emrah otan - Academia.edu (original) (raw)

Papers by emrah otan

Research paper thumbnail of Portal vein reconstruction with cryopreserved vascular grafts: A two‐edged sword

Pediatric Transplantation, 2021

BackgroundPortal vein anastomotic complications related to size discrepancy are important causes ... more BackgroundPortal vein anastomotic complications related to size discrepancy are important causes of morbidity and mortality in pediatric liver transplantation. Interposed vascular grafts in portal vein anastomosis can solve this problem. The aim of this study is to evaluate the results of pediatric liver transplantations performed using cryopreserved interposed vascular grafts between graft portal vein and superior mesenteric vein (SMV)‐splenic vein (SpV) confluence.MethodsTwenty‐nine pediatric patients received liver transplantation using cryopreserved venous grafts in our Liver Transplant Institute between 2013 and 2020 were included in this study. Demographic, clinical, and operative characteristics and postoperative follow‐up were analyzed.ResultsSixteen patients (55.2%) had portal hypoplasia and five patients (17.2%) had portal vein thrombosis. In total, six patients (20.6%) suffered portal vein thrombosis in the early postoperative period. Three patients (10.3%) experienced po...

Research paper thumbnail of Özofagus Varis Kanamalarına Güncel Yaklaşımlar

Research paper thumbnail of Clinical Results of Lipopolysaccharide Filter Use in Sepsis Developed After Liver Transplantation: Report of Two Cases

Background and Case Presentation: Sepsis remains as a preventable cause of mortality in ICU inpat... more Background and Case Presentation: Sepsis remains as a preventable cause of mortality in ICU inpatients. Lipopolysaccharide (LPS) is the endotoxin, a structural component of the cell wall of gram-negative bacteria. Its release in systemic circulation results in the release of a group of inflammatory mediators, leading to initialization and/or exacerbation of sepsis. We report two cases with a history of Liver Transplantation (LT) cases that underwent LPS filter treatment with a diagnosis of Gram-negative related septic episode and discuss the related literature. Conclusions: Our cases demonstrate that LPS filters have significant and accountable effect on prognosis in treatment of sepsis. Further studies would be promising to clarify mechanisms and effectivity profiles of these techniques to provide better treatment algorhytms.

Research paper thumbnail of HCC and Tumor Biomarkers: Does One Size Fits All?

Journal of Gastrointestinal Cancer, 2020

Hepatocellular carcinoma (HCC) is a highly malignant disease and early diagnosis rates remain to ... more Hepatocellular carcinoma (HCC) is a highly malignant disease and early diagnosis rates remain to be unsatisfactory. Owing to this limitation, advances in treatment options including liver transplantation (LT) are limited to improve survival. Recent HCC guidelines no longer recommend alpha-fetoprotein (AFP) as a surveillance and diagnostic tool for HCC. Hence, utilization of novel biomarkers has become imperative to improve disease management strategies. Noninvasive, serum-based biomarkers are potential options to aid early diagnosis as well as prompting treatment. However, further studies are required to find out the accuracy and potential of these approaches and introduce into clinical practice.

Research paper thumbnail of How to reduce and manage hepatic arterial complications in living and deceased donor liver transplantations

Hepatobiliary Surgery and Nutrition, 2021

Research paper thumbnail of Psychosocial Outcomes of Donors Whose Recipients Died After Living Donor Liver Transplantation

Journal of Gastrointestinal Cancer, 2020

Purpose Our aim was to investigate the psychosocial outcomes of the donors whose recipients died ... more Purpose Our aim was to investigate the psychosocial outcomes of the donors whose recipients died after living donor liver transplantation (LDLT). Methods Forty-one donors whose recipients died and 87 donors whose recipients were alive after LDLT at Inonu University Liver Transplantation Institute between 2012 and 2017 were included into the study. Demographic data form, Beck anxiety scale, Beck depression scale, Beck Hopelessness Scale, Posttraumatic Growth Inventory, Decision Regret Scale, Multidimensional Scale of Perceived Social Support, and general evaluation questionnaire (24 questions) were used in all donors by face to face questioning. In addition to the descriptive statistical analysis, chi-square and student's t tests were used to evaluate the differences between the groups. Results Recipient death after living donor liver transplantation is a factor that negatively increases the level of anxiety, depression, hopelessness levels, and repentance of donors, and adversely affects the psychological growth of the donors after donation experience. Conclusion Regular follow-up of the donors should be done psychosocially in the postoperative period, especially the donors whose recipients have died should be followed up more frequently, and their support and treatment should be provided when needed. The donors should also be informed about the psychosocial implications of operative management and postoperative period. More studies are needed regarding the psychosocial problems of the donors.

Research paper thumbnail of Artificial vascular graft migration into hollow viscus organs in patients who underwent right lobe living donor liver transplantation

Acta Chirurgica Belgica, 2020

Background: To share our experience with hollow viscus migration of artificial vascular grafts (A... more Background: To share our experience with hollow viscus migration of artificial vascular grafts (AVG) used for venous reconstruction of the right anterior sector in living donor liver transplantations (LDLT). Methods: Clinical, radiological, and endoscopic data of 13 right lobe LDLT patients (range: 26-67 years) with a diagnosis of postoperative AVG migration into adjacent hollow viscus were analyzed. Results: Biliary complications were detected in 12 patients. A median of four times endoscopic retrograde cholangiopancreatography (ERCP) procedures were performed in 11 patients prior to AVG migration diagnosis. A median of 2.5 times various percutaneous radiological interventional procedures were performed in eight patients prior to AVG migration diagnosis. The site of migration was the duodenum in eight patients, gastric antrum in four, and Roux limb in the remaining one patient. The migrated AVS were made of polytetrafluoroethylene (PTFE) in 10 patients and polyethylene terephthalate (Dacron) in three. The migrated AVGs were endoscopically removed in seven patients and surgically removed in six. Only one patient died due to sepsis unrelated to AVG migration. Conclusion: AVG migration into the adjacent hollow viscus following right lobe LDLT is a rare and serious complication. Repetitive ERCP, interventional radiological procedures, infection related to biliary leakage, and thrombosis of AVGs are among the possible risk factors.

Research paper thumbnail of Diaphragmatic hernias after pediatric liver transplantation: Experience of a high‐volume transplant center

Pediatric Transplantation, 2020

Diaphragmatic hernias (DHs) are rare complications after pediatric liver transplantation (PLT). I... more Diaphragmatic hernias (DHs) are rare complications after pediatric liver transplantation (PLT). It is now widely accepted that DHs after liver transplantation (LT) is a pediatric related condition. PLTs (under of age 18) performed between January 2013 and June 2019 at Malatya Inonu University Institute of Liver Transplantation were retrospectively scanned. Study group consisting DHs and a control group were compared. Among 280 PLTs, 8 of them were complicated with DHs (%2.9). Median age of the patients with DH was 3.0 (0.8‐9.5) years. Median graft recipient weight ratio was 2.5 (0.9‐4.4). Five patients were below 5th percentiles in terms of pediatric weight growth chart at the time of LT. Also, 6 patients were below 5th percentiles in terms of pediatric height growth chart. There was no statistical difference between study and control groups. There are many risk factors mentioned in literature that may be primarily responsible for DHs after PLT. These factors are left lobe and large...

Research paper thumbnail of Undetectable pancreatic insulinoma during surgery

Annals of Medical Research, 2018

Research paper thumbnail of Reconstruction of Anomalous Portal Venous Branching in Right Lobe Living Donor Liver Transplantation: Malatya Approach

Liver Transplantation, 2017

Reconstruction of anomalous portal vein branching (APVB) during right lobe living donor liver tra... more Reconstruction of anomalous portal vein branching (APVB) during right lobe living donor liver transplantation (LDLT) can be challenging. The goal of this article is to describe our surgical technique, named the Malatya Approach, in case of APVB during right lobe LDLT. The technique unifies the APVB and obtains a funnel‐shaped common extension with a circumferential fence by a saphenous vein conduit. In total, 126 (10.6%) of 1192 right lobe grafts had APVB that were divided into 2 groups according to the adopted surgical techniques: the Malatya Approach group (n = 91) and the previously defined other techniques group (n = 35). Both groups were compared regarding portal vein thrombosis (PVT), postoperative 90‐day mortality and survival. PVT developed in 3 patients (3.3%) in the Malatya Approach group and developed in 10 (28.6%) patients for the other group (P < 0.001). There were 8 (8.8%) 90‐day mortalities in the Malatya Approach group (1 PVT related) and 15 patients (9 PVT relate...

Research paper thumbnail of  Economic growth leads to increase of obesity and associated hepatocellular carcinoma in developing countries

Annals of hepatology

Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer and the third lea... more Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer and the third leading cause of cancer related death worldwide. In recent years, the prevalence of HCC has increased in both developing and developed countries. Most HCC cases develop in the presence of advanced chronic liver disease related to viral hepatitis. In particular hepatitis B virus and hepatitis C virus infections are considered as major HCC risk factors worldwide. However, current studies provide strong evidence for increasing numbers of HCC in nonalcoholic fatty liver disease (NAFLD). NAFLD represents the hepatic manifestation of metabolic syndrome which is based on obesity and insulin resistance. Epidemiologic data clearly demonstrates that NAFLD and obesity-related disorders are significant risk factors for tumor development in general and HCC in particular. As a consequence of life style changes towards higher calorie intake and less exercise, obesity and metabolic syndrome are spreading a...

Research paper thumbnail of İdiopatik Portal Ven Trombozuna Bağlı Mezenterik Venöz İskemi: Olgu Sunumu

Research paper thumbnail of Karaciğer Transplantasyonunda Supraçölyak Aorta Anastomozu: Olgu Sunumu

Research paper thumbnail of The 2-Stage Liver Transplant: 3 Clinical Scenarios

Experimental and Clinical Transplantation, 2015

The main goal of 2-stage liver transplant is to provide time to obtain a new liver source. We des... more The main goal of 2-stage liver transplant is to provide time to obtain a new liver source. We describe our experience of 3 patients with 3 different clinical conditions. A 57-year-old man was retransplanted successfully with this technique due to hepatic artery thrombosis. However, a 38-yearold woman with fulminant toxic hepatitis and a 5-year-old-boy with abdominal trauma had poor outcome. This technique could serve as a rescue therapy for liver transplant patients who have toxic liver syndrome or abdominal trauma. These patients required intensive support during long anhepatic states. The transplant team should decide early whether to use this technique before irreversible conditions develop.

Research paper thumbnail of Management of Giant Splenic Artery Aneurysm

Research paper thumbnail of Cytoprotective effects of amifostine, ascorbic acid and N-acetylcysteine against methotrexate-induced hepatotoxicity in rats

World journal of gastroenterology : WJG, Jan 7, 2014

To investigate the potential role of oxidative stress and the possible therapeutic effects of N-a... more To investigate the potential role of oxidative stress and the possible therapeutic effects of N-acetyl cysteine (NAC), amifostine (AMF) and ascorbic acid (ASC) in methotrexate (MTX)-induced hepatotoxicity. An MTX-induced hepatotoxicity model was established in 44 male Sprague Dawley rats by administration of a single intraperitoneal injection of 20 mg/kg MTX. Eleven of the rats were left untreated (Model group; n = 11), and the remaining rats were treated with a 7-d course of 50 mg/kg per day NAC (MTX + NAC group; n = 11), 50 mg/kg per single dose AMF (MTX + AMF group; n = 11), or 10 mg/kg per day ASC (MTX + ASC group; n = 11). Eleven rats that received no MTX and no treatments served as the negative control group. Structural and functional changes related to MTX- and the various treatments were assessed by histopathological analysis of liver tissues and biochemical assays of malondialdehyde (MDA), superoxide dismutase (SOD), catalase, glutathione (GSH) and xanthine oxidase activiti...

Research paper thumbnail of Frantz's tumor (solid pseudopapillary tumor) of the pancreas. A case report

JOP : Journal of the pancreas, Jan 9, 2009

A solid pseudopapillary tumor of the pancreas is a rare neoplasm which, for the most part, affect... more A solid pseudopapillary tumor of the pancreas is a rare neoplasm which, for the most part, affects young women and has a relatively favorable prognosis with a low malignant potential. These tumors usually have unclear clinical features and may form very large masses before being diagnosed. We report the case of a 29-year-old woman who underwent complete resection of the tumor using a distal pancreatectomy and splenectomy procedure. The patient is being followed-up and in good condition. A review of the relevant literature is also presented. A solid pseudopapillary tumor of the pancreas is a rare condition with a low potential for malignancy and favorable prognosis; surgical resection is generally curative.

Research paper thumbnail of Evaluation of Neurological Complications Following Living Donor Liver Transplantation

Noro Psikiyatri Arsivi, 2015

Introduction: Liver transplantation is one of the best treatment options for end-stage liver dise... more Introduction: Liver transplantation is one of the best treatment options for end-stage liver disease. In Turkey, living donor liver transplantation (LDLT) is performed more frequently than cadaveric transplantation, because organ donation is unpopular in our country. Neurological complications contribute to poor postoperative outcomes after liver transplantation. In the present study, we aimed to evaluate the outcomes of LDLT patients in whom such complications developed early during postoperative follow-up in the intensive care unit. Methods: Of 217 LDLTs performed between August 2011 and August 2012, neurology consultations were arranged for 29 patients (13.36%) because of development of new-onset neurological symptoms and/or findings in patients with neurologically uneventful preoperative histories. We retrospectively collected data on age, gender, primary disease, Model for End-Stage Liver Disease (MELD) score, and postoperative hospitalization duration of those who survived. The indications for neurological consultation and diagnoses were categorized into acute confusion/encephalopathy, epileptic seizures, leukoencephalopathy, and focal neurological deficits. The immunosuppressive treatment regimens prescribed were also considered. The outcomes of the 2 groups (with and without neurological complications) were compared. Results: The mean patient age was 44.52±16.24 years, and males predominated (65.5%, n=19). Acute confusion/encephalopathy was the most frequent complication (62.1%, n=18), followed by epileptic seizures (27.6%, n=8), cerebrovascular disease (6.9%, n=2), and leukoencephalopathy (3.4%, n=1). Statistically significant between-group differences in age (44.5±16.2 vs. 34.33±20.98 years; p<0.001), and proportions of patients with a disease of viral etiology (55.17% vs. 35.63%, p<0.05), were evident. Mortality was significantly higher in the group with neurological complications (65.5% vs. 37.32%, p<0.05). The duration of postoperative hospitalization was also significantly longer in this group (29.80±15.04 vs. 10.00±5.47 days; p<0.05). Conclusion: Mortality was significantly higher and the duration of postoperative hospitalization significantly longer in LDLT patients with new-onset neurological complications than in those without such complications.

Research paper thumbnail of Infections in the Intensive Care Unit Following Liver Transplantation: Profile of a Single Center

Russian Journal of Transplantology and Artificial Organs, 2014

Research paper thumbnail of En Masse Resection of Pancreas, Spleen, Celiac Axis, Stomach, Kidney, Adrenal, and Colon for Invasive Pancreatic Corpus and Tail Tumor

Case Reports in Surgery, 2013

Providing a more comfortable life and a longer survival for pancreatic corpus/tail tumors without... more Providing a more comfortable life and a longer survival for pancreatic corpus/tail tumors without metastasis depends on the complete resection. Recently, distal pancreatectomy with celiac axis resection was reported as a feasible and favorable method in selected pancreatic corpus/tail tumors which had invaded the celiac axis. Additional organ resections to the celiac axis were rarely required, and when necessary it was included only a single extra organ resection such as adrenal or intestine. Here, we described a distal pancreatic tumor invading most of the neighboring organs—stomach, celiac axis, left renal vein, left adrenal gland, and splenic flexure were treated by en bloc resection of all these organs. The patient was a 60-year-old man without any severe medical comorbidities. Postoperative course of the patient was uneventful, and he was discharged on postoperative day eight without any complication. Histopathology and stage of the tumor were adenocarcinoma and T4 N1 M0, respe...

Research paper thumbnail of Portal vein reconstruction with cryopreserved vascular grafts: A two‐edged sword

Pediatric Transplantation, 2021

BackgroundPortal vein anastomotic complications related to size discrepancy are important causes ... more BackgroundPortal vein anastomotic complications related to size discrepancy are important causes of morbidity and mortality in pediatric liver transplantation. Interposed vascular grafts in portal vein anastomosis can solve this problem. The aim of this study is to evaluate the results of pediatric liver transplantations performed using cryopreserved interposed vascular grafts between graft portal vein and superior mesenteric vein (SMV)‐splenic vein (SpV) confluence.MethodsTwenty‐nine pediatric patients received liver transplantation using cryopreserved venous grafts in our Liver Transplant Institute between 2013 and 2020 were included in this study. Demographic, clinical, and operative characteristics and postoperative follow‐up were analyzed.ResultsSixteen patients (55.2%) had portal hypoplasia and five patients (17.2%) had portal vein thrombosis. In total, six patients (20.6%) suffered portal vein thrombosis in the early postoperative period. Three patients (10.3%) experienced po...

Research paper thumbnail of Özofagus Varis Kanamalarına Güncel Yaklaşımlar

Research paper thumbnail of Clinical Results of Lipopolysaccharide Filter Use in Sepsis Developed After Liver Transplantation: Report of Two Cases

Background and Case Presentation: Sepsis remains as a preventable cause of mortality in ICU inpat... more Background and Case Presentation: Sepsis remains as a preventable cause of mortality in ICU inpatients. Lipopolysaccharide (LPS) is the endotoxin, a structural component of the cell wall of gram-negative bacteria. Its release in systemic circulation results in the release of a group of inflammatory mediators, leading to initialization and/or exacerbation of sepsis. We report two cases with a history of Liver Transplantation (LT) cases that underwent LPS filter treatment with a diagnosis of Gram-negative related septic episode and discuss the related literature. Conclusions: Our cases demonstrate that LPS filters have significant and accountable effect on prognosis in treatment of sepsis. Further studies would be promising to clarify mechanisms and effectivity profiles of these techniques to provide better treatment algorhytms.

Research paper thumbnail of HCC and Tumor Biomarkers: Does One Size Fits All?

Journal of Gastrointestinal Cancer, 2020

Hepatocellular carcinoma (HCC) is a highly malignant disease and early diagnosis rates remain to ... more Hepatocellular carcinoma (HCC) is a highly malignant disease and early diagnosis rates remain to be unsatisfactory. Owing to this limitation, advances in treatment options including liver transplantation (LT) are limited to improve survival. Recent HCC guidelines no longer recommend alpha-fetoprotein (AFP) as a surveillance and diagnostic tool for HCC. Hence, utilization of novel biomarkers has become imperative to improve disease management strategies. Noninvasive, serum-based biomarkers are potential options to aid early diagnosis as well as prompting treatment. However, further studies are required to find out the accuracy and potential of these approaches and introduce into clinical practice.

Research paper thumbnail of How to reduce and manage hepatic arterial complications in living and deceased donor liver transplantations

Hepatobiliary Surgery and Nutrition, 2021

Research paper thumbnail of Psychosocial Outcomes of Donors Whose Recipients Died After Living Donor Liver Transplantation

Journal of Gastrointestinal Cancer, 2020

Purpose Our aim was to investigate the psychosocial outcomes of the donors whose recipients died ... more Purpose Our aim was to investigate the psychosocial outcomes of the donors whose recipients died after living donor liver transplantation (LDLT). Methods Forty-one donors whose recipients died and 87 donors whose recipients were alive after LDLT at Inonu University Liver Transplantation Institute between 2012 and 2017 were included into the study. Demographic data form, Beck anxiety scale, Beck depression scale, Beck Hopelessness Scale, Posttraumatic Growth Inventory, Decision Regret Scale, Multidimensional Scale of Perceived Social Support, and general evaluation questionnaire (24 questions) were used in all donors by face to face questioning. In addition to the descriptive statistical analysis, chi-square and student's t tests were used to evaluate the differences between the groups. Results Recipient death after living donor liver transplantation is a factor that negatively increases the level of anxiety, depression, hopelessness levels, and repentance of donors, and adversely affects the psychological growth of the donors after donation experience. Conclusion Regular follow-up of the donors should be done psychosocially in the postoperative period, especially the donors whose recipients have died should be followed up more frequently, and their support and treatment should be provided when needed. The donors should also be informed about the psychosocial implications of operative management and postoperative period. More studies are needed regarding the psychosocial problems of the donors.

Research paper thumbnail of Artificial vascular graft migration into hollow viscus organs in patients who underwent right lobe living donor liver transplantation

Acta Chirurgica Belgica, 2020

Background: To share our experience with hollow viscus migration of artificial vascular grafts (A... more Background: To share our experience with hollow viscus migration of artificial vascular grafts (AVG) used for venous reconstruction of the right anterior sector in living donor liver transplantations (LDLT). Methods: Clinical, radiological, and endoscopic data of 13 right lobe LDLT patients (range: 26-67 years) with a diagnosis of postoperative AVG migration into adjacent hollow viscus were analyzed. Results: Biliary complications were detected in 12 patients. A median of four times endoscopic retrograde cholangiopancreatography (ERCP) procedures were performed in 11 patients prior to AVG migration diagnosis. A median of 2.5 times various percutaneous radiological interventional procedures were performed in eight patients prior to AVG migration diagnosis. The site of migration was the duodenum in eight patients, gastric antrum in four, and Roux limb in the remaining one patient. The migrated AVS were made of polytetrafluoroethylene (PTFE) in 10 patients and polyethylene terephthalate (Dacron) in three. The migrated AVGs were endoscopically removed in seven patients and surgically removed in six. Only one patient died due to sepsis unrelated to AVG migration. Conclusion: AVG migration into the adjacent hollow viscus following right lobe LDLT is a rare and serious complication. Repetitive ERCP, interventional radiological procedures, infection related to biliary leakage, and thrombosis of AVGs are among the possible risk factors.

Research paper thumbnail of Diaphragmatic hernias after pediatric liver transplantation: Experience of a high‐volume transplant center

Pediatric Transplantation, 2020

Diaphragmatic hernias (DHs) are rare complications after pediatric liver transplantation (PLT). I... more Diaphragmatic hernias (DHs) are rare complications after pediatric liver transplantation (PLT). It is now widely accepted that DHs after liver transplantation (LT) is a pediatric related condition. PLTs (under of age 18) performed between January 2013 and June 2019 at Malatya Inonu University Institute of Liver Transplantation were retrospectively scanned. Study group consisting DHs and a control group were compared. Among 280 PLTs, 8 of them were complicated with DHs (%2.9). Median age of the patients with DH was 3.0 (0.8‐9.5) years. Median graft recipient weight ratio was 2.5 (0.9‐4.4). Five patients were below 5th percentiles in terms of pediatric weight growth chart at the time of LT. Also, 6 patients were below 5th percentiles in terms of pediatric height growth chart. There was no statistical difference between study and control groups. There are many risk factors mentioned in literature that may be primarily responsible for DHs after PLT. These factors are left lobe and large...

Research paper thumbnail of Undetectable pancreatic insulinoma during surgery

Annals of Medical Research, 2018

Research paper thumbnail of Reconstruction of Anomalous Portal Venous Branching in Right Lobe Living Donor Liver Transplantation: Malatya Approach

Liver Transplantation, 2017

Reconstruction of anomalous portal vein branching (APVB) during right lobe living donor liver tra... more Reconstruction of anomalous portal vein branching (APVB) during right lobe living donor liver transplantation (LDLT) can be challenging. The goal of this article is to describe our surgical technique, named the Malatya Approach, in case of APVB during right lobe LDLT. The technique unifies the APVB and obtains a funnel‐shaped common extension with a circumferential fence by a saphenous vein conduit. In total, 126 (10.6%) of 1192 right lobe grafts had APVB that were divided into 2 groups according to the adopted surgical techniques: the Malatya Approach group (n = 91) and the previously defined other techniques group (n = 35). Both groups were compared regarding portal vein thrombosis (PVT), postoperative 90‐day mortality and survival. PVT developed in 3 patients (3.3%) in the Malatya Approach group and developed in 10 (28.6%) patients for the other group (P < 0.001). There were 8 (8.8%) 90‐day mortalities in the Malatya Approach group (1 PVT related) and 15 patients (9 PVT relate...

Research paper thumbnail of  Economic growth leads to increase of obesity and associated hepatocellular carcinoma in developing countries

Annals of hepatology

Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer and the third lea... more Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer and the third leading cause of cancer related death worldwide. In recent years, the prevalence of HCC has increased in both developing and developed countries. Most HCC cases develop in the presence of advanced chronic liver disease related to viral hepatitis. In particular hepatitis B virus and hepatitis C virus infections are considered as major HCC risk factors worldwide. However, current studies provide strong evidence for increasing numbers of HCC in nonalcoholic fatty liver disease (NAFLD). NAFLD represents the hepatic manifestation of metabolic syndrome which is based on obesity and insulin resistance. Epidemiologic data clearly demonstrates that NAFLD and obesity-related disorders are significant risk factors for tumor development in general and HCC in particular. As a consequence of life style changes towards higher calorie intake and less exercise, obesity and metabolic syndrome are spreading a...

Research paper thumbnail of İdiopatik Portal Ven Trombozuna Bağlı Mezenterik Venöz İskemi: Olgu Sunumu

Research paper thumbnail of Karaciğer Transplantasyonunda Supraçölyak Aorta Anastomozu: Olgu Sunumu

Research paper thumbnail of The 2-Stage Liver Transplant: 3 Clinical Scenarios

Experimental and Clinical Transplantation, 2015

The main goal of 2-stage liver transplant is to provide time to obtain a new liver source. We des... more The main goal of 2-stage liver transplant is to provide time to obtain a new liver source. We describe our experience of 3 patients with 3 different clinical conditions. A 57-year-old man was retransplanted successfully with this technique due to hepatic artery thrombosis. However, a 38-yearold woman with fulminant toxic hepatitis and a 5-year-old-boy with abdominal trauma had poor outcome. This technique could serve as a rescue therapy for liver transplant patients who have toxic liver syndrome or abdominal trauma. These patients required intensive support during long anhepatic states. The transplant team should decide early whether to use this technique before irreversible conditions develop.

Research paper thumbnail of Management of Giant Splenic Artery Aneurysm

Research paper thumbnail of Cytoprotective effects of amifostine, ascorbic acid and N-acetylcysteine against methotrexate-induced hepatotoxicity in rats

World journal of gastroenterology : WJG, Jan 7, 2014

To investigate the potential role of oxidative stress and the possible therapeutic effects of N-a... more To investigate the potential role of oxidative stress and the possible therapeutic effects of N-acetyl cysteine (NAC), amifostine (AMF) and ascorbic acid (ASC) in methotrexate (MTX)-induced hepatotoxicity. An MTX-induced hepatotoxicity model was established in 44 male Sprague Dawley rats by administration of a single intraperitoneal injection of 20 mg/kg MTX. Eleven of the rats were left untreated (Model group; n = 11), and the remaining rats were treated with a 7-d course of 50 mg/kg per day NAC (MTX + NAC group; n = 11), 50 mg/kg per single dose AMF (MTX + AMF group; n = 11), or 10 mg/kg per day ASC (MTX + ASC group; n = 11). Eleven rats that received no MTX and no treatments served as the negative control group. Structural and functional changes related to MTX- and the various treatments were assessed by histopathological analysis of liver tissues and biochemical assays of malondialdehyde (MDA), superoxide dismutase (SOD), catalase, glutathione (GSH) and xanthine oxidase activiti...

Research paper thumbnail of Frantz's tumor (solid pseudopapillary tumor) of the pancreas. A case report

JOP : Journal of the pancreas, Jan 9, 2009

A solid pseudopapillary tumor of the pancreas is a rare neoplasm which, for the most part, affect... more A solid pseudopapillary tumor of the pancreas is a rare neoplasm which, for the most part, affects young women and has a relatively favorable prognosis with a low malignant potential. These tumors usually have unclear clinical features and may form very large masses before being diagnosed. We report the case of a 29-year-old woman who underwent complete resection of the tumor using a distal pancreatectomy and splenectomy procedure. The patient is being followed-up and in good condition. A review of the relevant literature is also presented. A solid pseudopapillary tumor of the pancreas is a rare condition with a low potential for malignancy and favorable prognosis; surgical resection is generally curative.

Research paper thumbnail of Evaluation of Neurological Complications Following Living Donor Liver Transplantation

Noro Psikiyatri Arsivi, 2015

Introduction: Liver transplantation is one of the best treatment options for end-stage liver dise... more Introduction: Liver transplantation is one of the best treatment options for end-stage liver disease. In Turkey, living donor liver transplantation (LDLT) is performed more frequently than cadaveric transplantation, because organ donation is unpopular in our country. Neurological complications contribute to poor postoperative outcomes after liver transplantation. In the present study, we aimed to evaluate the outcomes of LDLT patients in whom such complications developed early during postoperative follow-up in the intensive care unit. Methods: Of 217 LDLTs performed between August 2011 and August 2012, neurology consultations were arranged for 29 patients (13.36%) because of development of new-onset neurological symptoms and/or findings in patients with neurologically uneventful preoperative histories. We retrospectively collected data on age, gender, primary disease, Model for End-Stage Liver Disease (MELD) score, and postoperative hospitalization duration of those who survived. The indications for neurological consultation and diagnoses were categorized into acute confusion/encephalopathy, epileptic seizures, leukoencephalopathy, and focal neurological deficits. The immunosuppressive treatment regimens prescribed were also considered. The outcomes of the 2 groups (with and without neurological complications) were compared. Results: The mean patient age was 44.52±16.24 years, and males predominated (65.5%, n=19). Acute confusion/encephalopathy was the most frequent complication (62.1%, n=18), followed by epileptic seizures (27.6%, n=8), cerebrovascular disease (6.9%, n=2), and leukoencephalopathy (3.4%, n=1). Statistically significant between-group differences in age (44.5±16.2 vs. 34.33±20.98 years; p<0.001), and proportions of patients with a disease of viral etiology (55.17% vs. 35.63%, p<0.05), were evident. Mortality was significantly higher in the group with neurological complications (65.5% vs. 37.32%, p<0.05). The duration of postoperative hospitalization was also significantly longer in this group (29.80±15.04 vs. 10.00±5.47 days; p<0.05). Conclusion: Mortality was significantly higher and the duration of postoperative hospitalization significantly longer in LDLT patients with new-onset neurological complications than in those without such complications.

Research paper thumbnail of Infections in the Intensive Care Unit Following Liver Transplantation: Profile of a Single Center

Russian Journal of Transplantology and Artificial Organs, 2014

Research paper thumbnail of En Masse Resection of Pancreas, Spleen, Celiac Axis, Stomach, Kidney, Adrenal, and Colon for Invasive Pancreatic Corpus and Tail Tumor

Case Reports in Surgery, 2013

Providing a more comfortable life and a longer survival for pancreatic corpus/tail tumors without... more Providing a more comfortable life and a longer survival for pancreatic corpus/tail tumors without metastasis depends on the complete resection. Recently, distal pancreatectomy with celiac axis resection was reported as a feasible and favorable method in selected pancreatic corpus/tail tumors which had invaded the celiac axis. Additional organ resections to the celiac axis were rarely required, and when necessary it was included only a single extra organ resection such as adrenal or intestine. Here, we described a distal pancreatic tumor invading most of the neighboring organs—stomach, celiac axis, left renal vein, left adrenal gland, and splenic flexure were treated by en bloc resection of all these organs. The patient was a 60-year-old man without any severe medical comorbidities. Postoperative course of the patient was uneventful, and he was discharged on postoperative day eight without any complication. Histopathology and stage of the tumor were adenocarcinoma and T4 N1 M0, respe...