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Öğe Compatible ABO mismatch and liver transplantation: A single center's experience(2006) Aladag M.; Gurakar A.; Camci C.; Yong Y.; Wright H.; Nour B.; Sebastian A.Objectives: The current shortage of suitable donor organs and clinical urgency can lead to implanting grafts from ABO-mismatched donors. One-year graft survival rates for patients in this scenario have been reported as ranging between 25% and 75% less than those for ABO-identical or ABO-compatible grafts. We review and compare our experiences with transplanting ABO-identical and ABO-compatible mismatched livers. Materials and Methods: Considering orthotopic liver transplantation (OLTx), 520 were performed at our institution between November 1992 and May 2003, 55 of which were ABO-compatible mismatched transplants. We retrospectively reviewed the data and compared patient and graft survival rates. Results: Overall 1-month and 1-, 5-, and 10-year patient survival rates among identical (group 1) and mismatched (group 2) groups were 97% and 91%, 90%, and 88.5%, and 79%, and 74%, 66%, and 65%, respectively. No significant difference existed between the 2 groups (P > .05). Similarly, 1-month, and 1-, 5-, and 10-year graft survival rates among groups 1 and 2 were 96% and 87%, 89% and 83%, 78% and 71% and 66% and 59%, respectively; these were not significant either (P > .05). All of the patients in the mismatched group had a high status according to the United Network for Organ Sharing (UNOS). Only 1 person received an incompatible mismatched graft (B to A), which subsequently developed primary nonfunction. Conclusions: ABO-compatible mismatch OLTx is unavoidable given the current state of organ shortage. Our results suggest that this type of OLTx can be performed with minimal risk among patients who require urgent transplantation and have high rankings according to the UNOS and the model for end-stage liver disease (MELD) system. Copyright © Başkent University 2006 Printed in Turkey. All Rights Reserved.Öğe Endoscopic retrograd cholongiopancreatography results in diagnosis and therapy(1999) Hilmioglu F.; Yildirim B.; Karincaoglu M.; Aladag M.; Taskin V.; Kantarceken B.The use of diagnostic and therapeutic endoscopy for pancreaticobiliary disease has increased in recent years. Choledocholithiasis and malignant strictures are most common diagnosis on endoscopic retrograde cholangiopancreatography (ERCP). We reviewed our recent experience to assess the spectrum of procedures performed and their results. Medical records and radiographic examinations of 338 consecutive patients undergoing therapeutic ERCP were studied. The most common diagnoses were choledocholithiasis and malignant strictures. Successful cannulation was 91.7% and successful treatment was 90%.Öğe Endoscopic treatment of biliary fistulas: Results of 20 patients(1999) Hilmioglu F.; Yildirim B.; Karincaoglu M.; Aladag M.; Kantarceken B.; Dogan I.Biliary fistula is an infrequent but serious complication which usually occurs following biliary tract surgery. In this study treatment consisted of standard sphincterotomy and if necessary, stone extraction with or without endoprosthesis placement. The aim of all treatments was to facilitate bile flow into the duodenum. The biliary tract and site of leakage were visualized during endoscopic retrograde cholangiopancreatography (ERCP) in all patients (100%) and 16 of 20 patients were treated endoscopically (80%). Bile leakage can be diagnosed safely and effectively by ERCP and subsequent endoscopic management is successful in most cases.Öğe Evaluation of choledochal stones(1999) Karincaoglu M.; Aladag M.; Yildirim B.; Hilmioglu F.We present a four year review of patients with suspected gallstones, in whom endoscopic retrogade cholangiopancreatography (ERCP) was performed prior to cholecystectomy. ERCP was performed on 84 patients with a provisional diagnosis of gallstones but stones were found in only 53 of these patients. The most sensitive diagnostic screening method was found to be alkaline phosphatase while the most specific was screening of intrahepatic bile duct dilation with ultrasound.Öğe The prevalence of lymphoid follicles and intestinal metaplasia in Helicobacter pylori associated clinically significant gastroduodenal diseases(Turkish Society of Gastroenterology, 1999) Taskin V.; Gurer I.; Sari R.; Aydin A.; Yildirim B.; Aladag M.; Hilmioglu F.This study was designed to investigate the prevalence of lymphoid follicle formation and intestinal metaplasia in patients with Helicobacter pylori (H.pylori) associated clinically significant diseases. Biopsies from the antrum, corpus and fundus of stomach were obtained from 153 patients (non-ulcer dyspepsia, n:110; duodenal ulcer n:23, duodenal ulcer complicated by obstruction, n:20) with histopathologically proven H. pylori infection. All biopsies were examined for lymphoid follicle with germinal center and intestinal metaplasia. Lymphoid follicles were found in 44.5% of non-ulcer disypeptic patients, 70% of duodenal ulcer complicated by obstruction patients and in 47.8% of uncomplicated duodenal ulcer patients. In contrast, 15.5% of non-ulcer disypeptic patients and 20% of complicated duodenal ulcer patients had associated intestinal metaplasia while no intestinal metaplasia was observed in uncomplicated duodenal ulcer patients. Intestinal metaplasia incidence was not statistically different among the different gastroduodenal pathologies (P>0.05). However the incidence of lymphoid follicles was significantly higher in patients with complicated duodenal ulcer (P<0.05). Our results indicate that H.pylori infection in complicated duodenal ulcers are relatively chronic and aggressive compared to H.pylori infection in other gastroduodenal disorders.
