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Öğe LIVING DONOR LIVER TRANSPLANTATION FOR HEPATOCELLULAR CARCINOMA: TWO-CENTER PRELIMINARY RESULTS(John Wiley & Sons Inc, 2009) Tokat, Yaman; Yilmaz, Sezai; Kirimlioglu, Vedat; Kirimlioglu, Hale; Kayaalp, Cuneyt; Yuzer, Yildiray[Abstract Not Available]Öğe Right Lobe Liver Transplantation Using Hyperbilirubinemic Donors(John Wiley & Sons Inc, 2010) Demirbas, Baha Tolga; Piskin, Turgut; Orug, Taner; Dayangac, Murat; Yaprak, Onur; Yuzer, Yildiray; Tokat, Yaman[Abstract Not Available]Öğe Right-lobe Liver Transplant From Donors With Gilbert Syndrome(Baskent Univ, 2012) Demirbas, Tolga; Piskin, Turgut; Dayangac, Murat; Yaprak, Onur; Akyildiz, Murat; Tokat, Yaman; Yuzer, YildirayObjectives: Donor safety is one of the most important aspects of living-donor liver transplant. The preoperative evaluation of candidates for such transplants essentially starts with serologic and biochemical analyses. However, some potential liver donors with normal liver function test results may have isolated mild hyperbilirubinemia (serum indirect bilirubin level > 20.5 mu mol/L [1.2 mg/dL]). Gilbert syndrome is an autosomal recessive condition that is a common cause of nonhemolytic unconjugated hyperbilirubinemia, and its prevalence is 3% to 10% in the healthy US population. Mild hyperbilirubinemia episodes are expected in people with Gilbert syndrome when they are exposed to physical stress, such as operative intervention or low energy intake. The liver morphologic findings of these individuals are normal; however, there is a debate on the use of people with Gilbert syndrome as living-liver donors. The purpose of this study was to assess the results of right-lobe living-donor hepatectomy of liver donors with Gilbert syndrome. Materials and Methods: Between 2004 and 2010, two hundred twenty-five living-donor liver transplants using right-lobe grafts were performed in our hospital. Donors with Gilbert syndrome were defined as those whose serum bilirubin level was greater than 20.5 mu mol/L (1.2 mg/dL). Six of 225 right-lobe living-donor liver transplants were performed using donors with Gilbert syndrome. Results: The median follow-up after transplant was 34 months (range, 18 to 51 mo). One week after the operation, the median bilirubin level for rightlobe liver donors was 34.5 mu mol/L (2.02 mg/dL) (range, 17.1 to 51.3 mu mol/L [1 to 3 mg/dL]), and the median prothrombin time (international normalized ratio) was 1.36 (range, 1.1 to 1.7). The median bilirubin level of the donors after 6 months was 29 mu mol/L (1.7 mg/dL) (range, 20.5 to 41 mu mol/L [1.2 to 2.4 mg/dL]). Conclusions: Living-donor liver transplant from Gilbert syndrome donors can be safely performed.Öğe Successful Treatment of Severe Hepatorenal Syndrome with Living Donor Liver Transplantation(H G E Update Medical Publishing S A, 2012) Demirbas, Baha Tolga; Piskin, Turgut; Dayangac, Murat; Yaprak, Onur; Oklu, Levent; Yuzer, Yildiray; Tokat, YamanHepatorenal syndrome is defined as renal failure caused by acute or chronic liver failure without any laboratory or histological reasons. The exact etiology of this syndrome is unknown. However, vasodilatation in the splanchnic area as a result of cirrhosis and portal hypertension, reflex systemic and splanchnic vasoconstriction are the basic pathophysiological reasons of this syndrome. The decrease of renal perfusion, decrease in glomerular filtration rate, sodium retention and deterioration of excretion of free water are the major renal problems and these remain progressive according to the stage of liver disease. The treatment of this syndrome is correction of the underlying problem. Here, we report a patient who was having hemodialysis, due to renal failure as a consequence of liver cirrhosis for three months and returned back to his normal life without a need for dialysis after liver transplantation.
