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Öğe The causes of death-censored graft loss among kidney transplant recipients(2024) Ciftci, Felat; Simsek, Arife; Piskin, Turgut; Unal, Bulent; Dogan, Sait Murat; Ulutas, Ozkan; Tabel, YilmazAim: This study presents the causes of death-censored graft loss among kidney transplant recipients. Materials and Methods: Medical records of the patients, who had undergone kidney transplantation at a tertiary center between November 2010 and December 2018, were retrospectively reviewed. Death-censored graft loss was described as an irreversible graft failure signified by return to long-term dialysis (or re-transplantation). Inclusion criteria were: patients who had undergone kidney transplantation, and subsequently lost their first graft, and a follow-up of more than one year after kidney transplantation. Results: Of 269 kidney transplant recipients, 33 recipients with a mean age of 33.54 ± 15.37 years (17 male and 16 female) were included in the study. The rate of death-censored graft loss was 12.26%. Of graft failures, 3.03% occurred in the hyperacute phase, 18.18% in the acute phase, and 78.78% in the chronic phase. Chronic allograft nephropathy was the leading cause of graft failure (48.48%). Other causes were medical problems (18.18), immunological problems (18.18%) and surgical complications (15.15%). Conclusion: Identification of the true causes of graft failure described under the heading chronic allograft nephropathy is noteworthy. Comprehensive biochemical, physiological, pathological, immunological, and genetÖğe Ectopic liver tissue (choristoma) on the gallbladder: A comprehensive literature review(Baishideng Publishing Group Inc, 2020) Akbulut, Sami; Demyati, Khaled; Ciftci, Felat; Koc, Cemalettin; Tuncer, Adem; Sahin, Emrah; Karadag, NeseBACKGROUND Liver tissue situated outside the liver with a hepatic connection is usually called an accessory liver, and that without a connection to the mother liver, is called ectopic liver tissue. AIM To identify studies in the literature on ectopic liver tissue located on the gallbladder surface or mesentery. METHODS We present two patients and review published articles on ectopic liver tissue located on the gallbladder surface accessed via PubMed, MEDLINE, Google Scholar, and Google databases. Keywords used included accessory liver lobe, aberrant liver tissue, ectopic liver tissue, ectopic liver nodule, heterotopic liver tissue, hepatic choristoma, heterotopic liver tissue on the gallbladder, and ectopic liver tissue on the gallbladder. The search included articles published before June 2020 with no language restriction. Letters to the editor, case reports, review articles, original articles, and meeting presentations were included in the search. Articles or abstracts containing adequate information on age, sex, history of liver disease, preliminary diagnosis, radiologic tools, lesion size, surgical indication, surgical procedure, and histopathological features of ectopic liver tissue were included in the study. RESULTS A total of 72 articles involving 91 cases of ectopic liver tissue located on the gallbladder surface or mesentery were analyzed. Of these 91 patients, 62 were female and 25 were male (no gender available for 4 patients), and the age range was 5 d to 91 years. Forty-nine patients underwent surgery for chronic cholecystitis or cholelithiasis, and 14 patients underwent surgery for acute cholecystitis. The remaining 28 patients underwent laparotomy for other reasons. Cholecystectomy was laparoscopic in 69 patients and open in 11 patients. The remaining 19 patients underwent various other surgical procedures such as autopsy, liver transplantation, living donor hepatectomy, Whipple procedure, and liver segment V resection. Histopathologically, hepatocellular carcinoma was detected in the ectopic liver tissue of one patient. CONCLUSION Ectopic liver tissue is a rare developmental anomaly which is usually detected incidentally. Although most studies suggest that ectopic liver located outside the gallbladder has a high risk of hepatocellular carcinoma, this is not reflected in statistical analysis.Öğe Histopathological Evaluation of Gallbladder Specimens Obtained From Living Liver Donors(Elsevier Science Inc, 2023) Akbulut, Sami; Sarici, Kemal Baris; Toprak, Serhat; Tuncer, Adem; Ciftci, Felat; Karadag, Nese; Gurluler, ErcumentBackground. Cholecystectomy is routinely performed during living donor hepatectomy both to see the structure of the biliary tract and to determine the demarcation line based on the biliary tract junction. This study aims to present the general histopathological features of the gallbladder specimen obtained from living liver donors (LLD). Methods. Data from 2577 LLDs who underwent living donor hepatectomy (n = 2511) or aborted living donor hepatectomy (n = 66) in our Liver Transplantation Institute between September 2005 and June 2021 were analyzed retrospectively. Age, gender, macroscopic (length, diameter, and wall thickness), and microscopic (histopathological) features of the gallbladder of the LLDs were recorded for use in this study. Results. A total of 2493 LLDs (men: 1486, women: 1007) with a median age of 29 years (interquartile range [IQR]: 13) met the inclusion criteria in this study. The median length, width and wall thickness of the gallbladder specimens were measured as 70 mm (IQR: 20), 50 mm (IQR: 20), and 2 mm (IQR: 1), respectively. The most common histopathological findings are normal structure (2026; 81.3%), chronic cholecystitis (n = 446; 17.9%), adenomyomatosis (n = 9), and papillary hyperplasia (n = 6), respectively. The most common pathologic findings in the gallbladder lumen are cholesterolosis (n = 207; 0.4%), cholelithiasis (n = 53), cholesterol polyp (n = 31), and noncholesterol polyp (n = 19), respectively. Significant differences were detected between the male and (content) (P < .001), and lymph node around the gallbladder (P = .015). Conclusions. The results we obtained in this study are true gallbladder pathologies that can be detected in healthy people. In this study, it was shown that the diameter and size of the gallbladder were larger in men, whereas the incidence of cholesterolosis and cholelithiasis was higher in women.Öğe Laparoscopic management of giant gastrointestinal stromal tumor masquerading as infected mesenteric cyst(Edizioni Luigi Pozzi, 2018) Akbulut, Sami; Ciftci, Felat; Dirican, AbuzerGastrointestinal stromal tumors (GISTs) are the most common non-epithelial (mesenchymal) tumors of the gastrointestinal tract. Although GISTs appear as solid and well-circumscribed lesions in most patients, they may also appear as solid-cystic (mixed) or pure cystic lesions due to reasons like intra-tumor hemorrhage and necrosis in a very small percentage of patients. Hence, cystic GISTs mostly lead to a diagnostic dilemma. In this paper we aimed to report a case of pure cystic giant GIST that was drained percutaneously twice after being misdiagnosed as a mesenteric cyst. An 83-year-old man was operated for a pre-diagnosis of a recurrent mesenteric cyst. The operation was started with the three-trocar laparoscopic technique. Six thousand milliliters of purulent fluid were drained from the cystic lesion. Then, a mini incision was performed above the umbilicus and the cyst and the distal ileal segment where it was originated were removed from the abdominal cavity. After the resection of a 15-cm ileal segment together with the cystic lesion, an intestinal anastomosis was performed. The histopathological and immunohistochemical findings showed that the mass was a GIST (size: 20 cm, mitosis: 3/50 HPF; Ki 67: %15, CD117: positive, DOG-1: positive). The patient was closely followed without imatinib therapy.Öğe Retrospective view and treatment of iatrogenic ureteral injuries(2020) Eryilmaz, Recep; Aslan, Rahmi; Demir, Murat; Duran, Arif Mehmet; Ciftci, Felat; Taken, KeremAim: Ureteral injuries are rare. Iatrogenic ureteral injury is the most common cause of ureteral traumas. This letter aims, evaluation of iatrogenic ureteral traumas and treatments.Material and Methods: Thirty two patients with major iatrogenic ureteral trauma were enrolled. Sonography, intravenous pyelography, CT of abdomen (contrast-enhanced and non-contrast enhanced), antegrade X-rays or diagnostic ureterenoscopy are used for the diagnosis. All patients were undergone endoscopic ureterenoscopy before the ureter was surgically repaired. Next, the surgical technique was decided. Injuries that can be managed with endoscopic approach were treated by inserting a Double J stent. For patients who were not eligible for endoscopic treatment, treatment was decided according to the location of ureteral injury.Results: Of the patients, 25 were female and 7 were male and mean age was 46.31±16.485 years. Ureteral injury was secondary to gynecologic intervention in 16 patients, general surgery procedures in 6 patients and urologic surgery in 10 patients. According to AAST, Grade 4-5 injury was identified in 71.9% of 32 patients, while Grade 3 and Grade 2 injuries were noted in 15.6% and 12.5% of patients, respectively. Four patients were treated in late period, while intraoperative or early treatment was instituted for 28 patients.Conclusion: Iatrogenic ureteral injuries develop mostly after laparoscopic or endoscopic pelvic surgeries. We should prefer endoscopic insertion of Double J stent for the first-line treatment.