Yazar "Kement, M." seçeneğine göre listele

Listeleniyor 1 - 2 / 2
  • Küçük Resim Yok
    Öğe
    Pregnancy After Liver Transplantation: Risks and Outcomes
    (Elsevier Science Inc, 2017) Baskiran, A.; Karakas, S.; Ince, V.; Kement, M.; Ozdemir, F.; Ozsay, O.; Kutluturk, K.
    Objective. The aim of this study was to evaluate the outcomes of liver transplant recipients who became pregnant after transplantation. Methods. The clinical data of all patients who underwent liver transplantation between January 2007 and December 2016 in our liver transplantation institute were reviewed. The following data were analyzed: indications for transplantation, recipient age at the beginning of pregnancy, the interval between transplantation and pregnancy, maternal and fetal complications, type of delivery, the health condition of neonates, and modifications in immunosuppressive therapy. Results. During the study period, 1890 patients underwent liver transplantation. There were 185 women (9.8%) in childbearing age (15-45 years old), and 18 (9.7%) of them became pregnant during the study period. There were a total of 26 pregnancies. The mean age of patients at the time of operation was 25.3 +/- 5.2 years, and the mean interval between operation and conception was 32.7 +/- 15.3 months. Seventeen pregnancies (65.4%) ended in a live birth in the study. Six pregnancies (23%) resulted with no maternal or fetal complications. The most frequent maternal complication during pregnancy was pregnancy induced hypertension (n = 3; 16.6%). Conclusions. Despite advances in immunosuppressive therapy and increasing experience in the management of these patients, pregnancies in liver transplant recipients are still more risky than in the general population for both the mother and the fetus. Thus, the issues related to fertility should be comprehensively discussed with the patients and their partners, preferably before transplantation, and pregnancies in liver transplant recipients should be followed up more carefully by a multidisciplinary team.
  • Küçük Resim Yok
    Öğe
    Significance and Outcome of Living-donor Liver Transplantation in Acute Mushroom Intoxication
    (Wolters Kluwer Medknow Publications, 2018) Baskiran, A.; Dirican, A.; Ozgor, D.; Kement, M.; Koc, S.; Sahin, T. T.; Ates, M.
    Introduction: Mushroom intoxication ( MT) can lead to acute liver injury which may result in Mushroom intoxication-related liver failure ( M-ALF) requiring liver transplantation ( LT). In the present study, we want to share the experience of our institute regarding living-donor LT ( LDLT) due to mushroom poisoning. Aim: The aim of this study is to identify the predictors of poor prognosis in patients with ALF secondary to mushroom intoxication requiring LDLT. Materials and Methods: All patients with MT between 2008 and 2016 were evaluated. Demographics, symptoms, interval between symptoms and admission to our institute, laboratory data, model for end-stage liver disease ( MELD)/ pediatric end-stage liver disease ( PELD) scores, clinical course, and outcomes of supportive therapy and LT were evaluated. There were two groups in the study: Group A = responsive to supportive therapy ( n = 9) versus Group B = unresponsive to supportive therapy ( n = 9). Results: During the study, a total of 18 patients were admitted with M-ALF. Twelve ( 66.7%) of them were female, and the mean age was 39.9 +/- 18.2 years. All of the nine patients in Group A fully recovered with supportive therapy. In Group B, one patient died during waiting period for LT and 8 patients received LDLT LDLT. Three of the eight patients who were transplanted died in the postoperative early period within postoperative 5 days. The patients in Group B had significantly higher MELD/ PELD scores and encephalopathy rate than in Group A ( P < 0.05). International normalized ratio ( INR), bilirubin, ammonium levels, and platelet count were significantly different between groups ( P < 0.05). The patients in Group B had significantly longer interval before admission to our institute ( P < 0.05). Conclusion: The presence of encephalopathy, higher MELD/ PELD, INR, bilirubin, ammonium levels, and lower platelet count was related to poor prognosis in MT. LDLT provides a good therapeutic option in patients with M-ALF. The time is a crucial factor in successful treatment of MT. Early admission to a tertiary referral center with expertise in LT results in a better prognosis and increased survival following M-ALF.