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Öğe Comparative results of transurethral incision with transurethral resection of the prostate in renal transplant recipients with benign prostate hyperplasia(Urol & Nephrol Res Ctr-Unrc, 2018) Sarıer, Mehmet; Duman, İbrahim; Kılıç, Süleyman; Yüksel, Yücel; Demir, Meltem; Aslan, Mesut; Emek, Mestan; Yücetin, Levent; Tekin, Sabri; Yavuz, Asuman HavvaPurpose: The aim of this study is to compare the results of transurethral incision of the prostate (TUIP) and transurethral resection of the prostate (TURP) for the surgical treatment of benign prostate hyperplasia (BPH) in patients with renal transplantation. Materials and Methods: Between April 2009 and May 2016, BPH patients with renal transplants whose prostate volumes were less than 30 cm(3) were treated surgically. Forty-seven patients received TURP and 32 received TUIP. The patients' age, duration of dialysis, duration between transplant and TURP/TUIP, preoperative and postoperative serum creatinine (SCr), International Prostate Symptom Score (IPSS), maximum flow rate (Qmax) and postvoid residual volume (PVR) were recorded. At 1-,6- and 12-month follow-up, early and long-term complications were assessed. Results were evaluated retrospectively. Results: In both groups, SCr, PVR and IPSS decreased significantly after the operation, while Qmax increased significantly (P < .001). There was no difference between the two groups in terms of increase in Qmax and decrease in IPSS, SCr and PVR (P = .89, P = .27, P = .08, and P = .27). Among postoperative complications, urinary tract infection (UTIs) and retrograde ejaculation (RE) rates were higher in the TURP group than the TUIP group (12.7% versus 6.2% and 68.1% versus 25%,respectively), whereas urethral strictures were more prevalent in the TUIP group (12.5% versus 6.3%). Conclusion: For the treatment of BPH in renal transplant patients with a prostate volume less than 30 cm(3) , both TUIP and TURP are safe and effective.Öğe Comparative Results of Transurethral Incision with Transurethral Tesection of the Prostate in Renal Transplant Recipients with Benign Prostate Hyperplasia(Lippincott Williams & Wilkins, 2018) Sailer, Mehmet; Duman, Ibrahim; Yuksel, Yucel; Demir, Meltem; Yucetin, Levent; Tekin, Sabri; Yavuz, Asuman H.[No abstract available]Öğe Donors with hepatitis B surface antigen positivity: Contraindication for renal transplantation or not?(Oxford Univ Press, 2015) Yavuz, Asuman; Tekin, Sabri; Yüksel, Yücel; Yücetin, Levent; Tuncer, Murat; Demirbaş, AlperBecause of the organ shortage, the number of patients awaiting kidney transplantation has increased rapidly requiring physicians to implement new methods to increase the number of grafts. In this study, we compared clinical and biochemical parameters of patients who received kidneys from hepatitis B surface antigen-positive (group 1) versus other living related kidney donors (group 2). The study included 414 female (15 group 1 and 399 group 2) and 816 male (20 group 1 and 796 group 2) donors for 1195 living related kidney transplantations performed between April 21, 2008 and March 1, 2011. Group 1 kidney transplantations were undertaken only if the recipient displayed a hepatitis B antibody titer >10 mIU/mL and donor hepatitis B virus (HBV) DNA was negative. Demographic characteristics, 1- and 2-year serum creatinine levels, glomerular filtration rates (GFR), and liver function test results were similar between the 2 groups. There were no new HBV infections throughout the study period. Acute rejection rates (7/35 in group 1 vs 232/1195 in group 2; P = .988), graft loss (1/35 in group 1 vs 55/1195 in group 2; P = .624), and patient loss (0/35 in group 1 vs 34/1195; P = .311) were similar between the 2 groups. Our study showed that hepatitis B surface antigen positivity was not a contraindication to living kidney donation.Öğe Emergent living donor liver transplantation for multible giant cavernous hemangiomas of liver: Case report(Lippincott Williams & Wilkins, 2015) Tekin, Sabri; Yüksel, Yücel; Demirbaş, Alper[No abstract available]Öğe First international paired exchange kidney transplantations of Turkey(Elsevier Science Inc, 2015) Tuncer, M.; Tekin, Sabri; Yüksel, Yücel; Yücetin, Levent; Dosemeci, L.; Şengul, A.; Demirbaş, A.Objective. We estimated that many patients on the waiting list for kidney transplantation in Turkey have immunologicaly incompatible suitable living donors. Paired exchange kidney transplantation (PETx) is superior to desensitization for patients with incompatible donors. Recently we decided to begin an international PETx program. Methods. We report three international living related paired kidney transplantations which occurred between May 14,2013, and March 7, 2014. The international donor and recipient operations were performed at Medical Park Hospital, Antalya, Turkey. All pairs were living related and written proofs were obtained according to Turkish laws. As with the donor procedures, the transplantation procedures were performed at the same time. Results. The uniqueness of these transplantations was that they are the first international exchange kidney transplantations between Turkey and Kirghizia. Currently all recipients are alive with wel-functioning grafts. Conclusion. In our institute, a 5% increase was obtained in living-related kidney transplantations by the help of PETx on a national basis. We believe that international PETx may also have the potential to expand the donor pool.Öğe Post-transplantation malignancy after kidney transplantation in Turkey(Elsevier Science Inc, 2015) Keleş, Yıldız; Tekin, Sabri; Düzenli, M.; Yüksel, Yücel; Yücetin, Levent; Döşemeci, L.; Tuncer, M.Objective. Kidney transplantation is the best treatment option for end-stage renal disease patients. Increased incidence of post-transplantation malignancy can be caused by immunosuppressive drugs and some oncogenic infections. The aim of this study is to show the incidence of post-transplantation malignancy in patients who had surgery and were followed up in the Organ Transplant Center, Medical Park Antalya, Antalya, Turkey. Method. The study was based on 2100 kidney transplantation patients who had surgery between May 2008 and December 2012 and also on 1900 patients who had surgery by members of our team in other centers and who were followed up routinely. In all of our patients, the type of malignancy, the time that malignancy developed, immunosuppressive regimens, and viral status (Epstein-Barr virus and cytomegalovirus) were investigated. Results. Malignancy was developed in 30 patients (60% of them were male, median age was 52.1 years). Post-transplantation malignancy development time was a median of 5.1 years. The types of malignancies were as follows: non-melanoma skin cancer in 12 patients (40%), urogenital cancer in 7 patients (24%), breast cancer in 4 patients (14%), lymphoproliferative disease in 3 patients (10%), thyroid cancer in 2 patients (6%), and lung cancer in 2 patients (6%). Discussion. In this study, we did not find any increased post-transplantation malignancy risk in our patients. This finding could be due to the low-dosage immunosuppressive protocols that we used.Öğe Results of minimally invasive surgical treatment of allograft lithiasis in live-donor renal transplant recipients: a single-center experience of 3758 renal transplantations(Springer, 2019) Sarıer, Mehmet; Duman, İbrahim; Yüksel, Yücel; Tekin, Sabri; Demir, Meltem; Arslan, Fatih; Yavuz, Asuman HavvaAllograft lithiasis is a rare urologic complication of renal transplantation (RT). Our aim is to present our experience with minimally invasive surgical treatment of allograft lithiasis in our series of live-donor renal transplant recipients. In a retrospective analysis of 3758 consecutive live-donor RTs performed in our center between November 2009 and January 2017, the results of minimally invasive surgery for the treatment of renal graft lithiasis diagnosed at follow-up were evaluated. Twenty-two (0.58%) patients underwent minimally invasive surgery for renal graft lithiasis. The mean age was 41.6 years, and duration between RT and surgical intervention was 27.3 months (range 3-67). The mean stone size was 11.6 mm (range 4-29). Stones were located in the urethra in 1, bladder in 2, ureter in 9, renal pelvis in 7 and calices in 3 patients. Surgical treatment included percutaneous nephrolithotomy in 1, cystoscopic lithotripsy in 3, flexible ureteroscopic lithotripsy in 6 and rigid ureteroscopic lithotripsy in 12 patients. No major complications were observed. One patient (4.5%) who underwent flexible ureteroscopy developed postoperative urinary tract infection. All patients were stone-free except two (9%) patients who required a second-look procedure after flexible ureteroscopic lithotripsy for residual stones. Stone recurrence was not observed in any patient during a mean follow-up duration of 30.2 months (range 8-84). Renal transplant lithiasis is uncommon and minimally invasive surgical treatment is rarely performed for its treatment. Endourological surgery may be performed safely, effectively and with a high success rate in these patients.Öğe Results of transurethral resection of the prostate in renal transplant recipients: A single center experience(Springer, 2018) Sarıer, Mehmet; Tekin, Sabri; Duman, İbrahim; Yüksel, Yücel; Demir, Meltem; Alptekinkaya, Furkan; Koşar, Alim; Yavuz, Asuman Havva; Güler, MehmetThe aim of this study was to retrospectively evaluate the early and long-term results of renal transplantation (RT) patients undergoing transurethral resection of the prostate (TURP) due to benign prostate hyperplasia (BPH). Eighty-nine patients with RT performed in our hospital underwent TURP between November 2008 and March 2016. Results were evaluated along with early and long-term complications. Patients were followed up for a minimum of 12 months. The mean age of the patients was 61.4 +/- 7.4 years. The median duration of dialysis was 28 (0-180) months. The median duration between transplantation and TURP was 13 (0-84) months. Before TURP, the mean serum creatinine (sCr) was 1.99 +/- 0.83 mg/dL and the mean prostate volume was 33.3 +/- 14.6 cm(3). The mean Q (max), Q (ave) and PVR values were 9.5 +/- 3.7, 5.2 +/- 2.2 ml/s and 85(5-480) mL, respectively. None of the patients developed perioperative and postoperative major complications. Twelve patients (13.4%) developed urinary tract infections in the postoperative period. The sCr, IPSS and PVR values significantly decreased, while Q (max) and Q (ave) significantly increased at the 1-month follow-up. At the 6-month follow-up, 63 (70.8%) patients had retrograde ejaculation. Patients were followed up for a median of 42 (12-96) months. Three patients (3.3%) were re-operated for bladder neck contracture and eight (8.9%) patients were re-operated for urethral stricture. TURP can be safely and successfully applied for the treatment of BPH after RT. LUTS and renal functions significantly improve after the operation. Patients should be followed up for UTIs in the short term and for urethral stricture in the long term.Öğe Successful kidney transplantation in case of completely occluded inferior vena cava and iliac veins: a case of inherited antithrombin deficiency(Asoc Regional Dialisis Trasplantes Renales, 2021) Tekin, Sabri; Erok, Berrin; Win, Nu Nu; Agolli, Elidor; Ucak, Alper; Akyol, Huseyin; el Mounjali, AssiyaProduced in the liver, Antithrombin III, now simply antithrombin (AT), is a vitamin K-independent serine protease inhibitor in the coagulation pathway. It is the most important primary physiologic inhibitor of thrombin in the human body. In addition to thrombin, AT also inhibits other coagulation serine proteases including VIIa, IXa, Xa, XIa, XIIa. (1-2) The deficiency of AT may be inherited or acquired. The incidence of inherited AT deficiency is about 1:2000-5000 in general population and is the least common of the three main anticoagulant deficiencies (the other two being protein C deficiency and protein S deficiency). (3) Its inheritance is generally in autosomal dominant fashion. The resultant procoagulant state leads to unprovoked recurrent venous thromboses and thromboembolic events such as deep vein thrombosis or pulmonary embolism which generally appear at the post-pubertal period, compared to the very low occurrence in the prepubertal period.(4) The diagnosis is based on both quantitative and qualitative measurement of AT level.(5) The measured AT activity in functional tests in healthy subjects is generally around 80% to 120%, and AT level of less than 70% is considered as being AT deficiency. This evaluation should be made while not on anticoagulation therapy, because heparin decreases AT levels for up to 10 days following its discontinuation and warfarin increases its level. (6) Patients with inherited AT deficiency rarely develops renal failure which may be caused by renal vein thrombosis or glomerular injury associated with fibrin accumulation. (7) In these young patients with end stage renal disease (ESRD), renal transplantation is currently the best therapeutic option to improve the quality of life and to avoid the risk of complications of other renal replacement treatment particularly thrombosis of the hemodialysis access. Kidney transplantation in patients with an occluded iliac veins and inferior vena cava (IVC) is a very challenging surgery to perform.(8-9) Despite the reported success in few cases for children, kidney transplant surgeries with thrombotic diseases in adults remain very limited in the literature. Herein, we present a successful kidney transplantation by using a polytetrafluoroethylene (PTFE) graft in a young male patient with AT deficiency associated with totally occluded IVC and iliac veins.Öğe Successful kidney transplantation in case of completely occluded inferior vena cava and iliac veins: a case of inherited antithrombin deficiency(Asociacion Regional de Dialisi y Transplantes Renales de Capital Federal y Provincia de Buenos Aires, 2021) Tekin, Sabri; Erok, Berrin; Win, Nu Nu; Agolli, Elidor; Uçak, Alper; Akyol, Hüseyin; Mounjali, Assiya ElProduced in the liver, Antithrombin III, now simply antithrombin (AT), is a vitamin K-independent serine protease inhibitor in the coagulation pathway. It is the most important primary physiologic inhibitor of thrombin in the human body. In addition to thrombin, AT also inhibits other coagulation serine proteases including VIIa, IXa, Xa, XIa, XIIa. (1-2) The deficiency of AT may be inherited or acquired. The incidence of inherited AT deficiency is about 1:2000-5000 in general population and is the least common of the three main anticoagulant deficiencies (the other two being protein C deficiency and protein S deficiency). (3) Its inheritance is generally in autosomal dominant fashion. The resultant procoagulant state leads to unprovoked recurrent venous thromboses and thromboembolic events such as deep vein thrombosis or pulmonary embolism which generally appear at the post-pubertal period, compared to the very low occurrence in the prepubertal period.(4) The diagnosis is based on both quantitative and qualitative measurement of AT level.(5) The measured AT activity in functional tests in healthy subjects is generally around 80% to 120%, and AT level of less than 70% is considered as being AT deficiency. This evaluation should be made while not on anticoagulation therapy, because heparin decreases AT levels for up to 10 days following its discontinuation and warfarin increases its level. (6) Patients with inherited AT deficiency rarely develops renal failure which may be caused by renal vein thrombosis or glomerular injury associated with fibrin accumulation. (7) In these young patients with end stage renal disease (ESRD), renal transplantation is currently the best therapeutic option to improve the quality of life and to avoid the risk of complications of other renal replacement treatment particularly thrombosis of the hemodialysis access. Kidney transplantation in patients with an occluded iliac veins and inferior vena cava (IVC) is a very challenging surgery to perform.(8-9) Despite the reported success in few cases for children, kidney transplant surgeries with thrombotic diseases in adults remain very limited in the literature. Herein, we present a successful kidney transplantation by using a polytetrafluoroethylene (PTFE) graft in a young male patient with AT deficiency associated with totally occluded IVC and iliac veins. © 2021, Asociacion Regional de Dialisi y Transplantes Renales de Capital Federal y Provincia de Buenos Aires. All rights reserved.
