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Öğe A case of krukenberg tumor, eight years after treatment of gastric cancer(Article)(Open Access) [Mide kanseri tedavisinden 8 yil sonra Gelişen Krukenberg tümörü olgusu](2018) Karagül, S.; Sümer, F.; Onur, A.; Tardu, A.; Dağli, A.F.; Kayaalp, C.Krukenberg tumor is a rare metastatic tumor of the ovary. The primary tumors are usually gastrointestinal cancers. Most of the Krukenberg tumors reported in the literature occurred within the first 2 years after treatment of the primary disease. Herein, we present a case of Krukenberg tumor in a 37-year-old woman who previously underwent surgery and chemotherapy for stomach cancer. This patient is noteworthy because it is one of the few documented cases of ovarian metastasis appearing after a disease-free period of 8 years following treatment of the primary tumor. Krukenberg tumors are associated with poor prognosis; therefore, regular gynecological examination in female patients with history of gastric cancer is very important for the early diagnosis and treatment of this disease. © 2018, Marmara University. All rights reserved.Öğe Futility Versus Acceptability of the Use of Grafts Taken From End of Line in the National Organ-Sharing Network(Elsevier Science Inc, 2015) Soyer, V.; Koc, S.; Onur, A.; Sarici, B.; Kayaalp, C.; Isik, B.; Unal, B.Background. The number of suitable donors for organ transplantation is limited in many countries. This limitation can be overcome with the use of organs removed from marginal donors (expanded-criteria donors [ECDs]). We examined the long-term results of 187 patients who underwent marginal cadaveric liver transplantation in our institution. Methods. The data of patients who underwent cadaveric liver transplantation from January 2007 to April 2014 were retrospectively reviewed. ECDs were evaluated by considering 19 internationally accepted criteria. The clinical data of recipients including age, clinical status, and Model for End-Stage Liver Disease (MELD) score were also assessed. Results. A total of 287 patients underwent cadaveric liver transplantation. A graft from an ECD was used in 181 (63.06%) patients. The mean MELD score was 18.8. In all, 45 patients (24.86%) underwent transplantations for fulminant liver failure and 136 patients (75.14%) underwent transplantations for other chronic conditions. The majority of donors died of cerebrovascular disease and trauma. Only hypotension requiring inotropic drugs and obesity significantly affected survival. The 90-day and 12-month survival rates of the recipients who received a graft from an ECD were 51.93% and 46.2%, respectively. Conclusions. The use of ECD allografts immediately and significantly expands the existing donor pool. Because of persistent organ scarcity, pressure to use a greater proportion of the existing donor pool will continue to increase.Öğe Liver Transplantation With Livers From Octogenarians and a Nonagenarian(Elsevier Science Inc, 2015) Dirican, A.; Soyer, V.; Koc, S.; Yagci, M. A.; Sarici, B.; Onur, A.; Unal, B.Introduction. A shortage of deceased donors has compelled the use of extended-criteria donor organs in liver transplantation. The purpose of this study was to evaluate the impact of using deceased donors older than 80 years. Materials and Methods. We retrospectively evaluated 13 patients who received a liver graft from cadaveric donors older than 80 years between December 2007 and March 2014. We analyzed the donor and their recipient characteristics together with morbidity and mortality of recipients. Results. All 13 donors were older than 80 years (median age, 82.7; range, 80-93). There were 9 male and 4 female recipients with an average age of 50.7 (range, 2-65) years. All of the recipients did not have a living donor for liver transplantation. Recipients' mean model for end-stage liver disease (MELD) score was 14.2 (range, 7-20). Graft with macroscopic steatosis was not accepted. Medium follow-up was 19.5 months. The most frequent cause for liver transplantation (LT) was hepatitis B virus (HBV) cirrhosis (8/13 patients). We had 1 case of primary nonfunction, and 4 patients died in 2 weeks after surgery. Of these patients, 2 of them received a split transplant from an 80-year-old cadaver liver. Overall the survival rate after 1 year was 61.5%. Conclusions. Deceased elderly donor usage in LT could expand the donor pool. Liver grafts from donors older than 80 years can be used in necessity or emergency situations. However, care should be taken to avoid early mortality and primary nonfunction. Procedures extending cold ischemia time such as split liver transplantation may increase the risk of primary nonfunction.Öğe Potentially life-threatening complication for living liver donors: Near-Miss Events(Lippincott Williams & Wilkins, 2018) Onur, A.; Akbulut, S.; Dirican, A.; Yilmaz, S.[Abstract Not Available]
