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Öğe Can Preoperative Parameters of Inflammation be Used to Predict Acute Kidney Injury in Pediatric Liver Transplant Recipients? A Single-Center Retrospective Study(Galenos Publ House, 2024) Demiroz, Duygu; Ozdes, Oya Olcay; Colak, Yusuf Ziya; Erdogan, Mehmet Ali; Gazioglu, Tugce; Karakas, Serdar; Tasolar, Sevgi DemirozIntroduction: Inflammation is one of the factors involved in the occurrence and progression of acute kidney injury (AKI). We evaluated the relationship between preoperative systemic inflammatory markers and early postoperative AKI development in pediatric liver transplantation (LT) patients. Methods: Data from 190 pediatric patients were retrospectively analyzed. The preoperative neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), and pan-immune-inflammation value (PIV) levels were calculated. AKI was classified according to the Kidney Disease: Improving Global Outcomes staging. Patients who did not develop AKI in the early postoperative period were classified as group 0, patients with stage 1 AKI were classified as group 1, and patients with stage 2-3 AKI were classified as group 2. The relationship between the inflammatory parameters and AKI was evaluated. Results: AKI developed in 20% of patients, and 16.31% of these patients had severe AKI. The NLR, SII, and PIV values were significantly higher in patients with severe AKI (p<0.001). Preoperative high PIV values were found to be an independent predictor of AKI development. Conclusion: High preoperative PIV values may be used as a predictive factor for the development of early AKI in patients undergoing pediatric LT.Öğe Effects of Sugammadex on the Coagulation Profile of Living Liver Donors Undergoing Hepatectomy: A Case-Control Study(Mdpi, 2025) Demiroz, Duygu; Colak, Yusuf Ziya; Akbulut, Sami; Ozdes, Oya Olcay; Ucar, Muharrem; Erdogan, Mehmet Ali; Karakas, SerdarBackground: The most important concern regarding living donor liver transplantation is the safety of living liver donors, of which anesthesia management is an important part. Sugammadex, which has recently been used frequently for the reversal of neuromuscular blockade, is known to cause adverse effects on the coagulation profile. This study seeks to assess the impact of neostigmine and sugammadex on coagulation parameters in living liver donors following hepatectomy. Methods: We compared the demographic, clinical, and coagulation parameters of 209 living liver donors who received sugammadex (2 mg/kg) for neuromuscular blockade reversal during donor hepatectomy procedures from January 2018 to July 2022, with 209 patients who received neostigmine (50 g/kg) for the same purpose during the same timeframe. We compared the following parameters: age, gender, prothrombin time (PT), partial thromboplastin time (PTT), international normalized ratio (INR), hemoglobin (Hb), platelet count, ICU stay, hospital stay, and relaparotomy for bleeding and other causes. Results: Demographic data and preoperative biochemical values were similar in both groups. PT (p = 0.004) and aPTT (p < 0.001) values were significantly longer in the postoperative period in both groups; the difference between preoperative and postoperative PT (p = 0.009) and aPTT (p < 0.001) was significantly higher in the sugammadex group. However, neither group showed any elongation beyond the reference range. The sugammadex group had an elevated postoperative platelet count (p = 0.040). The duration of patients' stay in the ICU was significantly shorter in the sugammadex group (p < 0.001). Conclusion: The prolonged aPTT and PT associated with sugammadex did not lead to any postoperative bleeding complications. The sugammadex group significantly reduced the duration of ICU stays, while the hospital stays remained comparable. Further multicentric prospective randomized studies should support our study's findings, which demonstrate the safe use of low-dose sugammadex.Öğe Incidence and Risk Factors of Acute Kidney Injury in Pediatric Liver Transplant Patients: A Retrospective Study(Jaypee Brothers Medical Publishers Pvt Ltd, 2024) Demiroz, Duygu; Colak, Yusuf Ziya; Ozdes, Oya Olcay; Ucar, Muharrem; Erdogan, Mehmet Ali; Toprak, Huseyin Ilksen; Karakas, SerdarBackground:Acute kidney injury (AKI) significantly contributes to the mortality and morbidity rates among pediatric liver transplant (LT) recipients. Objective: Our study aimed to assess the potential factors contributing to AKI in pediatric LT patients and to analyze the impact of AKI on postoperative mortality and hospitalization duration. Materials and methods: About 235 pediatric LT patients under the age of 18 between the years 2015 and 2021 were evaluated retrospectively. The relationship between preoperative and intraoperative variables of the patients and AKI developed when the early postoperative period was assessed. Results: A correlation was found between the patients' preoperative age, albumin levels, and AKI. AKI was found to be associated with the duration of surgery and intraoperative blood transfusion. Conclusion: Our findings revealed that the severity of AKI in pediatric LT patients is linked to extended surgical durations and increased blood transfusions resulting from hemodynamically compromised blood loss. Furthermore, independent risk factors for AKI were identified as prolonged warm ischemia and the overall duration of the operation.Öğe Living Liver Donor Paired Exchange: Can Anaesthesia Management Challenge?(Galenos Publ House, 2025) Erdogan, Mehmet Ali; Ucar, Muharrem; Colak, Yusuf Ziya; Demiroz, Duygu; Ozdes, Oya Olcay[No abstract available]Öğe The Effect of Rocuronium Dosage on Intubation Conditions in Liver Transplant Recipients(Galenos Publ House, 2025) Iclek, Sumeyye Koc; Demiroz, Duygu; Colak, Yusuf Ziya; Yagci, Neslihan Altunkaya; Ozdes, Oya Olcay; Erdogan, Mehmet Ali; Gulhas, NurcinIntroduction: Neuromuscular blockers (NMB) play an important role in improving conditions in orthotopic liver transplantation (OLT). Depending on clinical conditions, diseases, and pharmacological interactions, the effective NMB dose for complete NMB varies. Our study investigated the effects of rocuronium used during rapid sequence intubation. The effects of this drug on onset of action and intubation conditions were studied in a control group and in an OLT patient group. Methods: The study is prospective, involving 90 patients over the age of 18. The 45 patients scheduled to undergo OLT were assigned to Group 1, while the 45 patients without liver dysfunction scheduled to undergo a 4-6-hour surgery under general anesthesia were assigned to Group 2. Groups were dosed with 1.2 mg/kg rocuronium based on ideal body weight, and the effect on the time to reach a train-of-four (TOF) value of zero (TOF 0), time to intubation scores, and hemodynamic parameters was evaluated. Results: The demographic data across the groups were comparable. No significant differences were observed between the groups concerning TOF 0 time (p=0.806), intubation times (p=0.987), and intubation scores (p=0.898). However, when evaluating OLT patients individually, a statistically significant correlation was found between TOF 0 time and Child score (p=0.029, p<0.05). Conclusion: In patients with end-stage liver disease undergoing OLT, administering rocuronium at a dosage of 1.2 mg/kg based on ideal body weight, during rapid sequence intubation results in sufficient intubation conditions. Furthermore, there were no delays noted in the onset of rocuronium's action.
