Burak Kocak - Academia.edu (original) (raw)

Papers by Burak Kocak

Turkiye Klinikleri General Surgery - Special Topics, 2009

ABSTRACT For several centuries humankind has always imagined of transplanting body parts to stren... more ABSTRACT For several centuries humankind has always imagined of transplanting body parts to strengthen the powers of himselves. This idea has only been achieved in the past half century in terms of transplanting living tissues from one location to another in order to restore ...

International Journal of Anatomical Variations, 2019

Kidney transplantation is one of the mainstay therapies in chronic kidney disease. It is vital fo... more Kidney transplantation is one of the mainstay therapies in chronic kidney disease. It is vital for a surgeon to know anatomy of the retroperitoneum to perform successful kidney transplantations. Inferior vena cava (IVC), traversing through the retroperitoneum, is the primarily responsible vascular structure for blood return of the lower extremities, pelvis and abdomen to the heart. In laparoscopic donor nephrectomy it is vital to know anatomy of IVC and its relations with neighboring structures. In this paper we represent a rare representation of IVC, a duplicated inferior vena cava (DIVC) case in a donor nephrectomy. Furthermore in this paper, management and possible embryological background of this unique variation is also being discussed.

Turkish journal of urology, 2018

To retrospectively evaluate our database to determine our partial nephrectomy and radical nephrec... more To retrospectively evaluate our database to determine our partial nephrectomy and radical nephrectomy rates and to see percentage of the discarded kidneys which were suitable for transplantation after radical nephrectomy. Patients who underwent radical or partial nephrectomy between January 2000 and December 2016 were identified. Only stage I tumors according to tumor, node, metastasis classification were included in this review. Tumor size, location, proximity to renal collecting system and hilum were considered while deciding the suitability of a kidney for transplantation. A statistically significant gradual increase in the number of patients treated with partial nephrectomy was observed (p=0.00001). Only 17 out of 181 kidneys with a tumor size smaller than 3 cm could be an appropriate candidate for a renal transplantation if they were to be transplanted. Exact number of the discarded kidneys with small renal masses which can be used for kidney transplantation should be determine...

Transplantation Proceedings, 2013

Turkish journal of surgery, Sep 1, 2021

Transplantation Proceedings, 2020

The Journal of Urology, 2001

Demographic data on patient age, male-to-female ratio and body mass index were similar in the 2 g... more Demographic data on patient age, male-to-female ratio and body mass index were similar in the 2 groups. Operative time, transfusion rate, time to oral intake and complications were also similar. However, estimated blood loss, change in hematocrit preoperatively to ...

Transplantation Proceedings, 2008

Turkiye Klinikleri J …, 2009

For several centuries humankind has always imagined of transplanting body parts to strengthen the... more For several centuries humankind has always imagined of transplanting body parts to strengthen the powers of himselves. This idea has only been achieved in the past half century in terms of transplanting living tissues from one location to another in order to restore ...

Angiology

Gemfibrozil-statin combination therapy is a well-known risk factor for myopathy and rhabdomyolysi... more Gemfibrozil-statin combination therapy is a well-known risk factor for myopathy and rhabdomyolysis. Cerivastatin is a currently available statin with dual elimination; it is therefore expected to cause less drug-drug interaction. This case is the second reported case with severe rhabdomyolysis caused by cerivastatin-gemfibrozil combination. Moreover, in this case, the rhabdomyolysis was more severe and caused severe renal failure and death. The authors discuss how these drugs cause rhabdomyolysis and how rhabdomyolysis can cause renal failure.

Introduction: Ureteral complications could be observed during ureteral procedures. Ureteral avuls... more Introduction: Ureteral complications could be observed during ureteral procedures. Ureteral avulsions could require an additional procedure to restore the continuity of the urinary tract. Nephrectomy, ileal ureter interposition, transureteroureterostomy and autotransplantation are the possible theurapeutic options. We reported an autotransplantation following total avulsion of the ureter secondary to a ureteric intervention and discussed this theurapeutic procedure.

Clin Transplant, 2010

The past decade has seen laparoscopic donor nephrectomy (LDN) transform into a standard of care p... more The past decade has seen laparoscopic donor nephrectomy (LDN) transform into a standard of care procedure. Furthermore, LDN has evolved with the introduction of new technologies aimed at increasing efficiency and safety. There are few large, single center experiences detailing the results of LDN, its associated complications, and their management. We performed a retrospective review of 1200 LDN performed at our center for both pediatric and adult recipients. Mean body mass index of donors was 27.1 (range 17-48). Twenty-six percent of kidneys had multiple renal arteries. Greater than 99% were left LDN. Mean length of stay was 1.37 +/- 0.6 d, which decreased to 1.1 +/- 0.5 d for the last 475 cases. The overall complication rate was 5.6%. Among those patients, 1.6% of the patients experienced an intraoperative complication, including eight renovascular injuries; 7/8 renovascular injuries led to open conversion. Four conversions were elective; our overall conversion rate was 0.92%; 4.0% had a post-operative complication; 1.2% required readmission for complication management. Three of 1200 patients have required reoperation for prolonged ileus and internal hernia (2), respectively. There have been no cases of donor renal failure or death. Since 2003, we have routinely used hand-assisted LDN (HALDN). There have been no cases of primary non-function. Urologic complications have been uncommon. Our series supports the safety and efficacy of LDN/HALDN.

Urology, Jan 20, 2015

To determine the incidence of adrenal incidentalomas in a single-center series of living renal do... more To determine the incidence of adrenal incidentalomas in a single-center series of living renal donors, to describe an evaluation algorithm for adrenal incidentalomas in this patient population, and to compare the complication rates of hand-assisted laparoscopic donor nephrectomy (HALDN) with those of combined HALDN and adrenalectomy. We performed a single center, retrospective study of consecutive living kidney donors who underwent laparoscopic nephrectomy for transplantation, with or without simultaneous ipsilateral adrenalectomy, between January 2008 and September 2014. During the study period, adrenal incidentalomas were detected in 18 of 1033 potential living renal donors who underwent computerized tomographic angiography. Application of additional donor selection criteria and of an adrenal mass assessment algorithm resulted in 849 HALDN of which 13 were combined with simultaneous adrenalectomy. The hospital length of stay (2.4 vs 2.6 days), perioperative (0.025 vs 0.077), early...

$Research paper thumbnail of Eculizumab for Treatment of Refractory Antibody-Mediated Rejection in Kidney Transplant Patients: A Single-Center Experience$

Transplantation Proceedings, 2015

ABSTRACT Antibody-mediated rejection (AMR) is responsible for up to 20%-30% of acute rejection ep... more ABSTRACT Antibody-mediated rejection (AMR) is responsible for up to 20%-30% of acute rejection episodes after kidney transplantation. In several cases, conventional therapies including plasmapheresis, intravenous immunoglobulin, and anti-CD20 therapy can resolve AMR successfully. But in some cases the load of immunoglobulins that can activate complement cascade may submerge the routine desensitization therapy and result in the formation of membrane attack complexes. Eculizumab, a monoclonal antibody against C5, was reported to be an option in cases with severe AMR that are resistant to conventional therapy. Here, we present 8 cases that were resistant to conventional therapy and in which eculizumab was given as a salvage treatment. Given the bad prognosis for renal transplants displaying acute injury progressing rapidly to cortical necrosis on the biopsy, the prompt use of eculizumab could have the advantage of immediate effects by stopping cellular injury. This can provide a therapeutic window to allow conventional treatment modalities to be effective and prevent early graft loss. Copyright © 2015. Published by Elsevier Inc.

Herein, the first case of single port transumbilical laparoscopic donor nephrectomy was presented... more Herein, the first case of single port transumbilical laparoscopic donor nephrectomy was presented. The surgery was conducted through a tri-lumen port introduced into the abdomen via a 2-cm periumbilical incision. An additional 5-mm trochar was inserted for aiding tissue ecartation to facilitate upper pole dissection. The donor kidney was removed by extending the previous periumbilical incision. The single port surgery was completed successfully, without any intraoperative complication. The allograft functioned immediately after transplantation. Single port transumbilical laparoscopic donor nephrectomy can be performed successfully in selected patients.

Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation, 2010

Immunosuppressive treatment generally increases the severity of active infection. Therefore, live... more Immunosuppressive treatment generally increases the severity of active infection. Therefore, liver transplant is contraindicated in the presence of active tuberculosis. Despite the importance of supportive treatment, liver transplant is the only treatment for fulminant hepatic failure. We report a case of successful liver transplant for fulminant hepatic failure in the presence of active tuberculosis infection. We immediately performed a liver transplant from a live donor. The patient received low-dose immunosuppressive treatment and antituberculosis treatment. The patient was cured and discharged on the 25th day after surgery. We stopped antituberculosis treatment 10 months after discharge. The patient has been followed for 32 months after transplant with normal graft function and has been free of pulmonary tuberculosis infection. Liver transplant can be performed in cirrhotic patients with active infections, such as tuberculosis, as a life-saving procedure.

Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation, 2014

There are numerous changes in inflammatory status that occur after a kidney transplant. Pentraxin... more There are numerous changes in inflammatory status that occur after a kidney transplant. Pentraxin 3 is a marker of inflammation, but little information is available about pentraxin 3 levels after a kidney transplant. We evaluated the relation between pentraxin 3 and other inflammatory markers including high sensitivity C-reactive protein, interleukin 6, and tumor necrosis factor alpha in kidney transplant recipients. Adult patients (40 patients; aged, 18-80 y; mean age, 38 ± 10 y) who had a kidney transplant from living-related donors were studied. Patients who had comorbidities associated with chronic inflammation were excluded. Blood samples were obtained before starting immunosuppressive treatment and 2 months after kidney transplant for measurement of pentraxin 3, high sensitivity C-reactive protein, interleukin 6, and tumor necrosis factor α levels. After transplant, mean levels of high sensitivity C-reactive protein and interleukin 6 decreased but levels of pentraxin 3 and tum...

Surgery, 2004

Laparoscopic live donor nephrectomy (LDN) is a less invasive alternative to traditional open neph... more Laparoscopic live donor nephrectomy (LDN) is a less invasive alternative to traditional open nephrectomy that has several potential advantages. However, there have been few large series reports describing the complications of LDN and the details of their management. We performed a retrospective review of 500 LDNs performed at our center between October 1997 and September 2003. We evaluated preoperative donor characteristics, intraoperative parameters and complications, and postoperative recovery and complications. A modification of the Clavien classification was developed and used to grade the severity of all complications. The overall rate of intraoperative complications was 2.8%. There were 9 open conversions (1.8%), of which 6 were in the first 100 cases. Six of the 9 open conversions were for management of complications; 3 were elective. Seven renovascular incidents (1.4%) all required open conversion except one. The overall rate of postoperative complications was 3.4%. Thirty of 500 patients in our LDN series experienced an intraoperative or procedure-related complication (6.0%). When graded by severity, 18 of 31 (58.1%) of all complications were grade 1, 11 of 31 (35.4%) grade 2, and 2 of 31 (6.5%) grade 3. Only 1 recipient experienced delayed graft function, and only 1 recipient had a urologic complication. Our series supports the safety and efficacy of LDN with very low intraoperative complication and conversion rates. Most of the intraoperative complications can be managed laparoscopically. Readmissions are extremely rare (1.5%). Aberrant vascular anatomy and obesity are not contraindications to LDN, but they require experience. With careful surgical technique, delayed graft function and urologic complications in recipients can be avoided. A graded classification scheme for reporting complications of donor nephrectomy might be useful for maintaining registry information on donor outcomes and when informing potential donors about the risks and benefits of this procedure.