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Öğe Aborted Donor Hepatectomies for Living Donor Liver Transplantation: A Single Center Experience(Lippincott Williams & Wilkins, 2016) Kutluturk, Koray; Otan, Emrah; Dirican, Abuzer; Yilmaz, Mehmet; Isik, Burak; Ozdemir, Fatih; Ince, Volkan[Abstract Not Available]Öğe Analysis of Risk Factors Affecting the Development of Infection in Artificial Vascular Grafts Used for Reconstruction of Middle Hepatic Vein Tributaries in Living Donor Liver Transplantation(Lippincott Williams & Wilkins, 2019) Koc, Cemalettin; Akbulut, Sami; Ozdemir, Fatih; Kose, Adem; Isik, Burak; Yologlu, Saim; Yilmaz, SezaiBackground. To analyze the risk factors affecting the development of infection in artificial vascular grafts (AVGs) used for reconstruction of middle hepatic vein (MHV) tributaries in living donor liver transplantation (LDLT). Methods. Between January 2009 and January 2018, 1253 right lobe LDLTs were performed at our Transplant Institute, and MHV tributaries of the 640 right lobe liver grafts were reconstructed with AVG. Reconstructed MHV tributaries were removed due to AVG infection in 25 of these patients (case group; n = 25). To determine risk factors for AVG infection, right lobe LDLT patients without AVG infections were selected as control group (n = 615). Both groups were compared about demographic parameter, transcystic catheter usage, bile leakage, type of biliary anastomosis (duct-to-duct, telescopic duct-to-duct), number of graft biliary duct (=1 versus >1), number of biliary anastomosis (=1 versus >1), AVG thrombosis, AVG types (Dacron versus polytetrafluoroethylene). Univariate analyses were used for comparison of different variables, and variables with P <= 0.20 were taken into logistic regression model. Results. Univariate analysis shows that statistically significant differences were found between groups regarding bile leakage (P < 0.001), graft thrombosis (P = 0.002), transcystic catheter (P = 0.049), and AVG types (P = 0.013). Variables with P <= 0.20 were taken into logistic regression model. Multivariate analysis shows that bile leakage (odds ratio, 13.3) and AVG thrombosis (odds ratio, 9.8) were determined as independent and strong risk factors for development of AVG infection. Conclusions. This study revealed that bile leakage and graft thrombosis are independent and strong risk factors for infections of AVGs used for anterior sector drainage reconstruction.Öğe Auxiliary Reno-Portal Anastomosis in Living Donor Liver Transplantation: A Novel Technique for Recipients with Low Portal Inflow(Wiley-Blackwell, 2012) Akbulut, Sami; Kayaalp, Cuneyt; Yilmaz, Mehmet; Ozdemir, Fatih; Yilmaz, Sezai[Abstract Not Available]Öğe Budd Chiari Syndrome Secondary to Compressive Effect of Giant Hydatid Cyst(Wiley-Blackwell, 2012) Yilmaz, Mehmet; Ozdemir, Fatih; Akbulut, Sami; Kahraman, Aysegul; Yilmaz, Sezai[Abstract Not Available]Öğe Chylous ascites after liver transplantation: Incidence and risk factors(Wiley-Blackwell, 2012) Yilmaz, Mehmet; Akbulut, Sami; Isik, Burak; Ara, Cengiz; Ozdemir, Fatih; Aydin, Cemalettin; Kayaalp, CuneytIn this study, we evaluated the diagnosis, epidemiology, risk factors, and treatment of chylous ascites developing after liver transplantation (LT). Between 2002 and 2011, LT was performed 693 times in 631 patients at our clinic. One-hundred fifteen of these patients were excluded for reasons such as retransplantation, early postoperative mortality, and insufficient data. Chylous ascites developed after LT (mean +/- SD = 8.0 +/- 3.2 days, range = 5-17 days) in 24 of the 516 patients included in this study. Using univariate and multivariate analyses, we examined whether the following were risk factors for developing chylous ascites: age, sex, body mass index, graft-to-recipient weight ratio, Model for End-Stage Liver Disease score, vena cava cross-clamping time, total operation time, Child-Pugh classification, sodium level, portal vein thrombosis or ascites before transplantation, donor type, albumin level, and perihepatic dissection technique [LigaSure vessel sealing system (LVSS) versus conventional suture ligation]. According to a univariate analysis, a low albumin level (P = 0.04), the presence of ascites before transplantation (P = 0.03), and the use of LVSS for perihepatic dissection (P < 0.01) were risk factors for developing chylous ascites. According to a multivariate Cox proportional hazards model, the presence of pretransplant ascites [P = 0.04, hazard ratio (HR) = 2.8, 95% confidence interval (CI) = 1.1-13.5] and the use of LVSS for perihepatic dissection (P = 0.01, HR = 5.4, 95% CI = 1.5-34.4) were independent risk factors. In conclusion, the presence of preoperative ascites and the use of LVSS for perihepatic dissection are independent risk factors for the formation of chylous ascites. To our knowledge, this study is the most extensive examination of the development of chylous ascites. Nevertheless, our results should be supported by new prospective trials. Liver Transpl, 2012. (C) 2012 AASLD.Öğe Correction of Portal Venous Narrowing With Saphenous Vein Graft During Right Lobe Living Donor Hepatectomy(Lippincott Williams & Wilkins, 2015) Koc, Cemalettin; Ozdemir, Fatih; Soyer, H. Vural; Dirican, Abuzer; Isik, Burak; Yilmaz, Mehmet; Yilmaz, Sezai[Abstract Not Available]Öğe Deceased donor liver transplantation from donors with central nervous system malignancy: Experience of the Inonu University(Kare Publ, 2017) Ince, Volkan; Ersan, Veysel; Ozdemir, Fatih; Barut, Bora; Koc, Cemalettin; Isik, Burak; Kayaalp, CuneytOBJECTIVE: Liver transplantation from deceased donors with a central nervous system (CNS) malignancy has some risk of tumor transmission to the recipient. Though the risk is small, this group of donors is regarded as marginal. The use of marginal grafts may be an acceptable alternative practice in order to expand the donor pool in countries where there is a shortage of donated organs. The aim of this study was to examine and present the outcomes of liver transplantations performed using donors with a CNS tumor. METHODS: Between March 2002 and July 2017, 1990 (deceased donor: n=399, 20%; living donor: n=1591, 80%) liver transplantations were performed at the center. Of the 399 deceased donors, 17 (4.2%) had a CNS tumor. The data of donors with a CNS tumor and of recipients who survived for more than 1 month (n=11) were retrospectively reviewed. Demographic data, the grade of the CNS tumor, tumor transmission to recipient data, and survival rates were analyzed. RESULTS: Only 2 (18%) grafts were provided locally, 6 (54%) were offered to the transplantation center after all of the national centers had declined them, and 3 (37%) were made available to us by the national coordination center for patients with a documented notification of urgency. High-grade (grade III-IV) brain tumors were detected in 7 (64%) donors, while low-grade (grade I-II) tumors were found in 2 patients. The remaining 2 donors were not pathologically graded because the diagnosis was made radiologically. The 1-, 3-, and 5-year overall and tumor-free survival of the patients was estimated at 100%, 70%, and 45%, respectively. CONCLUSION: A median survival of 40 months (range: 13-62 months) was achieved in recipients of grafts from a donor with a CNS tumor and no donor-related malignant transformation was observed.Öğe Diaphragmatic Hernia Following Donor Hepatectomy(Lippincott Williams & Wilkins, 2016) Koc, Cemalettin; Ince, Volkan; Otan, Emrah; Ersan, Veysel; Barut, Bora; Baskiran, Adil; Ozdemir, Fatih[Abstract Not Available]Öğe Diffusion-weighted imaging (DWI) of the liver in assessing chronic liver disease: effects of the presence and the degree of ascites on ADC values(Springer, 2016) Kahraman, Aysegul Sagir; Kahraman, Bayram; Ozdemir, Zeynep Maras; Gormeli, Cemile Ayse; Ozdemir, Fatih; Dogan, MetinPurpose: The aim of this study was to determine the correlation between the liver and spleen apparent diffusion coefficient (ADC) values of patients with chronic liver disease and the presence and the degree of ascites. Materials and method: In this retrospective study, we assessed 107 patients with chronic liver disease and 39 control subjects who underwent upper abdominal MR imaging including echo-planar diffusion-weighted imaging (DWI). Among the 107 cirrhotic patients, 56 were classified as group 1, 25 as group 2, and 26 as group 3 according to the absence, the presence of minimal, and the presence of massive ascites, respectively. The scores of model for end-stage liver disease (MELD) were matched between groups as the standard reference. The liver ADC, spleen ADC, and normalized liver ADC values were compared between the control group and patients' groups. Results: Patients with massive ascites had significantly higher MELD score compared with the other groups. The MELD score was also significantly higher in patient groups than in control group. The liver and normalized liver ADCs of patients' groups were significantly lower than that of the control group. With some overlap among groups, the measured ADC values decreased as the amount of the ascites increased, and these relationships were statistically significant. Furthermore, compared to control group, patients with massive ascites had significantly higher spleen ADCs. Conclusion: Our results indicate that the ADC value of the liver and spleen correlates with the presence and the degree of ascites in patients with chronic liver disease, and merits further study.Öğe Donor Evaluation in Living Donor Liver Transplantation.(Wiley-Blackwell, 2013) Dirican, Abuzer; Baskiran, Adil; Dogan, Murat; Ates, Mustafa; Ozdemir, Fatih; Isik, Burak; Yilmaz, Sezai[Abstract Not Available]Öğe An Elbow Patch Reconstruction Technique for Narrowed Remnant Portal Veins during Right Lobe Living Donor Hepatectomy: A Rescue Surgery(Mdpi, 2024) Usta, Sertac; Akbulut, Sami; Sarici, Kemal Baris; Garzali, Ibrahim Umar; Ozdemir, Fatih; Gonultas, Fatih; Baskiran, AdilBackground: Treatment of established portal vein narrowing after living donor hepatectomy is challenging. We aimed to present a new approach termed the elbow patch reconstruction technique to correct the narrowed remnant portal vein just or late after right lobe living donor hepatectomy. Methods: Demographic and clinical data of 12 living liver donors with narrowed remnant portal veins and treated with the elbow patch reconstruction technique were prospectively collected and retrospectively evaluated. Anatomic variation of the portal vein was defined in accordance with the Nakamura classification; six of the living liver donors had type A, three had type B, and the remaining three had type C. In eight of the living liver donors with a narrowed remnant portal vein, diagnosis was detected by intraoperative Doppler ultrasonography and visual inspection by experienced transplant surgeons in the living donor hepatectomy procedure. In the remaining four living liver donors, diagnosis was performed postoperatively when elevation of liver enzymes was noticed during the routine liver function test and Doppler US. The diagnosis was confirmed by multidetector computed tomography. Results: Data from nine males and three females aged 18 to 54 years were analyzed. All of the living liver donors were followed up for a median of 1710 days (min-max: 1178-4447 days; IQR: 1516 days), and none of the living liver donors had any structural or functional complications in the portal vein. Conclusions: Narrowing remnant portal veins are rare, but they are a life-threatening complication in living liver donors, and this condition requires urgent management. Image guided interventions and narrowed segment resection with end-to-end anastomosis using a vascular graft carried a potential risk for thrombosis and restenosis. To avoid these complications, we shared a technique named elbow patch reconstruction technique. This technique can be very effective in relieving the narrowing of the remnant portal vein after right lobe living donor hepatectomy.Öğe HBsAg relapse after living donor liver transplantation in hepatocelluler carcinoma patients with hepatitis D virus infection may result in hepatocellular carcinoma relapse(Elsevier, 2020) Baskiran, Adil; Sahin, Tevfik Tolga; Ince, Volkan; Karakas, Serdar; Ozdemir, Fatih; Cicek, Ipek Balikci; Yalcin, Kendal[Abstract Not Available]Öğe HBV Recurrence in Patients Undergone Liver Transplantation for HBV and HDV(Wiley-Blackwell, 2014) Baskiran, Adil; Ozdemir, Fatih; Ince, Volkan; Isik, Burak; Yilmaz, Sezai[Abstract Not Available]Öğe History of Major Abdominal Surgery Affects Patients Mortality after Liver Transplantation.(Wiley-Blackwell, 2014) Ara, Cengiz; Ozdemir, Fatih; Baskiran, Adil; Ince, Volkan; Yilmaz, Sezai[Abstract Not Available]Öğe The Importance of AFP in Liver Transplantation for HCC(Springer, 2020) Ozdemir, Fatih; Baskiran, AdilIntroduction The most common biomarker for HCC is serum alpha-fetoprotein (AFP). AFP is used for screening and diagnosing HCC, and also, it is used for predicting prognosis and monitoring the response to treatment. Discussion AFP secretion is associated with poor tumor histologic grade and aggressive tumor biological behavior. The risk of dropout on the waiting list for liver transplantation and the risk of tumor recurrence after liver transplantation are associated with high AFP serum levels. Therefore, using AFP levels for selecting patients to include on the liver transplantation waiting lists is critical. It is also known that a low AFP serum level before liver transplantation has limited informative value, but high AFP levels prior to liver transplantation indicate a higher risk for HCC recurrence. Conclusion AFP's performance as a screening, diagnostic, and prognostic marker for HCC is not ideal, but it is the most frequently used biomarker in the management of HCC.Öğe Incidental Hepatocellular Carcinoma after Liver Transplantation: Clinicopathologic Features and Prognosis(Mdpi, 2023) Ozdemir, Fatih; Ince, Volkan; Usta, Sertac; Carr, Brian I. I.; Bag, Harika G. G.; Akatli, Ayse Nur; Kahraman, Aysegul SagirBackground: The prognostic impact and clinicopathologic features of incidental hepatocellular carcinoma (iHCC) detected in explanted livers of patients undergoing liver transplantation (LT) has been a controversial issue in previous studies when compared with patients who are diagnosed with hepatocellular carcinoma (pdHCC) before LT. We aimed to review and compare these patient groups in a high-volume LT center. Methods: The present study involves a retrospective analysis of 406 HCC patients who received LT between January 2002 and April 2022. Among these patients, demographic data, histopathologic features and prognosis for iHCC and pdHCC were evaluated. Results: In our series, 406 patients' final diagnosis was HCC after they had received LT, nevertheless 54 patients in this HCC group were diagnosed incidentally after the pathological evaluation of the explanted livers. The etiology of the underlying liver disease between pdHCC (n = 352) and iHCC (n = 54) groups had some differences in our study population. Most of the patients in the pdHCC group had moderately differentiated tumors (45.7%). On the other hand, most of the patients in the iHCC group had well differentiated tumors (79.6%). There were 158 (44%) patients who met the Milan criteria in the pdHCC group while there were 48 (92%) patients in the iHCC group (p < 0.001). IHCC patients had statistically better 1, 3, 5 and 10 years disease-free and overall survival rates when compared with pdHCC patients. There was only 1 (1.8%) patient who had tumor recurrence in the iHCC group while 76 (21%) patients had tumor recurrence in the pdHCC group (p = 0.001). There is no disease free and overall survival difference when iHCC patients are compared with pdHCC patients who met the Milan criteria. Conclusion: It is the first study to show that iHCC patients may differ from pdHCC patients in terms of etiological features. IHCC tumors show better histopathologic features than pdHCC with low recurrence rate and iHCC patients have better survival rates than pdHCC patients.Öğe Intraoperative Vasculer Complications in Living Donor Right Hepatectomy(Lippincott Williams & Wilkins, 2015) Dirican, Abuzer; Soyer, Vural; Sarici, Baris; Ates, Mustafa; Ozdemir, Fatih; Koc, Suleyman; Yilmaz, Sezai[Abstract Not Available]Öğe Intraperitoneal rupture of the hydatid cyst: Four case reports and literature review(Baishideng Publishing Group Inc, 2019) Akbulut, Sami; Ozdemir, FatihBACKGROUND Most patients with hydatid cysts are asymptomatic, and they are diagnosed incidentally during radiological evaluations performed for other reasons. However, some patients develop symptoms and complications due to cyst size, location, and the relationship between the cyst and adjacent structures. The most serious complications that can occur are rupture of the cysts into the biliary tract, vascular structures, hollow viscus, and peritoneal cavity. We aimed to describe the management of four cases of intraperitoneal rupture of hydatid cysts. CASE SUMMARIES Four patients aged between 27 and 44 years (two men and two women) were admitted to our clinic with sudden abdominal pain (n = 4), hypotension (n = 3), and anaphylaxis (n = 2). Three of the perforated cysts were located in the liver, and one was located in the spleen. Two patients developed cyst rupture after minor trauma, and the other two developed spontaneous rupture. Enzyme-linked immunosorbent assay IgG results were positive for two patients and negative for the other two. All patients received albendazole treatment after surgical intervention (range: 2-6 mo). Two patients developed hepatic abscesses requiring drainage; one of these patients also developed hydatid cyst recurrence during postoperative follow-up (range: 25-80 mo). CONCLUSION Intraperitoneal rupture is a life-threatening complication of hydatid cysts. It is important to manage patients with surgical intervention as soon as possible with aggressive medical treatment for anaphylactic reactions.Öğe Liver Transplantation After Bone Marrow Transplantation: Consecutive Two Cases(Lippincott Williams & Wilkins, 2015) Ersan, Veysel; Ozdemir, Fatih; Karakas, Serdar; Baskiran, Adil; Ince, Volkan; Yilmaz, Sezai[Abstract Not Available]Öğe Liver Transplantation for Hepatic Epitheloid Hemangioendothelioma: Single Center Experience(Lippincott Williams & Wilkins, 2016) Ince, Volkan; Ersan, Veysel; Barut, Bora; Koc, Cemalettin; Baskiran, Adil; Ozdemir, Fatih; Ara, Cengiz[Abstract Not Available]
