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Öğe Development of a model to predict the risk of early graft failure after adult-to-adult living donor liver transplantation: An ELTR study(Lippincott Williams & Wilkins, 2024) Giglio, Mariano Cesare; Dolce, Pasquale; Yilmaz, Sezai; Tokat, Yaman; Acarli, Koray; Kilic, Murat; Zeytunlu, MuratGraft survival is a critical end point in adult-to-adult living donor liver transplantation (ALDLT), where graft procurement endangers the lives of healthy individuals. Therefore, ALDLT must be responsibly performed in the perspective of a positive harm-to-benefit ratio. This study aimed to develop a risk prediction model for early (3 months) graft failure (EGF) following ALDLT. Donor and recipient factors associated with EGF in ALDLT were studied using data from the European Liver Transplant Registry. An artificial neural network classification algorithm was trained on a set of 2073 ALDLTs, validated using cross-validation, tested on an independent random-split sample (n=518), and externally validated on United Network for Organ Sharing Standard Transplant Analysis and Research data. Model performance was assessed using the AUC, calibration plots, and decision curve analysis. Graft type, graft weight, level of hospitalization, and the severity of liver disease were associated with EGF. The model (http://ldlt.shinyapps.io/eltr_app) presented AUC values at cross-validation, in the independent test set, and at external validation of 0.69, 0.70, and 0.68, respectively. Model calibration was fair. The decision curve analysis indicated a positive net benefit of the model, with an estimated net reduction of 5-15 EGF per 100 ALDLTs. Estimated risks>40% and<5% had a specificity of 0.96 and sensitivity of 0.99 in predicting and excluding EGF, respectively. The model also stratified long-term graft survival (p<0.001), which ranged from 87% in the low-risk group to 60% in the high-risk group. In conclusion, based on a panel of donor and recipient variables, an artificial neural network can contribute to decision-making in ALDLT by predicting EGF risk.Öğe The effect of clinicopathologic findings of hepatocellular carcinoma on posttransplant survival: a multcenter cohort from TASL liver transplantation special interest group(Elsevier, 2022) Akyildiz, Murat; Gencdal, Genco; Ince, Volkan; Harputluoglu, Muhsin Murat; Bozkurt, Birkan; Zeytunlu, Murat; Kilic, Murat[Abstract Not Available]Öğe Immunohistochemical Expressions of the Antimicrobial Peptides (hBD-3 and hCAP-18/LL-37) in Colon, Stomach and Lung Adenocarcinomas(Akad Doktorlar Yayinevi, 2015) Kilic, Murat; Oguztuzun, Serpil; Simsek, Gulcin; Cakir, EbruThis study investigated the immunohistochemical staining characteristics of human beta defensin-3 (hBD-3) and human cationic antimicrobial peptide-18/cathelicidin (hCAP-18/LL-37) in colon, stomach and lung adenocarcinomas and normal tissues (periphery to tumor tissues) from 22, 24 and 24 patients, respectively. Expressions of hBD-3 and hCAP-18/LL-37 were assessed by immunohistochemistry for colon, stomach and lung adenocarcinomas of 70 patients from Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital and Kecioren Training and Research Hospital. both located in Ankara, Turkey. The differences between the expressions of hBD-3 and hCAP-18/LL-37 in normal and carcinoma tissues were analyzed by Mann-Whitney U Test. When the normal and tumor tissues of these cases were compared according to their staining intensity of positive staining, the hBD-3 and hCAP-18/LL-37 expressions in colon, stomach and lung adenocarcinomas cells were significantly higher than those in normal cells (p<0.05). Immunostaining of HBD-3 and hCAP-18/LL-37 was found to be a marker of malignancy in colon, stomach and lung adenocarcinomas. The expressions of hBD-3 and hCAP-18/LL-37 were, for the first time, shown to be significantly altered in colon, stomach and lung adenocarcinomas as compared to controls. In conclusion, the present findings suggest that beside the antimicrobial activity of Antimicrobial Peptides (AMPs), hBD-3 and hCAP-18/LL-37 can also play a role in the pathogenesis of colon, stomach and lung adenocarcinomas.Öğe The influence of pneumothorax, pneumomediastinum, and other factors on the mortality and morbidity in patients with viral infections(2024) Kilic, Murat; Karatepe, UmitAim: This study examines the effects of pneumothorax and pneumomediastinum on the mortality and morbidity of patients with respiratory virus infections. It analyses blood parameters and the Systemic Immune Inflammation Index (SII) in patients who acquired these complications compared to those who did not. Materials and Methods: We conducted a retrospective assessment of 2246 COVID19 patients who received treatment at our medical facility between August 2020 and February 2021. This study included a total of 118 patients who were admitted to the hospital due to a respiratory virus illness. The patients were categorised into two groups: one consisting of individuals who experienced pneumothorax and/or pneumomediastinum, and the other consisting of individuals who did not acquire these complications. Both groups had an equal number of participants. The study analysed many factors including metabolic profiles, hemogram results, length of hospital stay, SII levels, and the incidence of pneumothorax, with a focus on their association with morbidity and mortality outcomes. Results: Significantly, female patients who experienced pneumothorax during COVID19 treatment exhibited a worse mortality rate. Patients with pneumothorax had elevated leukocyte and neutrophil counts, along with heightened systemic immune-inflammation index (SII) and decreased levels of total protein and albumin. The data highlight the potential importance of specific blood measurements, as well as the presence of pneumothorax, as indications for death in patients with respiratory virus infections. Conclusion: For enhanced patient outcomes, it is important to closely monitor and manage female patients who get pneumothorax after receiving therapy for respiratory virus infection.
