordinators took part in the study. Süleyman Demirel University Hospital's operating rooms, intensive care units, pharmacies, laboratories, transplant outpatient and hemodialysis unit, inpatient services and technical infrastructure were prepared. Trained health workers, technical and auxiliary staff was made ready for organs transplant. Several informational and coordination meetings were held with 112 emergency, hospitals and dialysis units in this region.Discussion:The establishment of organ transplant center in a university hospital requires, patience, dedication, effort, coordinated working with many units and provided by a multidisciplinary approach. The organ transplantation program involving almost all branches is carried out in this understanding. Conclusion :An experienced academic staff, medical and technical infrastructure, are the main priorities to establish a transplant center.It is possible to establish the transplant center at a university hospital following these rules. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Cadaveric organ donation is not at desired levels in our country. However, the number of patients on cadaveric kidney waiting lists is increasing. This situation also makes it difficult to follow cadaveric kidney recipient candidates at transplantation centers. It is very important for the medical status and information of the waitlisted candidates to be current at the time of the cadaveric kidney transplant call. In this study, we investigated the exclusion reasons of cadaveric transplantation candidates at our center. MATERIAL and METHODS: A total 252 adults called for cadaveric kidney transplantation between January 2013 and August 2015 were included the study. Electronic data, immunology laboratory results and transplantation council records were examined. Exclusion reasons of the candidates were evaluated according to the list order. Candidates with a lower rank than the transplanted candidate were excluded. RESULTS: In this period, 252 (56.7% male, 43.3% female, 46.2±12.2 years) adults were called for 81 cadaveric donors (120 kidneys). A total of 144 (57.1%) candidates were excluded. Exclusion reasons were being unable/unwilling to come to the center (59, 34.1%), positive lymphocyte cross-match test (40, 22.9%), inability to reach the patient (24, 13.9%), chronic HCV infection (20, 11.6%), active infection (11, 6.6%), cardiovascular reasons (8, 4.6%), and respiratory system disorders (5, 2.5%). CONCLUSION: Unexpected problems of cadaveric donor candidates can lead to exclusion from transplantation. It will therefore be useful to maintain contact between the patient and his/her relatives and the dialysis and organ transplantation centers, and to update the candidates' information. [ABSTRACT FROM AUTHOR]

New direct acting antiviral agents are quite effective in treating hepatitis-C virus infection (HCV). Treating HCV that occurs or relapses after kidney transplantation necessitates a heedful approach for selecting the proper antiviral alternatives with respect to possible drug interactions. Here we want to lay emphasis on drug interactions in kidney transplant recipients along with a case that developed calcineurin inhibitor toxicity after initiation of anti-HCV treatment. A 48-year-old male was admitted after acute severe toxicity with tacrolimus due to a drug interaction with an antiviral regimen including ritonavir for relapsing genotype-1b HCV infection. Cessation of tacrolimus and antiviral therapy provided recovery. Sustained viral response was achieved with the same antiviral regimen with conversion to very low dose cyclosporine-A (CsA). Selection of a proper anti-HCV treatment combination for kidney transplant recipients requires consideration of the viral genotype, clinical features and possible drug interactions with immunosuppressives. These patients must therefore be followed by a hepatologist as well as a nephrologist. [ABSTRACT FROM AUTHOR]

OBJECTIVE: It was evaluated the sufficiency of YouTube videos related with kidney transplantation as a source of information in this study. MATERIAL and METHODS: A search was made on YouTube web site on 01.09.2015 with the “kidney transplantation” keyword. Videos were evaluated by two nephrology specialists experienced in kidney transplantation. Scores (between 0 and 10) for “reliability”, “quality”, “usefulness” were given to each video content during expert evaluation. Chi-square, Mann-Whitney U, and Kruskal-Wallis analyses were carried out for the evaluation of the acquired data using SPSS 20.0. RESULTS: It was determined that 10% of the videos included in the study contained misleading information. It was determined that the videos which have received the highest number of views were on herbal products, surgical intervention and religious knowledge videos respectively (p<0.05). When the distribution of evaluated score averages with regard to the source uploading the video was considered, statistically significant differences were determined in all areas (p<0.05). CONCLUSION: Even though there is information on YouTube related with kidney transplantation, there are also videos that include misleading and unprofessional information. It is thought that healthcare professionals have significant responsibilities for ensuring that videos with reliable content are available in social media. [ABSTRACT FROM AUTHOR]

The risk of neoplasm increases after transplantation in patients with organ transplantation. Immunosuppressive treatments or oncogenic viruses are major risk factors. Epstein-Barr virus (EBV) and Human Herpesvirus-8 (HHV-8) are the most frequently shown types among oncogenic viruses. Herein, we present a case of spindle cell neoplasm in a 70-year-old renal transplant recipient who underwent immunosuppressive treatment for 4 years, and presented with jaundice and fatique. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Pneumonia increases morbidity and mortality in kidney transplant (KT) recipients. This study aimed to investigate characteristics of pneumonias in KT recipients by focusing on clinical and radiographic findings and diagnostic methods over a long study period. MATERIAL and METHODS: The medical records of kidney transplant recipients who had a diagnosis of pneumonia from 1988 to 2011 were reviewed retrospectively. RESULTS: Among 406 consecutive KT recipients, 20% had pneumonia during the study period and total 111 episodes of pneumonia developed in these patients. Fifty-six percent of the pneumonias were community acquired and 44% nosocomial. Bacterial infections were the most common cause (20%) and 13 (12%) of the episodes were polymicrobial. Antibiotic usage in the last three months was significantly more common in fungal pneumonia episodes than others. Bronchoscopy had the highest final overall diagnostic yield. CONCLUSION: Community-acquired pneumonia was more common, but it showed a more benign clinical course. Bacterial pneumonia was the most common cause, but polymicrobial infection was present in a significant number of KT recipients. Fungi can invade KT recipients, in particular, patients in the interval of 1-6 month after transplantation and patients who have used antibiotics in the last three months. [ABSTRACT FROM AUTHOR]

Renal transplantation is the most prominent treatment of end-stage renal failure. Unfortunately, acute and chronic rejections and drug toxicities reduce graft survival in the post-transplantation period. An attempt has therefore been made in recent years to develop new drugs that can reduce rejections and drug toxicities. In this review, we intended to summarize the new immunosuppressive drugs that have entered use in recent years. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The study was planned to investigate the interventions of patients to protect themselves at home after kidney transplantation. MATERIAL and METHODS: This descriptive study was conducted at a university hospital. The data were collected from 87 patients that came to the clinic for follow-up after having kidney transplants. After obtaining an approval from the Scientific Ethics Committee for the study, written permission was obtained from the institution where the study was going to be conducted RESULTS: The average age of the patients was 40.34±1.18 years; 55.2% were male and 73.6% were married. It was determined that 29.9% had three people living in their houses, 67.8% had their own rooms, 58.6% separated the toilette they used, 97.7% were careful about hand hygiene, 37.9% were always using masks at home, and 90.8% followed hygiene measures. CONCLUSION: It was determined that most of the patients were following the hand hygiene measures and hygiene measures while carrying out their daily living activities. [ABSTRACT FROM AUTHOR]

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Objective: The pharmacokinetics of mycophenolic acid (MPA) differ among individuals. MPA is primarily metabolized by uridine diphosphate-glucuronosyltransferase (UGT), and UGT2B7 is an important UGT for the glucuronidation of MPA. This study aimed to examine the pharmacokinetics of MPA in Turkish renal transplant patients with UGT2B7 His268Tyr (802C>T) polymorphisms. Materials and Methods: Sixty-five renal transplants patients were included in this study. UGT2B7 (802C>T) genotyping was performed using PCR-RFLP. Concentrations of MPA were determined using a cloned enzyme donor immunoassay (CEDIA). All patients were monitored for acute rejection and graft function during the study period. Results: The UGT2B7 (802C>T) CC, CT, and TT genotype frequencies among patients were 24 (36.9%), 36 (55.4%), and 5 (7.7%) respectively. At three and six months post-transplant respectively, levels of MPA were significantly higher in UGT2B7 (802C>T) TT carriers than in CT and CC carriers (p=0.038; p=0.021). The ratio of plasma concentration to MPA dosage for patients with 802C>T TT genotype was higher than that of CC and CT genotypes at six months post-transplant (p=0.042). Individuals carrying the TT genotype demonstrated lower dose requirements at three and six months compared with those of the CC and CT genotypes respectively (p=0.109, p=0.238). Additionally, there was no association found between UGT2B7 (802C>T) polymorphism and acute rejection (p>0.05). Conclusion: Our results demonstrated a correlation between the UGT2B7 (802C>T) polymorphism and MPA pharmacokinetics among renal transplant patients. Determination of UGT2B7 polymorphism may be helpful for determining the optimum dose of MPA to achieve the target plasma concentration. [ABSTRACT FROM AUTHOR]

Vitamin D is a steroidal hormone produced by skin under the impact of sunlight. Vitamin D plays a role in vital events as cellular growth, proliferation, apoptosis, oxidative stress, membrane transport, cellular adhesion, and immune system function. Vitamin D deficiency is claimed to affect mean platelet volume (MPV) by its impact on inflammatory system. In various studies increased MPV has been shown to be related to vascular diseases as venous thromboembolism, hypertension, and coronary artery disease To our knowledge, there is no study about the relation between vitamin D and MPV in kidney transplant recipients (KTRs). The aim of this study is to determine the relation between vitamin D levels, MPV and cardiovascular disease (CVD) in KTRs. Ninety two out of 150 patients whose vitamin D levels were measured were admitted to our clinic between November-December 2015. Patients' data were retrospectively gathered. Patients were grouped in two categories according to vitamin D levels: Group I vitamin <20 ng/mL (n:63) and Group II vitamin D >20 ng/mL (n:29). Any correlation between MPV, CVD, and vitamin D was not detected. In our study, 68.5% of the patients had vitamin D deficiency. This incidence was similar to that found in other studies.In correlation analysis any correlation was not determined between vitamin D levels and MPV (rs=0.16, p=0.60). MPV did not correlate with CVD (p=0.19). Although there is great interest in vitamin D and MPV, it is unclear whether vitamin D deficiency causes inflammation and MPV can be used as a marker of vitamin D deficiency in KTRs. When vitamin D replacement is performed, it should be noted that there may be adverse effects due to accumulation of vitamin D, as well as the positive effects expected from this treatment. Further randomized controlled trials are needed to address the relationship between vitamin D deficiency, MPV and CVD. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study is to retrospectively evaluate the results of the transplantation program that started in 2012 in our hospital. Methods: We examined the demographic variables, immunosuppressive protocols, rejection rates, graft survival, mortality, postoperative surgical complications, BK viremia (BKV) and BK virus-assoiciated nephropathy (BKN), cytomegaloviruse (CMV) infection rates, tuberculosis (TBC) rates and posttransplant malignancy rates of 115 patients who received kidney transplant in our transplantation center between September 2012 and December 2016. Results: Twelve (10.4%) patients received kidney from cadaver donors and 103 (89.6%) paients received kidney from living donors. The Mean donor age was 42 (23-72) and the mean recipient age was 34.65 (12-68). Male to female ratio was 65/50 for the recipients and 48/67 for the donors. Median discharge creatinine was 1.03 mg/dl [interquartile range=0.55-1.48]. Seven patients (6%) suffered from acute rejection and graft loses occurred in four (3.4%) patients. There was no mortality. Conclusion: Our kidney transplantation program is in the developmental stage. However, short-term outcomes are consistent with the literature. More meaningful results can be obtained with long-term follow-up results. [ABSTRACT FROM AUTHOR]

Background: Organ transplantation is carried out with multidisciplinary, which requires big effort, dedication and sacrifice. The weakest part of this work is shortcomings in cadaveric organ donation. T. C. Ministry of Health, both medical and social aspects of organ transplantation and organ sharing the significant progress has been made in our country. The aim of study is to present the effects of newly established 'Organ Transplantation Center' on organ donation in Isparta, and examples of multiple organ harvesting in the region and to share our experience in this field. Materials and Methods: On 15.05.2015 the permission for organ transplantation were taken from T. C. Health Ministry. Subsequently, ventilator-assisted intensive care units, transplant outpatient, inpatient services. hemodialysis unit and the technical infrastructure was prepared. Coordination and informing meetings were held for 112 emergency, hospitals and hemodialysis units in the region. Later, the declaration of brain death occurred in Isparta were evaluated by the relevant coordinator of The National Coordination Unit and statement was made. Nine organs of brain-dead patients were distributed to hospitals. Results: While an average of 4-5 cadaver donations have been made in the past years, within one year following the establishment of the center an increase of approximately 50% with 9 cadaver donations was provided. Seven kidneys and 6 livers were transplanted to the patients in transplantation center. Conclusion: The succes of organ transplantation can be achieved with a sufficient number organ donation. The establishment of organ transplantation center has increased the rate of organ donation in the region. Everyone has a great responsibility. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aim of the study was to retrospectively investigate and evaluate clinical findings and influencing factors related with graft and patient survival in kidney transplant recipients at Dokuz Eylul University Hospital. MATERIAL and METHODS: 286 kidney transplant recipients were included in the study. All patients were transplanted between the dates of January 1993 and January 2014 at Dokuz Eylul University Hospital. The demographic features, clinical and laboratory findings, donor types, HLA matchings, donor properties, renal failure etiology, dialysis modalities, post transplant complications, rejection attacks, and graft loss and death etiology were retrospectively investigated. RESULTS: The mean post transplant follow-up period of 286 patients (166 male, 120 female, mean age 37±12.09 years) was 93.55±54.45 months. 147 had living donors and 139 had deceased donor transplantation. Although graft and patient survival rates were higher in the living donor group than the deceased donor group, no statistically significant difference was found between the two groups. CONCL USION: The overall graft and patient survival rates in our study were compatible with the literature. Morbidity and mortality related with transplantation continues for many years in kidney transplant recipients due to the suppression of the immune system with drugs. [ABSTRACT FROM AUTHOR]