Yazar "Tuncer, M." seçeneğine göre listele

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    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.
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    Kidney transplantation from elderly donor
    (Elsevier Science Inc, 2015) Tekin, S.; Yavuz, H. A.; Yüksel, Y.; Yücetin, L.; Ateş, I.; Tuncer, M.; Demirbaş, A.
    Aim. In recent years, there has been an increase in usage of grafts from advanced-age donors because of the shortage of organ availability. Acceptance of elderly living-kidney donors remains controversial due to the higher incidence of comorbidity and greater risk of postoperative complications. The objective of this study was to evaluate the graft function and patient survival using kidneys from living-related and unrelated donors who were older than 65 years of age. Materials and Methods. From December 2008 until December 2013 we compared the outcomes of 294 patients (mean age, 47.67 +/- 12.4 years; range, 16 to 74 years old) who received grafts from donors >= 65 years old to 2339 patients who received grafts from donors who were younger than 65 years old. Results. We observed no significant differences in sex, time on dialysis, or cold ischemia time between the groups. The recipient ages between two groups were similar. For survival analysis we used the Kaplan-Meier survival estimator. Patient survival at 1, 2, and 3 years was 91.1%, 89.1%, and 88.5%, respectively, for patients transplanted with kidneys from donors >= 65-years-old vs 96.7%, 95.9%, and 95.0%, respectively, in the <65-year-old donor group. Multivariate analysis showed the variables associated with patient survival to be donor age at time of transplantation in years (hazard ratio [HR], 1.65; 95% confidence interval [CI], 1.59-1.71; P < .05), time on dialysis in months (HR, 1.22; 95% CI, 1.21-1.23; P = .002). Graft survival rates at 1, 2, and 3 years censored for death with functional graft at was 97.6%, 96.4%, and 94.1%, respectively, for patients transplanted with kidneys from donors older than 65 years vs 97.5%, 96.8%, and 95.2%, respectively, in the <65-year-old donor group. Multivariate analysis, HLA-DR mismatches (HR, 1.23; 95% CI, 1.12-1.55; P = .050), delayed graft function (HR, 1.77; 95% CI, 1.53-2.07; P = .021), and perhaps acute rejection (HR 1.14; 95% CI, 0.82-1.95; P = .093) were the variables associated with graft survival. Conclusion. We concluded that the use of kidneys from donors older than 65 years of age allows us to increase the rate of renal transplantation to approximately 15 to 20 per million population, with good graft and patient survivals provided that the protocol for expanded criteria organs ensured proper macroscopic and microscopic evaluation of the organ for transplantation.
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    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.