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Öğe Kaposis sarcoma after liver transplantation from a donor with a history of ventriculoperitoneal shunt and craniotomy for primary central nervous system lymphoma report of a case(Surgery Today, 2008) Işık, Burak; Yılmaz, Sezai; Kırımlıoğlu, Vedat; Kırımlıoğlu, Hale; Yılmaz, Mehmet; Söğütlü, Gökhan; Ara, Cengiz; Katz, DanielThe transplantation of organs from donors who have undergone shunt surgery or craniotomy for a malignant central nervous system (CNS) tumor is controversial. We report a case of Kaposi’s sarcoma (KS) developing as a result of immunosuppression in the recipient of a liver transplant from a donor who underwent craniotomy and ventriculoperitoneal shunt surgery for primary CNS lymphoma. Polymerase chain reaction assay did not isolate human herpes virus-8 in the Kaposi lesions. To our knowledge, this is the only case ever reported of KS developing after liver transplantation from a donor with lymphoma. Thus, with appropriate screening to exclude possible dissemination, patients with a history of high-grade primary CNS lymphoma treated by ventriculoperitoneal shunt and craniotomy may be accepted as donors.Öğe A life saving but inadequately discussed procedure tube duodenostomy known and unknown aspects(World Journal of Surgery, 2007) Işık, Burak; Yılmaz, Sezai; Kırımlıoğlu, Vedat; Söğütlü, Gökhan; Yılmaz, Mehmet; Katz, DanielObjective The most successful method of managing the difficult duodenum, including the stump leakage, has been the tube duodenostomy technique, but it has not gained wide acceptance and is rarely used. The purpose of this study is to describe the details of the procedure for indication, technical approach, and postoperative care. Methods During the period from 1998 to 2006, a tube duodenostomy was performed in 31 patients for possible insecure duodenal stump closure during gastric resection, postoperative duodenal stump leakage, duodenal leak after primary closure of duodenum for perforation or injury, or anostomotic leak after choledochoduodenostomy. All of the tube duodenostomies were performed through the open end of the duodenum. We also inserted a T-tube into the common bile duct in 19 of 31 patients (61.2 %) with tube duodenostomy.Öğe Urgent revascularization of a liver allograft with a saphenous vein interposition graft between the hepatic artery and the recipient splenic artery after late hepatic artery thrombosis(Digestive Diseases and Sciences, 2005) Yılmaz, Sezai; Kırımlıoğlu, Vedat; Işık, Burak; Yılmaz, Mehmet; Kırımlıoğlu, Saime Hale; Ara, Cengiz; Söğütlü, Gökhan; Battaloğlu, Bektaş; Katz, DanielHepatic artery thrombosis (HAT) after liver transplantation is a severe complication which may lead to graft infarction and subsequent graft loss. It complicates 2–12% of adult liver transplantations (1, 2) and subsequently leads to retransplantation in 50–75% of patients (3). Fortunately, innovations in Doppler ultrasonography and digital angiography technologies have provided an accurate and rapid method for detecting HAT before ischemic damage of the allograft (4). Revascularization procedures that can be performed once the diagnosis of HAT has been confirmed include thrombectomy alone, intrahepatic arterial thrombolysis with thrombolytic agents, creation of a new anastomosis between a more proximal part of the recipient artery and a more distal part of the donor hepatic artery, and introduction of an interposition graft (3). Early diagnosis is a prerequisite for these revascularization strategies.